Oct 7 2009 9:19 1a/@6/ 2889 83:55 8584146749 DEPR OGA PAGE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, ve Licensé No 1619874 PINES ba INC License Type 2010 Respondent Case No 2008066041 / ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Petitioner"), files ths Administrative Complaint against PINES DQ INC, DAIRY QUEEN, ("Respondent’), and says 1 Petitioner ts 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 2 Respondentis, and has been al all times material hereto, licensed by or subject to the junsdictian of the Division of Hotels and Restaurants The respondent's business address of record 1s 17529 PINES BLVD, PEMBROKE PINES, FLORIDA 33029 The mailing address of record 1s DAIRY QUEEN, at 17529 PINES BLVD, PEMBROKE PINES, FLORIDA 33022 3 inspection of this establishment conducted pursuant to Sec 509 032, Florida Statules, revealed violations of the provisions of Chapter 509, Florida Statutes, and / or the rules promulgated thereto governing operation of the establishment The violation(s) found and applicable law are deseribed in Exhibit “A,” altached hereto and incorporated herein by reference Inspection documents are attached as Exhibit “B", incorporated herein by reference WHEREFORE, Petitioner respectfully requests entry of an Order imposing one or more of the following penalties. admuimstrative fine not 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, revecation, of refusal of a license issued pursuant to this Chapter, and/or any other rehef authonzed by Chapter 509, Florida Statutes, or the ruleg promulgated thereto Signed December 15, 2008 Ken Buck, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT Charles F Tunnliff, Lead Attorney Flonda Bar No 0153831 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: | HEREBY CERTIFY thal a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this. day of , 2008 Received by ~ Operator's Signature inspector's Signature Tile Title Case Number 2008066941 File Number 108651 Distnet Number 02 Form revised 07 07 07 License Number 1619974 2010 PINES OD ING 19/26 Oct 7 2009 9:19 1a/@6/ 2889 83:55 8584146749 DEPR OGA PAGE 28/26 Exhibit A License Number 1619874 License Type 2010 PERMANENT FOOD SERVICE Case Number 2008066041 "FC" ag cited herein references specific provisions of the Food Code, Recammendations of the United States Public Health Service, Food and Drug Administration, meorporated by Chapter 61C, Flonda Administrative Cade "NFPA" as cited herein references specific provisions of the National Fire Protection Association Life Safety Code, incorporated by reference at Chapter 44-3, "Fire Prevention, General Provisions", Florida Admmunstrative Code, and 61C-1.004(5), Florida Adminstratwe Code “” denotes a critical violation Its allaged that on September 23, 2008, December 5, 2008 the licensee was in violation of Flonda Statute §09(FS) and/or the Rules of the Division of Hotels and Restaurants, Flonda 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 OBA-28-1 3-305.11FC. FOOD STORAGE (A) EXCEPT AS SPECIFIED IN PARAGRAPHS (8) AND (C) OF THIS SECTION, FOOD SHALL BE PROTECTED FROM CONTAMINATION BY STORING THE FOOD (1) IN A CLEAN, DRY LOCATION, (2) WHERE IT IS NOT EXPOSED TO SPLASH, DUST, OR OTHER CONTAMINATION; AND (3) AT LEAST 6 INCHES ABOVE THE FLOOR (B) FOOD IN PACKAGES AND WORKING CONTAINERS MAY BE STORED LESS THAN 6 INCHES ABOVE THE FLOOR ON CASE LOT HANDLING EQUIPMENT AS SPEGIFIED UNDER SECTION 4-204.122 (C) PRESSURIZED BEVERAGE CONTAINERS, CASED FOOD IN WATERPROOF CONTAINERS SUCH AS BOTTLES OR CANS, AND MILK CONTAINERS IN PLASTIC CRATES MAY BE STORED ON A FLOOR THAT [8 GLEAN AND NOT EXPOSED TO FLOOR MOISTURE OBSERVED FOOD STORED ON THE FLOOR....SLICED STRAWBERRIES, WATER AND ICE CREAM Mix IN THE WALK-IN COOLER. * 250-081 509244(2)FS (2) APPLICATION FOR LICENSE. EACH PERSON WHO PLANS TO OPEN A PUBLIC FOOD SERVICE ESTABLISHMENT SHALL APPLY FOR AND RECEIVE A LICENSE FROM THE DIVISION PRIOR TO THE COMMENCEMENT OF OPERATION OBSERVED ESTABLISHMENT OPERATING WITHOUT A CURRENT HOTEL AND RESTAURANT LICENSE (EXPIRED 12/01/06)... LICENSE FEES DUE: $936. Gase Number 2008066941 File Number 108651 Disincl Number 02 Form revised O7 07 07 License Number 1619874 2010 PINES DQ ING

Docket for Case No: 09-005464