12/28/2087 15:68 8584146749 DEPR OGA Dec 20 2007 15:05 PAGE arfld STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS. AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, VS. 1 ms WAFFLE HOUSE #719 teense Wo OO Respondent. Case No, 2007060112 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Petitioner"), files this Administrative Complaint against WAFFLE HOUSE #719, (“Respondent”), and says: 4. Petitioner is the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Section 20.165 and Chapter 509, Florida Statutes. 9. Respondent is, and has beén at all times material hereto, licensed by or subject to the jurisdiction of the Division of Hotels and Restaurants. The respondent's business address of record is 3639 W HWY 80, LAKE CITY, FLORIDA 32056. The mailing address of record ls WAFFLE HOUSE #719, at 3639 W HWY 90, LAKE CITY, FLORIDA 92056. , 3. Inspection of this establishment conducted pursuant to Sac, 509.032, Florida Statutes, revealed violations of the provisions of Chapter 509, Florida Statutes, and / or the rules promulgated tharato governing operation of the establisnment, The violation{s) found and applicable law are deseribed in Exhibit “A,” attached hereto and ineorporated herein by reference. Inspection documents are attached as Exhibit "B”, incorporated herein by reference. WHEREFORE, Petitioner respectfully requests entry of an Order imposing ohe or more of the following penalties; administrative fine nat to exceed $1,000 per offense; mandatory attendance at Respondent's expense at an educational program sponsored by the Department's Hospitality Education Program, suspension, revocation, of refusal of a license issued pursuant to this Chapter, and/or any other rallef . authorized by Chapter 508, Florida Statutes, or the rules promulgated thereto. Signed November 02, 2007 Steven von UV Lor. Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Charles F. Tunnicllff, Lead Attorney Florida Bar No. 0153831 Department of Business & Professional Regutatlan 4940 North Monroe Street . Tallahassee, Florida 32399-1007 ; GERTIFIGATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: | THEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been , 2007. hand served by ma on this day of Recelved by: Inspectors Signature Operator's Signature Title . Title Number: 2007080112 Fille Number. 409276 District Number: 08 Ceense form revised 07.19.07 Ucanse Number: 2200358 2010 WAFFLE HOUSE #719 ° 12/28/2087 15:68 8584146749 DEPR OGA Dec 20 2007 15:05 PAGE Exhibit A License Number: 2200358 . License Type: 2010 PERMANENT FOOD SERVICE © Case Number: 2007060112 FC as cited herein references specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, incorporated by Chapter 61C, Florida Administrative Cade, NEPA as cited herein references specific provisions af the National Fire Protection Association Life Safety Code, incorporated by reference at Chapter 44-3, Fire Prevention, General Provisions, Florida Administrative Code, and 610-1.004(5), Florida Administrative Cade. * denotes a critical violation. It is alleged that on January 10, 2007, February 28, 2007, Qctober 3, 2007 the licensee was in violation of Florida Statute 509(FS) and/or the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (FAC), in the following particulars. Copy(s)of the report(s) for the above referenced inspection(s) are attached hereto and incorporated by reference as Exhibit B. * 4.03A-07-1 3-501.16(A) FC: (A) EXCEPT DURING PREPARATION, COOKING, OR COOLING, OR WHEN TIME IS USED AS THE PUBLIC HEALTH CONTROL AS SPECIFIED UNDER SECTION 3-501,19, AND EXCEPT AS SPECIFIED IN PARAGRAPH (B) OF THIS SECTION, POTENTIALLY HAZARDOUS FOOD SHALL BE MAINTAINED: (1) AT 125 DEGREES FAHRENHEIT OR ABOVE, EXCEPT THAT ROASTS COOKED TO A TEMPERATURE AND FOR A TIME SPECIFIED IN PARAGRAPH 3-401.11(B) OR REHEATED AS SPECIFIED IN PARAGRAPH 3-403.11(E) MAY BE HELD ATA TEMPERATURE