Oct & 2008 9:41 _ 1a/ge/ 2888 14:38 8584146749 _DEPR OGA PAGE 5/15 STATE OF FLORIDA | DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, VS. License No. 3915746 ZAXBY'S Respondent License Type 2010 spon pe Gase No. 2008045417 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Petitioner’), files this Administrative Complaint against ZAXBY'S, (“Respondent”), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Sectlon 20,165 and Chapter 809, Florida Statutes. 2. Respondent is, and has been 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 2028 E SR 60, VALRICO; FLORIDA 33594, The malling address of record is ZAXBY'S, at 2028 E SR 60, VALRICO, FLORIDA 33594. 3. Inspection of this establishment conducted pursuant to Sec, 509.032, Florida Statutes, revealed violations of the provisions of Chapter 609, Florida Statutes, and / or the rules promulgated thereto governing operation of the establishment. The violation(s) found and applicable law are described in Exhibit “A,” attached hereto and incorporated herein by reference. Inspection documents are attached as Exhiblt"B", incorporated herein by reference. WHEREFORE, Petitioner respectfully requests entry of an Order imposing one or more of the following penalties: administrative fine not to exceed $1,000 per offense; mandatory attendance at Respondent's expense at an educational program sponsored hy the Department's Hospitality Education Program, suspension, revocation, or refusal of a Ilcense Issued pursuant to this Chapter, and/or any other relief authorized by Chapter 509, Florida Statutes, or the rules promulgated therato. Signed August 14, 200. By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Charles F. Tunnicliff, Lead Attorney Florida Bar No. 0153831 Department of Business & Professional Regulation 1940 North Monroe Street Tailahassee, Florida 32399-1007 Mo Certified. Article Number’ CERTIFICATE OF SERVICE 260 350} Boas 5e3e SEO). BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: SENDERS RECORD © | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this, day of , 2008 Received by: Inspector's Signature Operator's Signature Title Title Case Number: 2008045417 — File Number: 183742 District Number; 03 Linenae Number 394 5748 2010 ' Form ravised 07.07.07 ZAXBY'S | Oct $$ 2008 9:42 la/ae/2aee = 1a:38 8584146749 DEPR OGA PAGE 6/15 Exhibit A Licansa Number: 3915746 License Type: 2070 PERMANENT FOOD SERVICE Case Number: 2008045417 FC as clted herein references specific provisions of the Food Cade, Recommendations of the United States. Public Health Service, Food and Drug Administration, incorporated by Chapter 61C, Florida Administrative Gode. NFPA as cited herein references specific provisions of the National Fire Protectlan Association Life Safety Code, incorporated by reference at Chapter 4A-3, Fire Prevention, General Provisions, Florida Administrative Code, and 61C-1,004(5), Florida Administrative Code. ‘* denotes a critical violation, [tis alleged that on May 13, 2008, July 15, 2008 the licensee was in violation of Florida Statute 509(FS) and/or the Rules of the Division of Hotels and Restaurants, Florida Administrative Gade (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. 08A-29-1 3-302.71(A)4) FO: (A) FOOD SHALL BE PROTECTED FROM CROSS CONTAMINATION BY: (4) STORING THE FOOD IN PACKAGES, COVERED CONTAINERS, OR WRAFPINGS; OBSERVED UNCOVERED FOOD IN WALKIN FREEZER. 