OF 130 DEGREES FAHRENHEIT OR ABOVE; OR (2) AT A TEMPERATURE SPECIFIED IN THE FOLLOWING: {A} 41 DEGREES FAHRENHEIT OR LESS; OBSERVED POTENTIALLY HAZARDOUS FOOD COLD HELD AT GREATER THAN 410F - CHEESE 53¢F AND MILK 47¢F IN PIE COOLER; HAM 48°F IN COOLER DRAWER AND SHELL EGGS 45°F ON COOKLINE, INSPECTIONS DATED 01/10/07 AND 10/03/07. * 2208-0941 4-703.11(A) AND (B) FC: AFTER BEING CLEANED, EQUIPMENT FOOD-CONTACT SURFACES AND UTENSILS SHALL BE SANITIZED IN: (A) HOT WATER MANUAL OPERATIONS BY IMMERSION FOR AT LEAST 30 SECONDS AS SPECIFIED UNDER SECTION 4-801,111; (B) HOT WATER MECHANICAL OPERATIONS BY BEING CYCLED THROUGH EQUIPMENT THAT IS SET UP AS SPECIFIED UNDER SECTIONS 4-501.15 AND 4.501.112 AND 4-801,.113 AND ACHIEVING A UTENSIL SURFACE TEMPERATURE OF 160 DEGREES FAHRENHEIT AS MEASURED BY AN IRREVERSIBLE REGISTERING TEMPERATURE INDICATOR. OBSERVED THERMOTAPE FAILED TO TURN BLACK TQ INDICATE SANITIZATION TEMFERATURI WAS ACHIEVED ON DISH SURFACE. INSPECTIONS DATED 01/10/07 AND 10/03/07. . District 05 License Type: 2010 File Number! 109376 * denotes critical violation Case Number: 20070801 12 Licanse Number: 2200358 WAFFLE HOUSE #719 ge/l4 12/26/2887 15:88 8584146749 Dec 20 2007 15:05 “Epps, cook line, 45 Qegraas F. otis, stoam 1ablewbatn marie, 150 Degree F_ NOTE: tame marked above with an eaterisk (*) Indicate 6 violation . s Inspector's Gomments “alts : lacussed time as a public health cantrol, 3-507 49 If time is used only as 8 puble health control, the establishment must have written procedures on He and avallabla to the Division (nspectar, The potentially hazardous food Is markediidenttied with the maximunt 4 hour tine perlod in which the rodudt will ba capked, served or discarded. After 4 nours or ifthe product is unmarked regarding time, the foods shall ba discarded, Employees relnad by Florida Restaurant Asaotlatlon No Boller On Site, [acknowledge receipt of this inspection form and comments. 10-03-07 as . Signature of Reciplent Inspector Signature Date P For further information please contact: Reeiplent: Angata J Brown * ‘Title . Judy Hentges Manger Sanitation and Satety Specialist 7960 Arlington Expy Phone: 386 755 s086 . 850-487-1398/ Fax 904-727-5558 STATUS : SQURCGE STATUS _PHF TEMPERATURE CONTROL in *O1a Approved Source _. | Out “03a oe food at proper temperaturas duiting storage, In “Ob Wholesome, sound condition | display, Service, In 402 Orlgine! container; properly labeled, date marking la *03b Hot food at proper temperature NIA "02-11 Consumer advispry on fawiunderconked oysters In *03c Foods properly cooked/rahsated in “92-13 Coneumar advisory on rewiundercooked animal NIA “03d Foods praparly cooled Out “04 Facilities to malhtaln product tempersture *05 Tharmometars provided and conspicuously placed L h06 Potentially hazardous foods s properly thawed, Violations marked with an asterisk are critfeal viotatian®. lems marked IN are in compliance, tame Marked OUT era viclations. Specife detalla of violation are llatad on | subsequent pages, [tare marked N/A are Not Applicable, tema Marked as N/O ere Not Observed, and wata not belig conducted atthe time of Inspection, DBPR Form HR 022-016 DEPR OGA PAGE 9/14 _- Page 1 of4 STATE OF FLORIDA oo DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS EXHIBIT B www.nyflorida.com/dbpr FOOD SERVICE INSPECTION REPORT : foo LEGAL NOTICE “e “ ve Fallure te comply with this Notice may initiate an administrative complaint that may result in suepansion or revocation of your ileenge and fines. 