2, 18-04-1 4603.12 FG: PRECLEANING. (A) FOOD DEBRIS ON EQUIPMENT AND UTENSILS SHALL BE SCRAPPED OVER A WASTE DISPOSAL UNIT OR GARBAGE RECEPTACLE OR SHALL BE REMOVED IN.A WAREWASHING MACHINE WITH A PREWASH CYCLE, (8) IF NECESSARY FOR EFFECTIVE CLEANING, UTENSILS AND EQUIPMENT SHALL BE PREFLUSHED, PRESOAKED, OR SCRUBBED WITH ABRASIVES. OBSERVED OLD LABELS STUCK TO FOOD CONTAINERS AFTER CLEANING. * 3.22-17-4 4-602.41(C) AND (D) FC:: (GC) EXCEPT AS SPECIFIED IN PARAGRAPH (D) OF THIS SECTION, IF USED WITH POTENTIALLY HAZARDOUS FOOD, EQUIPMENT FOOD-CONTACT SURFACES AND UTENSILS SHALL BE CLEANED THROUGHOUT THE DAY AT LEAST EVERY 4 HOURS. (D) SURFACES OF UTENSILS AND EQUIPMENT CONTACTING POTENTIALLY HAZARDOUS FOOD MAY . BE CLEANED LESS FREQUENTLY THAN EVERY 4 HOURS IF: (1) IN STORAGE, CONTAINERS OF POTENTIALLY HAZARDOUS FOOD AND THEIR CONTENTS ARE MAINTAINED AT TEMPERATURES SPECIFIED UNDER CHAPTER 3 AND THE CONTAINERS ARE CLEANED WHEN THEY ARE EMPTY; (2) UTENSILS AND EQUIPMENT ARE USED TO PREPARE FOOD IN A REFRIGERATED ROOM OR AREA THAT IS MAINTAINED AT ONE OF THE TEMPERATURES IN THE FOLLOWING CHART AND: (A) THE UTENSILS AND EQUIPMENT ARE CLEANED AT THE FREQUENCY IN THE FOLLOWING CHART [TEMPERATURE/CLEANING FREQUENCY] THAT CORRESPONDS TO THE TEMPERATURE: [AT 44 DEGREES FAHRENHEIT OR LESS - 24 HOURS; GREATER THAN 41 DEGREES FAHRENHEIT TO 45 DEGREES FAHRENHEIT - 20 HOURS; GREATER THAN 45 DEGREES FAHRENHEIT TO 50 DEGREES FAHRENHEIT - 16 HOURS; GREATER THAN 50 DEGREES FAHRENHEIT TO 55 DEGREES FAHRENHEIT ~ 10 HOURS] (B) THE CLEANING FREQUENCY BASED ON THE AMBIENT TEMPERATURE OF THE REFRIGERATED ROOM OR AREAS IS DOCUMENTED IN THE FOOD ESTABLISHMENT. (3) CONTAINERS IN SERVING SITUATIONS SUCH AS SALAD BARS, DELIS, AND CAFETERIA LINES HOLD READY-TO-EAT POTENTIALLY HAZARDOUS FOOD THAT IS MAINTAINED AT THE TEMPERATURES SPECIFIED UNDER CHAPTER 3, ARE INTERMITTENTLY COMBINED WITH ADDITIONAL SUPPLIES OF THE SAME FOOD THAT IS AT THE REQUIRED TEMPERATURE, ANDTHE | GONTAINERS ARE CLEANED AT LEAST EVERY 24 HOURS; (4) TEMPERATURE MEASURING DEVICES ARE MAINTAINED IN CONTACT WITH FOOD, SUCH AS WHEN LEFT IN A CONTAINER OF DELI FOOD OR IN A ROAST, HELD AT TEMPERATURES SPECIFIED UNDER CHAPTER 3; (5) EQUIPMENT IS USED FOR STORAGE OF PACKAGED OR UNPACKAGED FOOD SUCH AS A REACH-IN REFRIGERATOR AND * denotes critical violation : District: 03 Case Number: 2008045417 _ Licensa Type: 2010 License Number: 3915746 Fila Number: 183742 ZAXBY'S Oct 8 2008 4:42 18/88/2088 16:38. 8584146749 DBPR OGA ___ PAGE a7/15 Exhibit A THE EQUIPMENT IS CLEANED AT A FREQUENCY NECESSARY TO PRECLUDE ACCUMULATION OF SOIL RESIDUES; (6) THE CLEANING SCHEDULE 15 APPROVED BASED ON CONSIDERATION OF; (A) CHARACTERISTICS OF THE EQUIPMENT AND ITS USE, (B) THE TYPE OF FOOD INVOLVED, (G} THE AMOUNT OF FOOD RESIDUE ACCUMULATION, AND (D) THE TEMPERATURE AT WHICH THE FOOD IS MAINTAINED DURING THE OPERATION AND THE POTENTIAL FOR THE RAPID AND PROGRESSIVE MULTIPLICATION OF PATHOGENIC OR TOXIGENIC MIGROORGANISMS THAT ARE CAPABLE OF CAUSING FOODBORNE DISEASE; OR (7) IN-USE UTENSILS ARE INTERMITTENTLY STORED IN A CONTAINER OF WATER IN WHIGH THE WATER IS MAINTAINED AT 135 DEGREES FAHRENHEIT OR MORE AND THE UTENSILS AND CONTAINER ARE CLEANED AT LEAST EVERY 24 HOURS OR AT A FREQUENCY NECESSARY TO PRECLUDE ACCUMULATION OF SOIL RESIDUES. : OBSERVED SOILED REACHIN COOLER GASKETS. SOUTH, TWO DOOR REACHIN COOLER. 4, 23-07-1 4-602.13 FC: NONFOOD-CONTACT SURFACES OF EQUIPMENT SHALL BE CLEANED AT A FREQUENCY NECESSARY TO PRECLUDE ACCUMULATION OF SOIL RESIDUES. OBSERVED GASKETS WITH SLIMY/MOLD LIKE BUILD UP; WALKIN COOLER, 5A. 25-06-1 4-903.12(A) AND (B) FC:: (A) EXCEPT AS SPECIFIED IN FARAGRAPH (B) OF THIS SECTION, SINGLE-SERVICE AND SINGLE-USE ARTICLES MAY NOT BE STORED: (1) IN LOCKER ROOMS; (2) IN TOILET ROOMS; (3) IN GARBAGE ROOMS; (4) IN MECHANICAL ROOMS, (5) UNDER SEWER LINES THAT ARE NOT SHIELDED TO INTERCEPT POTENTIAL DRIPS;, (6) UNDER LEAKING .WATER LINES INCLUDING LEAKING AUTOMATIC FIRE SPRINKLER HEADS OR UNDER LINES ON WHICH WATER HAS CONDENSED; (7) UNDER OPEN STAIRWELLS; OR (8) UNDER OTHER SOURCES OF CONTAMINATION. (8) SINGLE-SERVICE AND SINGLE-USE ARTICLES THAT ARE PACKAGED OR IN AFACILITY SUCH AS A CABINET MAY BE STORED IN A LOCKER ROOM. OBSERVED SINGLE SERVICE ARTICLES STORED WITHOUT PROTECTION FROM CONTAMINATION. 6B. 25-04-17 4-903.11(C) AND (D) FC:: (C) SINGLE-SERVICE AND SINGLE-USE ARTICLES SHALL BE STORED AS SPECIFIED UNDER PARAGRAPH (A) OF THIS SECTION AND SHALL BE KEPT IN THE ORIGINAL PROTECTIVE PACKAGE OR STORED BY USING OTHER MEANS THAT AFFORD PROTECTION FROM CONTAMINATION UNTIL USED. (D) ITEMS THAT ARE KEPT IN CLOSED PACKAGES MAY BE STORED LESS THAN 6 INCHES ABOVE THE FLOOR ON DOLLIES, PALLETS, RACKS, AND SKIDS THAT ARE DESIGNED AS PROVIDED UNDER SECTION 4-204. 122. : OBSERVED SINGLE SERVICE ITEMS STORED ON FLOOR. 6. 29-03-1 §-202.11FC:: APPROVED SYSTEM AND CLEANAGBLE FIXTURES. (A) A PLUMBING SYSTEM SHALL BE DESIGNED, CONSTRUCTED, AND INSTALLED ACCORDING TO LAW, (B)A PLUMBING FIXTURE SUCH AS A HANDWASHING FACILITY, TOILET, OR URINAL SHALL BE EASILY CLEANABLE, OBSERVED WATER DRAINING ONTO FLOOR SURFACE FROM THREE COMPARTMENT SINK DRAIN. * 7.30-02-1 5203.14 FC:; BACKFLOW PREVENTION DEVICE, WHEN REQUIRED. A PLUMBING SYSTEM SHALL BE INSTALLED TO PRECLUDE BACKFLOW OF A SOLID, LIQUID, OR GAS CONTAMINANT INTO THE WATER SUPPLY SYSTEM AT EAGH POINT OF USE AT THE FOOD ESTABLISHMENT, INCLUDING ON A HOSE BIBB IF A HOSE IS ATTACHED OR ON A HOSE BIBB IF A HOSE IS NOT ATTACHED AND BACKFLOW PREVENTION IS REQUIRED BY LAW, BY: (A) PROVIDING AN AIR GAP AS SPECIFIED UNDER SECTION 5-202. 13; OR (B) INSTALLING AN APPROVED BACKFLOW PREVENTION DEVICE AS SPECIFIED UNDER SECTION 5-202. 74. VACUUM BREAKER MISSING AT HOSE BIBB; MOP SINK. * 8,32-15-1 6301.14 FC AND 61C-1.004(2)(C) FAC::, HANDWASHING SIGNAGE. A SIGN OR POSTER THAT NOTIFIED FOOD EMPLOYEES' TO WASH THEIR HANDS SHALL BE POSTED AT ALL HANDWASHING LAVATORIES USED BY FOOD EMPLOYEES’ AND SHALL BE CLEARLY VISIBLE TO FOOD EMPLOYEES". NO HANDWASHING SIGN PROVIDED AT A HANDSINK USED BY FOOD EMPLOYEES; MAIN KITCHEN AREA. * denotes critical violation . District: 93 Case Number: 2008045417 License Type: 2010 License Number, 3915746 Flla Number: 183742 ZAXBY'S Oct $$ 2008 9:42 la/ae/2aee = 1a:38 8584146749 DEPR OGA PAGE 8/15 Exhibit A 9, 37-02-71 610-1,004(6) FAC:; (6) ALL BUILDING STRUCTURAL COMPONENTS, ATTACHMENTS AND FIXTURES SHALL BE KEPT IN GOOD REPAIR, CLEAN AND FREE OF OBSTRUCTIONS. OBSERVED HOLE IN WALL BEHIND SODA FOUNTAIN, SERVER AREA, * 10, 414-08-1 7-201.11 FG:: SEPARATION. POISONOUS OR TOXIC MATERIALS SHALL BE STORED $0 THEY CAN NOT CONTAMINATE FOOD, EQUIPMENT, UTENSILS, LINENS, AND SINGLE- SERVICE AND SINGLE-USE ARTICLES BY, (A) SEPARATING THE POISONQUS OR TOXIC MATERIALS BY SPACING OR PARTITIONING; AND (8) LOCATING THE POISONOUS OR TOXIC MATERIALS IN AN AREA THAT IS NOT ABOVE FOOD, EQUIPMENT, UTENSILS, LINENS, AND SINGLE-SERVIGE OR SINGLE-USE ARTICLES. THIS PARAGRAPH DOES NOT APPLY TO EQUIPMENT AND UTENSIL CLEANERS AND SANITIZERS THAT ARE STORED IN WAREWASHING AREAS FOR AVAILABILITY AND CONVENIENCE IF THE MATERIALS ARE STORED TO PREVENT CONTAMINATION OF FOOD, EQUIPMENT, UTENSILS, LINENS, AND SINGLE-SERVICE AND SINGLE-USE ARTICLES. OBSERVED TOXIC ITEM STORED BY SINGLE SERVICE UTENSILS. * 44, 53A-19-1 610-4.023(1) FAC: (1) ALL MANAGERS WHO ARE RESPONSIBLE FOR THE STORAGE, PREPARATION, DISPLAY, AND SERVING OF FOODS TO THE PUBLIC SHALL HAVE PASSED A CERTIFICATION TEST APPROVED BY THE DIVISION DEMONSTRATING A BASIC KNOWLEDGE OF FOOD PROTECTION PRACTICES AS ADOPTED IN THIS CHAPTER. THOSE MANAGERS WHO SUCCESSFULLY PASS AN APPROVED CERTIFICATION EXAMINATION SHALL BE ISSUED A CERTIFICATE BY THE CERTIFYING ORGANIZATION, WHIGH IS VALID FOR A PERIOD OF FIVE YEARS FROM THE DATE OF ISSUANCE, OBSERVED EXPIRED FOOD MANAGER GERTIFIGATION. MATHEW WORTMAN CERTIFICATION DATE 10/09/2002, EXPIRED 10/09/2007, * denotes critical violation ; District: 03 Case Number: 2008045417 ‘ License Type: 2010 License Number: 3915746 Fila Number: 183742 ZAXBY'S Oct 1a: 38 la’ ae/ 2888 8584146749 DEPR OGA STATE OF FLORIDA, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS wit, MyFlaide.com/dbpr/ar FOOD SERVICE INSPECTION REFORT| _ EXHIBIT. 8 2008 9:43 PAGE 89/15 ane Lats FOLLOW-UP INSPECTION N REQUIRED Inspector determined violations require further review, but are not an immediate threat to the public, LEGAL NOTICE Faflure to comply with this Notice may initiate an administrative complaint thet may result In suspension or revocation of your lleansa and finaa, 05/13/08 10:27 AM Routine 3918746 SEAT Inspection Date and Time Inspection Reason License Number GATOR BAIT FOODS LLC ADMINISTRATIVE COMPLAINT Owner Name fecomme | -Bia-65 7.6989 ZAKBY'S Araa Gode/Talephone Number Business Name Inspection Result . Bo O71 4/2008 11:00 oaan\2008 Number of Linits Callback Date/Time Lleanee Expiration 2028 E SA 60 VALRICO, 33594 Address / Gity / State / Zip / ate, hem 03: Food Temperatures item 53a: Cert. Food Managers llam 20: Warewasshling Sanitization ttem 45: Fire Extinguishars and Fire pression Systeme Qetee | ehlekan , reach in cooler, 38 Dagring F, chowsa, roach ih cooler, 41 Ongena F, crageinge , reach hi cooler, 38 Dapaes F, chicken , wath in cooler, 37 Dagrees F. Manager Name: Matthew Warman Cartiiication Date: 1hoa\z002 Gortified by; Natlonal Restaurant Association 300 of PPM, Sanitizer Type: Quaternary Ammonium found at concentration 4. Clana K typo Firs Exlingulaher, found in/at idithon has a cerifcation date efO4\Z008 4 Hood Supprasson type Firs Extinguisher, found In/at biichen hes aceriicetion date of oa\zo08 A Class ABC lypn Ato Exlingulaher, foun inal Aitchdn has a corttficaton data of 14008 NOTE: items marked above with an asterisk (*) Indicate 4 violation Inspector's Comments ater Sourca: MunielpalUtility. Sewage: Municipal/Wtillty, No Boller On Site, Lapknowledge recelpt of this inspection form and comments. Dorit