10/03/07.07:58 AM Routine 2200358 SEAT Inspection Date and Time Ingpection Reason Licanse Number WAFELE HOUSE ING ADMINISTRATIVE COMPLAINT racommendad. Cwner Name (885)755-9066 WAFFLE HOUSE #719 Area Gode/Talaphone Number Business Name Inspection Result 41 06/01/08 Number of Units Callback Date/Time Ucense Expiration 3638 W HWY 90 LAKE CITY, 32055 Address / Clty / State / Zip / ate, ltem 03: Feed Temperatures tem Sda: Gert, Food Managers ic 20; Warewashing Sanitization | Item 45: Fire Extinguishers and Fire 2 1 Systems Hates, chtaken , wait atallan, 2B Degman P, *Sanitzing Tamperature fs less than ACIngs ABG type Fire Extinguiahar, eundtn/al woHla Battal, rauch in coeler, 41 Degroos F, lichen has ocertifeation dai af 607 ‘ehaoas, reach In costar, 53 Oxgriue P. teQ degrees Degrees Faranhelt. | Giees Re tire Evlngulther, found Inst chill, steam telea/oain macs, 148 Degrees F. Wiletan haa & eerlifontion ste of B07 . ‘ham, reach in codler, 4B Pagraes F : 4 Maod Suppression type Fins Extinguisher, ‘ “mk, maach In ceoler, 47 Geptees F. found [n/a kilthan hae 4 gartifceilon Ose of 6/07 12/28/2087 Dec 20 2007 15:06 15:08 85ad146749 DBPR OGA PAGE 10/14 CRHIBIT Barer Li Numb ‘ STATECF FLORIDA SEAT 2200858 DEPARTMENT OF BLSINESS AND PROFESSIONAL RESMMMTION — pucinese Name IV! noon opaneceraner varreneuseens FOOD SERVICE INSPECTION REPORT Pepe Oa: 7 AVSO AM LEGAL NOTICE Faljure te comply with this Notice may Initiate an sdministrative complaint that may result in suspension or revocation of your licanse and fines. STATUS PHF TEMPERATURE CONTROL STATUS GARBAGE AND REFUSE DISPOSAL in 07 Unwrapped or potentially hazardous food not rerarvad 44 Containers covered, adequate number, insect and rodent th hO8a Food protection during storage, praparation, display, lproof, empiled at proper intervals, elean j service, transportation ot __| 34 Qutside storage area clean, enclosuta properly ih hngb Crose-contemination, equipment, personnal, starage .— feonatructed SoS Potential for eroes-contamination; storage practices; (sraTus INSECT AND RODENT CONTROL damaged food segregated WaSa Presence of insects/rodents. Animals prohibited In KOS Fonds handled with minimum contact "35h Outer openings protected from insects, rodent proof lio in use food dispensing utensils prapetly stored STATUS FLOORS, WALLS, CEILINGS STATUS _ PERSONNEL Out lag Floors properly constructed, clean, drained, caved in 11 Personnel with Infeptions restricted Out 57 Walls, callings, and attached equipment, constructed, Gut 13a Hands washed and clean, goed hyglenle practices clean (observed), altetnative operating plan 98 Lighting provided as required, Fbuures shielded in *412b Proper hygienic practices, pating/drinking/smoking 86 Rooms ang equipment - venied as required (evidence) STATUS OTHER AREAS 13 Clean clothes, halt restraints 40 Employee lockers provided and used, clean STATUS. FOOD EQUIPMENT AND UTENSILS: In 41a Toxic items properly stored 44 Food contact sutfaces designed, constructed, {ln *A4b Toxle items labeled anc used { properly, . malntalned, installed, locsted . 42 Premises malntalned, free of liter, unnecessary articles, 15 Non-food contact surfacas designed, constructed, Cleaning end maintenanes equipment property stored. maintained, Installed, located Kitchen restricted to authorized personnal Out “16 Dishwashing faciltias designed, constructed, operatad __. 43 Complete separation from living/sleaping ates, laundry 1, Wash 2, Rinse 3, Sanitize 44 Clean and soiled tIinen aegragated and properly stored Out "47 Thermometers, gauges, test kits provided __ | STATUS SAFETY —" Pre-fluahad, scraped, sveked. Out "45 Fire extinguishers - proper and sufficiant Lo. 19 Wash, rinse water clean, proper temperature 46 Exiting system adequate, good repair "20 Sanitizing concentration 447 Electrical wiring - adequate, ood repair Out *20b Sanitizing temperature "48 Glas appliances - properly installed, malniained Out 24 Wiping cloths clean, used properly, storert 49 Flammatle/combustible materials - propetly stored Out 99 Feed contact surfaces of equipment and utensils claan STATUS GENERAL 23 Non-food cantact surfaces clean oe 50 Currant license properly digalayed | 24 Storage/handting of clean equipment, utenslis Out [81 Othar conditions genitery and safe operation STATUS SINGLE SERVICE ARTICLES +82 False/misieading statements published or sdvertised out 25 Service Items properly stored, handled, dispensed relating tp foodibaverage 26 Single service attcles net re-used : Out *S3a Food management cattification valid STATUS WATER AND SEWAGE/PLUMBING In "Gab Employse trainings lidation °27 Water sourga safe, holand colt under pressure 54 Flatida Clean inddeaalr Act "28 Sewage and waste water disposed properly 55 Automatic Gratiily Notice 29 Plumbing installed and maintained . 