bo 05-13-03 mare bate Signature of Reciplent Reelpient: Tommy Thompson Title Mer. Phone: 813-657-6363 Inspeetor Signature For further Information please contact: Eric Singletary Sanitation and Safety Speclalial 3726 W Grace $1 52 B50-487-1395 STATUS SOURCE PHF TEMPERATURE CONTROL "Dia Approved source In ‘Dib Wholesome, sound condition y In *D2 Original container; properly Jabeled, date marking N/A, “02-116 eradvisory on rewundercooked oysters "02-13 Consumer advisory on raw/undercooked animal "0 Patent 03a Cold food at proper temperatures during storage, display, service, *03b Hot food al proper temperature *03d Foods properly cooled “05 Thermometers provided and conspicuously placed! tially hazardous foods, property ihawed Violations marked wilh pn aslerisk are erillcsl violationa, lama marked IN ere in coniptianee, [tems Marked OUT are violations. Specific delalla of vietaltan are fisted on ‘subsequent pages. ema markad N/A ato Net Applicebla, flame Marked aa N/O are Nol Observed, and warg net balng conducted at [ho ime af (napactian, GEPR Form MR 5022-016 la/ae/2aee = 1a:38 8584146749 Oct $ 2008 9:43 DEPR OGA PAGE _ - EXHl pil B Page 2ofd STATE OF FLORIDA Liesnes Number 5746 DEPARTMENT OF BLISINESS AND PROFESSIONAL REGULATION Business Name PIVISION OF HOTELS AND RESTAURANTS ZAXBY'S- www myfloride.cam/dbpr alld Inspection Date Foop SERVICE NSP ECTION REPORT 05/19/08 10:27 AM Fallure to comply with this Notice may Initiate an administrative complaint that may reault In suspension of ravacation of your llcense and fines, STATUS PHE TEMPERATURE CONTROL STATUS GARBAGE AND REFUSE DISFOSAL In PO? Unwrapped of potentially hazarous food not re-served 33 Containers covered, adequate number, insect and rodent Out "8B Food protectlon during storage, preparation, display, | procf, emptied at proper intarvele, clean service, transportation 34 Outside storage eres clean, enclasure properly f joonstructed In 8b Cross-contamination, equipment, personnel, storage __ damaged food segregated 6G TAN RODENT CONTROL "doe Presence of insects/rodants. Animals probibltad “O8c Potente! for eross-conteminatlon; storage practices; POS Foods handled with minimum contact *35b Outer openings pratected from insects, rodent proof 10 in Lae ipod dispensing utéensilé properly stored STATUS FLOORS, WALLS, CEILINGS PERSONNEL 36 Floors properly constructed, cloan, drained, caved 441 Personnel with infections rasirictad Out a7 Walls, celllngs, and attachad equipment, construatad, If (evidence) FOOD EQUIPMENT AND UTENSILS Qut "419 Toxic items properly stored 14 Food contact surfaces designed, constructed, in "41b Toxic tame labeled and used properly _{maintained, installed, located 22 Hande washed and clean, good hygienic practleas (observed), alternative operating plan "426 Proper hygienic pradices, sating/drinking/smoking 38 Rooms and equipment - vantad as required OTHER AREAS 40 Employee lockers provided and used, claan 13 Clean clothes, halrrestralnts 42 Premises malntalned, free of litter, unnecessary articles. Cleaning and maintenance equipment properly stored. Kitchen restricted to authorized personnel 15 Non-food contact surfaees designed, eonatructed, maintainod, installed, located "46 Dishwashing fecililes designed, constructed, operated 44 Complete separation fram IIving/sleaping area, laundry 1.Wash 2, Rinse 3. Sanitize 44 Clean and salled linen segregated and properly stored. Out 17 Thermometers, gauges, tast kits provided STATUS: SAFETY 18 Pre-lushed, scraped, soaked Sut “45 Fire extinguishers - proper and sufficient 19 Wash, rinse water clean, proper temperature “46 Exiting system - adequate, good rapalr 20a Sanitizing concentration Out “47 Electical wiring - adequate, goad repelr *20b Sanitizing tamperature M48 Gas appliances - properly installed, maintalned 21 Wiping cloths clean, used properly, storad *49 Flammablefoombustibia materials - properly storad Out "22 Food contact surfaces ofequipmentandutensiis dean | STATUS GENERAL Out 23 Non-food contact surfaces clean Out 80 Currant licanae properly displayect 24 Storage/handilng of clean equipment, utanells Out 51 Other conditions sanitary and safe operation STATUS SINGLE SERVICE ARTIGLES . "52 False/misleading statements published or advertised Out 25 Serving itams properly stored, handled, dispensed relating to fopd/aeverage 26 Single service erticles not re-used Out *52e Food management certification velict STATUS WATER AND SEWAGE/PLUMBING ‘Out 53b Employee tralning validation ho? Water source safe, hot end cold undar pressure.” ~_'|54 Florida Cleah Indoor Alr Act "2 Sewage and waste water dlaposed properly 55 Automatic Gratuity Notice lon fag Plumbing Installed and maitiained : 56 Copy of Chapter 508, Florida Statutes, available at Out 30 Cross-connection, back siphonage, backflow STATUS GENERAL STATUS TOILET AND HANDWASHING FACILITIES S?7 Hospitality Education Program Information provided Out "34 Tollat and handwashing fealllties, number, convenient, ; tesioned, installed Total Number of GOS Violations: Out "32 Restrooms with self-closing doors, fixtures operate properly, facility clean, supplied with handsaap, disposable ‘Total Number of Repeat Violations: towels or hand drying devices, tlssue, covered waste Violatlang merked with an esietisk ore ertical violations. llems marked IN are in compliance, llama Marked OUT arg vielations, Specific detaiia of vielalion ara lisled on subsequent pages. ame marked N/A are Not Applicable. tame Marked as AVG are Mot Observed, and ware nal belng conducted al the time of inspection. DSPA Farm HR 5022-015 1a/15 Oct $ 2008 9:43 la/ae/2aee = 1a:38 8584146749 DEPR OGA PAGE 11/15 EXHIBIT Bo eagour Usenaa Number . STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ugeeume DIVIBION OF HOTELS AND RESTAURANTS we. nyflorda.com/dbpr ZAXEY'S , Inspection Date FOOD SERVICE INSPECTION REPORT " 05/13/08 10:27 AM LEGAL NOTICE so, . Failure bo comply with this Natica may Initiate an adrinistrative camplalnt that may reaull In suspanglon or revacatlon of your licange and fines. Admipistrative Complnint(s); . ' 50-08-1;Estebjlehment operating without « currant Hotel end Resiaurant feanee. Werhtna(s): 534-08-1:No currently cerlifled food aarvica manager on duly with four of more employees engaged in bod preparation, 530-19-1:Obeerved expired Food Mareger Gertificatian, §1-18-1iNo copy of fatest Inspection report. 45-35=1:No current hood fire suppression syslem Inapection report avaliable, a7a4el Insufficient space around electrical equipment te permit ready and cofe operation of such equipment, 82615-]:Ne handwashing sign provided ats handsink used by load empleyeoe, main kitchen area. “HAO21:ObSered toxle llom siorod by food, 414-0B-1:Obgerved toxic lem stored by single service utenslla. 