56 Copy of Chapter 508, Florida Statutes, avallable —| ha0 Croge-tonnection, beck siphanage, beckfow STATUS GENERAL sas | TOILET AND HANDWASHING FACILITIES s7 Hospitality Educetlon Program Information provided il 31 Tollat and handwashing facilities, number, convenlent, : designed insted Total Number of GOS Violations: In * +32 Restroom with self-closing daors, fixtures operate pronerly, fecilty clean, supplied whh handsoap, disposable ‘Total Number of Rapeet Violations: towels or hand drying devieaa, tissue, covered waste stein, Vialations frarked with an gstarisk ary crillcal vielations. Items mmorked IN subsequent pages. Items marked N/é.are Nel Applicable, lems Marked 89 NVQ are Not Qhserved, and wert hol being eanducted’ DBPR Form HA 5022-15 ate in compliance. lars Marked OUT ora violations. Stage datalls of violation are Iisted on tle of inspection, Dec 20 2007 15:06 11/14 12f2e/28e7 16:68 s58d146749 DEPR OGA PAGE f Page Saf 4 — YHIBITB a STATE OF FLORIDA STSEAT 7200858 DEPARTMENT OF BUSINESS AND PROFESSIONAL ne LATION Businesa Name ‘ DIVISION OF HOTELS AND RESTAURAN ” Srnec ru tousea FOOD SERVICE INSPECTION REPORT ° {003/07 07:56 AM LEGAL NOTICE Faliure to comply with this Natlea may initiate en administrative complaint that may result In suspension or revocation of your licenge and fines. Vialation(é}: + 034-07-1;Observed potentially hazerdaus food cold hald at greater than 47 degrees Fahranhelt. Cheeze In ple capler Is 53 dagrecs O3A-07-1:Obsarved potentlatly hazardous food cold hate at graster than 41 dagraee Fahrenhelt. Hert 48 degrees in reachin cooler drawer. DjA-07-4:Cbserved patentlally hazardous food cald hold et greater than 47 degrees Fohrenhelt, Milk 47 degraos in pla evoler. Q3A.07-1:Observed potnitially hazerdoua food cold held at greater than 41 dagrads saben, Shall agg 45 dagreas on cockline . 4 24-08+1:Batablishment doas net heve & written copy of their approved Alternative Ooerating Procedure for baré-hand cantactwith retely-to-eat food. ‘ 42001-1-Food amployae nat using bond aenitizer ater washing handé os required by the Altertallve Operating Procedure for bata hand contact with randy-to-sat food” 83A-01-1:/Manager lacking proof of Food Manager Certification. B0B-03-4:Thermotapa falled to tum blaek to indlewte that the sanitizellon temperature of 160 degrans Fehrenhalt was achlavad on the diet surface. 45-90-41 :Portable fire exllnguisher net properly mounted ak least 4 inghos off the floor and the top no highar then 5 foes off the fleer. 46-13-1:Observed fate debris accumulated on walkin cooler fost, 22-21-1:Oserved gol buldup Insida fee bln, meiske bullcun seortteld holding rquipment Incapable of melntalring potentially hezerdous faod et proper ternperstures, Ple coolers & reachin cooler drawers 16.03+1:Observed accumulation of debris In waroweehing machine and aesaclated equipment, Lima-llke bulldury 21-71=1: Wiping eloth chforne sanitizing solution net at proper minim ssrangth "O"ppm 25.08-1:Observed singla-serviee aniei¢s stored wlthout protection fram contamination, Too CUnS lide net stored Invartad. 37-184: Observed alr canditioning vents with condensation buildup over coakiine. 477 1-4:No prapar chemical test kit provided for measuring the concentration of 4a sanitizat selution used for wiping al he. 54-13-1:No Helmileh manguver sign posted. DBPR Form HR 5022-015 12/26/2887 15:88 8584146749 Dec 20 2007 15:07 DEPR OGA PAGE 12/14 DEPARTMENT OF BLISINERS AND proressiona-meaULATiOy B Division of Hotels and Restaurante? 