25-D6-1:Observed singla-serviee aflelas stored without protection fram contamination, 22-17-1:Observed soiled mach-in cooler gaakels. South, two door reachin cooler, 10e28« Hood fiers are not tightefilling and fimiy held In placa + lnaying Open spaces, 26-04 :Observed water draining onto fear surince from three compertment sink drain, 48-04 1:0bserved ole [stale atuek ta food contalners after eloaning. ‘{4-38-t: Observed utensila in poor condition, lexan contalnara creeked / Sroken, 24-08-1 Equipment and ulema nel properly alr-dried, 31-12-1:Ohgerved hendwaah sink used-for purposes olver han handwashing. 22-24-41 Observed bulldup of siima on soda fountaln, loa dispensing fazzle. DBPA Form HR 9022-015 la/ae/2aee = 1a:38 Oct $$ 2008 9:44 8584146749 DEPR OGA PAGE EXHIE~ B Page 4 of4 Ucense Number ; STATE OF FLORIDA SEAT 3915746 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Business Name DIVISION OF HOTELS AND RESTAURANTS ZAXBY'S www. myfiorda.com/dbpr FOOD SERVICE INSPECTION REPORT Inspection Dae LEGAL NOTICE OB/3/08 10:27 AM Fallure to comply with this Notice may Invate an administrative complelnt that may result In suspension or revocation of your license and fines. 22-20-1:Observed bulldup of allma In the interlor oFice machine. 37-02- 1:0bservad hole In wall bahind sods fountatn, server ave, 25-04-1:Cbeerved aingle-sarvice hams storad on floor. 30-024 1:Vaeuun breaker Mizing mi hose bib, mop sink, 24.07-1:Ohaerved gaskets wilh elimy/mald-tike build-up, walkin cooley, 05-09-1:No conspicuously foented Lhermameterin holding unit, walkin cooker, 088-25-1:Obaerved uncovered food in walkin faazer, BSB-0Bei:Na proof of raquired amployee tralning provided. Alt publle food service aetebllehmenta mus! provide the division with proof of employee valning Upon request, Inctuding, but nat limited to, at the ime of any division ingpeellon of the establishment. Pro 97-03-1:0berved wailln dlerepalr, Corner moding missing near smployas entry door and front server sree BPR Form HR 5020-015 12/15 Oct $$ 2008 9:44 _ la/ae/20e8 18:38 8584146749 DEPR OGA PAGE 13/15 | EXHIBITS STATE OF FLORIDA Page 1 of 3 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS FOLLOW-UP INSPECTION REQUIRED wa. MyPlorida.com/tbpihr Inspector determined violations require further review, but are not an immediate threat to the public. CALL BAGK INSPECTION REPORT| LEGAL NOTIGE , Failure to camply with this Natica may Initiate an administrative complain: that may result In suspension or revocation of your lIcanse and finos. 5975748 SEAT. G7/15/08 03:44 FM Warning Callback Inspection Date and Time Inspection Reason License Number GATOR BAIT FOODS LLC . ADMINISTRATIVE COMPLAINT reeommended. 813-697-6963 Owner Name Area Code/Telephona Number ZAXBY'S: ‘ : Business Name Inspection Result 78 ' 0543/2008 Number of (nits Requested Callback Date/Time Initial Warning Cate 2028 E SR 60 VALRICO, 33694 Address / City / Slate /Zip/ ete, Comments Tha (otlow!hng (term(s) hava bean recommenced for Administrative Complatnt; jotta: Saat Observed expled Food Manage Gerlficallon. jolalion: 41,4-O8-1 Observed toxic tam alored by aingit scavies Literals. jefaliort 37-92-41 : (JOsarved hoin (n wall babind soda founiein, server ance, 07-15-08 Date Signature of Reciplant Ingpactor Signature Reclplent: Matt Wortmen _ For further information plaase contact: , ' . Erie Singletary THe Mer. BROS 7-4 395 Phone: 318-867-6363 DBPR Form HR 5027-005 Oct $$ 2008 9:44 8584146749 DEPR OGA PAGE - | EXHIBirB caw License Number STATE OF FLORIDA SEAT 3915746 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS Business Name ZAXBY'S ‘www. myflorida.com/dbpr CALL BACK INSPECTION REPORT : Inspection Hate LEGAL NOTICE 07/15/08 03:44 PM Failure to comply with this Notice may Initiate en administrative complaint that may result in suspengion or revocation af your license and flnas. jolation: $2-16-1 heandwashhp sign providnd pte henceirk used by food amployees, mah Michen Bree, olavion: 3034 /acuum brankar miting nl hosabibb, mop tlre, noe 23034 Sibserved water dreining ania floor surface from tran compartment sink drain, Miolatlon: 25-0641 Observed aingle-aarvica sriicsa sleredwilhoul protection trem conambalion, halaltor: 254044 Jbnarved angle-servics lama slored on for. Nolan: 2347-1 Dbservead caskele vith alimy/motcike bulld-yp, walsin cooker, Jolt: 22-17-1 baervad aollad reschin coolsr gaakets. Gouth, wo dog rapchin cooler, jofstlon: 12-04-1 . Pibsarved off labels aruck 1@ food conlainers attar cleaning, Hately: DBA-28-1 Ingeryed urcovertd food In walkin reezer. @ (cllowing Nemn(a) are In compliance: fotation: 6398-08-17 jo preet of raquited employer training provided. Atl public Food service establahmanta must provide the division with proofaf mmployne training uponirequénl, Méludlng, Bul rot linked ta, at the tne of pny divielon hspedion of the eslebiehment Fra lelellon: SA-08-1 JO cutrentty cariiied food saree mandga’en diy with four oF mers ampeyses argaged In food pmparatian. Hiakation: 81-16-17 DPR Farm HR 5022-005 14/15 18/88/2088 16:38 a85adide7as DEPR OGA STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS ww. myflonda.cam/dbpr CALL BACK INSPECTION REPORT LEGAL NOTICE Oct $8 2008 9:44 EXHIBIT B recess PAGE 15/15 License Number SEAT 3975745 * Business Name ' CAXBY'S Inspectlon Date O7/18/0B 03:44 PM Fallure to comply with thle Notlce may Initiate an administrative complaint that may reault in euspenglon or revocation of your license and fines, [ copy offaten Inaction rapa, loletion: BIMAE+ Eatablishment operating wRhout e cureni Hotel and Resteurent lcenae, loletion: 6714-1 euifcier pace mun Slecirieal aquiomant tonermil ready ard asfe oppraiten of such equinmant, Malatton: 4B-48-1 J Cura! had Me suppreeion system inspection reper avaliable, Lrasion: a1 A084 bservad lovic llem stored by focd, jotation: 37-03-17 Dbserved wall ih disrepat, Comer molding missing nase employse eniry coor andfrontancver area Iotation: 3112-4 . Etpgerved hencwath sink unedlor purosasolher Ihan handwashing, lalntlon: 24-0801 Equipment ane utenells nen properly ainelrled lolalion: 2224-1 . baerved oulcup of etime an roda founiain, Ice dispanding nozze. pletion: 22A04 Dbeerved buldup of allme In the Interior of tom rretehiria. platen: 15-28-1 Hage Miers are not Ughlefilling and firmly hetd in place -lBaving GOAN Epaces, Iptathony; 448-4 Ibarrved ulenalé [a poor condition, laxan containers cracked / broken, tolallggy: O5 +0861 > conapicudutly teen ladt Iharmomarerin heleingunit, wetkin cooler, OBPR Form HR 5024-005

Docket for Case No: 08-004982