4h HW i Food Service Inspection Report LEGAL NOTICE As s al {_fLinansing (LIG) {01 Complaint Full (COMP) (Gi Complaint Parllal (CPAR) [2] Bilsaster Response {(DSTR} {71 Epidernlologioal {EPI} Bed) Ownet Name: (2 2013 Catering (3 2014 Monlla Food Dispensing Vehicle We tle {os Pane nel aL [21 2018 Vending Machine Business (DEA) Name: He House F114, (0 2051 Unilcenaed Food (21 Service Request (SERV) [Oi Quelty Assurance (QA) © Training sTRNG) re Be ae Ah ah The clroled letters to the eft of each fem Indicate that Item's status Looalion Addrass: 3d ut Haoy a0 E ji nen | cy siti: Like Coty, “he 27055 RAOO 358 iepeiorate yea | val 2 = - Vill time - REMINDER: vertunee nie obo O7 ole le { le jos fy originat visit [7 Callback Mark “X" In appropriata box for COS and/or R I = jt compllange_ OUT = nol ln compliance NiO = not observed N/A = not gppticable GOS = comested on-site during Inspection R= repaat ylolalion : COMPLIANCE STATUS ' cos | & Ota | Food obtained from approved source Approved Source ‘1h_{ Wholesome, sound conditlon 02_ [Original container, properly jabeled, date marking, shell stock tags, T 02-17 | Consumer advisory on raw/undercooked oystars Cansumer Advisory OU b OUT | NO _| NIA 0 a] U UT NA | 07-13 | Consumer advisory on rawiundercooked animal products Potentially Cold food at proper temperatures during storage, display, service, transport, and cold holding Hazardous Food Timne/Temperature Foods properly cooled —— _ Protection from Contamination Foods handled with minimum contact Personnel wilh infections restricted Hands washed and clean, good hygienic practices (observed), altemative oparating plan ‘ Personnel | Proper hygienic practices, gaiingidrnkinglemoking (evidence) Chemical * Restroams with self-closing doors, fixtures operate properly, facility clean, supplied with hand soap, disposable towels or hand drying devices, tissue, covered waste receptacles 7a _| Toxic substances properly stored Toxie substances properly labeled, used Food management carlification valid “ Demonatration of Knowledge IN rea ata ela Employee Training verification PRORAR: 3 ) Administralve Gamplalnt Recommended (AOR EOCL) ar Recommended C1 Waming Given (WARN) 1 Callback - Extenston ivan (GBEX) ‘Administratve Gomplamt Calbpck = Gomplied (ACGM) Gomplled (EOCM)_ Emergency Order Callback — Time TZ. Senzonel (SEAS) ) ceno) Callback — Admin. Gomplairt Recommended QO ja oO "Administrative Complaint Gallback = Tena Extension (ACE) a oO a Emangency Order Callback = im Extension (EOEX) Oo .)11 Closed Out of Business (COFE) ‘Adminietravva Daterminadon Racommended ‘Administralve Complaint Gallback - Not led (ACO Com Emergency Onier Callack = Not 0 (EQNO} FrxwAwa tt oe eso 487 1945" Paraon iy Cherge SigNATe DBPR Form HR 5022-015 “Talaphonn i] Inspectoyy Signi www. MyFlorida, com/dbar Tnspactork Talephons 2006 May 2 Dec 20 2007 15:07 12/28/2087 15:08 85ad146749 DEPR OG PAGE 13/14 flevidich Pistons, PARTMENT OF BUSINESS AND PROFES: AGKTE, | 4 : - DBPR, | beranran® oF suai avo proressonn. resi) [> B Page 20f <5 am LEGAL NOTICE sues Pi hs . Food Service Inspection Report |: ne SOMPLIANGE STATUS "04 Fatiltieg to maintaly product temperature a “E05 “Thernomelers provided and conspicuously placed eae *35q Presence on insests/rogents, Animals prohibited | le 08 Polanllally hazardous foods properly thawed "35h Outer gpanings protected from insects, rodent proof a 1°} "086 Potenilal for crose-contaminalion, storage practices; damaged: coved : {ood sagregaled — : 70 _In-usa food dispensing ulénslls properly sioted _ a 37 Physical facillles-walls, celings and attached equipment, 48, Clean clothes, hakrresitaints a - ate constructed, CBM ener _ 44° Food contact surfaces designed, constructed, maintalned, : 38 Lighting provided ag required, Fixtures shielded __-_—_inelalted, located eet ee cH 3g Rooms and equipment = vented aa renulred a EJ 15 Nandood contact surfaces designed, constructed, maintalned, 40. Employes lockers provided and used, clean : Instalted, located (0 42 Prerhisas maintained, no unnecessary atticles, Cleaning & ty 48 Dishwashing facies designed, constructed, operated, maintenance equipment properly stored. Kitchen restricted, 1. Wash 2.Rinse_ 3, Sanitze 7a Complete separation from tiving/slegping area, laundty 44. Clean and solled linen segragated and properly stored 745 Fire extinguishers — proper and sufficient T7_ Thermometers, gauges, fest kite proylded 78 _Pre-fushed, sctaped, soaked 19 Wesh, vinge wate clean, proper temperature + FIRE EXTINGUISHERS: Date(s) SUPPRESSION SYSTEMS: Oalale) *20a Sanltizing spnoentralion ppm a “fo 0b Saniizinglempetaure arent ne Ae le Ole 71 _ Wiping cloihs clean, used properly, stored an Oke . DR. 23 Non-food contact surfaces Clea “46_Exiting system - adequate, good repalr__ a ee ee 24 Storane/hancling of clean equipment, ulengil _. A Electrical wiring adequate, good repalr i 25 Service items properly slorad, handled, dispensed AR Gas appliances — property Installed, maintained 26 Single aemvice articles tol re-used _ “45” Flammablefcombustible materials — properly stored *97 Water source safe, hot and cold under preseuré . . “f)°50_ Current Iicenge, properly displayed 798 Sewage, and waate waler dispased properly _ 1_Other gondlfions sanitary and safe operation sre 20 Plumbing Installed and maintained 52 False/misteading stalements published or adverllsed retating “L320 _Css-comection, back siphonace, backiow to faod/baverage age a Fy31 Tolet and hand washing faciilies, number, convanient, designed, 64 Flonda Glean Indoor Ar Act Compliance a : Installed __ 85 Automatic Gratuity Notice j ais 33 Garbage confalnars covered, adequate Tumber, insect and rodent 56 Copy of Chapter 609, Florida Statutes ayallable proof, ampited at proper Intervala, clean {_EI 8? Hospitality Education Program Information provided z HE this report must be corrected within the tim y,or ag slated on page 4. Violations ciled eher wie . . : ane clots a ere alae wat ia) at gio Le. 5 hands. a et! Se Ce vad Se : . prea s— est eure: £ iA, Zonk — Ee werk analalle. _ - Be ewe 2 aus crveed . ak Tred’ pave! esck rhe vecharge “zexe 1 ub RE * Citemieal isbn eS 19, el oS pease. Warldwqa Had _ | dtehatt hazardous. “Sood, tat held lat 4 desires or Gade Se _ Sansa se du? in veath wm cwoler » Addivonal Comments on Attached Sheet . -Pefson in Charge (Signatysa} ~~~ * ee ; bate fs? espn) Sab esc Date of -/620'7 inspector (Signature, DBPR Form HR 6022-015 yw, MyFlorida.com/dbpr 2006 May 2 Dec 20 2007 15:08 12f2e/28e7 16:68 s58d146749 DEPR OGA PAGE 14/14 EXHIBIT B Feil fine. State of Florida ; Control Number DBPR _ Department of Business and Professional Regulation ; ‘ boi Divislon of Hotels and Restaurants Pe- OC B85& " a www. hospitalityeducation.org COMMENTS SHEET ci -/0-07 page of 3 Addendum te DBPR Forms HR 5022-005, 5022-014, 5022-015, 5022-082, or 5022-083. For comments to the Lodging, Food Service, or HAGCP Inspection; Gall Back/Reingpection Report, or HACCP Plan Verification. Faq - Wet ureter ema wut an at Drew Vand wasgk sink, Wok Enplyees ot properly uinshing hands. (Ne tet water) _ . YiDA- Evuployeos not usashins hotsls cohen changin f _—_-spacthns on gloves , +20 lo - Lest gootker anche. a, disamaclune. Tne ler nse nat teaching, spreper yerperature ak man deld. “Test shri ye Jeouled +e, teary, black + a be not use cigh machine ~urch | it s woor king _vroverly. se. triple sink to wash, rinse nohce + : avy dry * : : \lo- ~L terior est dishmachine : has heousy lyme—like. : burldeg, 3a- Mend wash. signs “pravided ade chend soos h sinks used ou ensplouees : bebh rooms DBPR Fam HR 6022-042 lo 0 2004 Decamber 06

Docket for Case No: 07-005761