Oct $ 2009 9:34 la/e7/2689 84:15 8584146749 DEPR OGA PAGE STATE OF FLORIDA. DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitiorier, ¥5. . ‘ License No. 2525994 DAIRY QUEEN Respondent License Type 2010 P ; 7 Case No. 2007061773 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (“Patitioner’), files this Administrative Complaint against DAIRY QUEEN, (“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 Section 20.165 and Chapter 509, 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 18534 NW 67 AVE, MIAMI, FLORIDA 33015.The mailing address of record is DAIRY QUEEN, at 18534 NW 87 AVE, MIAMI, FLORIDA 33015. Inspection of this establishment conducted pursuant to Sec. 509,032, Florida Statutes, revealed violations ‘of the provisions of Chapter 509, Florida Statutes, and / or the rules promulgated thereto governing aperation 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 Exhibit "B’, incorporated herein by reference. . . & WHEREFORE, Petitioner respectfully requests entry of an Order imposing one or more of the fallowing penalties: administrative 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, revocation, or refusal of a license issued pursuant to this. Chapter, andior any other relief authorized by Chapter 509, Florida Statutes, or the rules promulgetted theret. Signed Nevember 13, 2007 Carlos Lezcano, Deputy District Manager By delegation of the Diractor, or dasignee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: ~ ; Charles F. Tunnicliff, Lead Attorney Florida Bar No, 0153834 Department of Business & Profassional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: 7160 3901 9849 9961 3780 | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this. day of , 2007. Received by: ——_— Inspector's Signature Operator's Signature te Title Tithe Case Number 2007061773 File Number: 113732 : Olstriet Number: 01 License Number: 2325984 2010 Form revised 07.07.07 DAIRY QUEEN 3/19 Oct $ 2009 9:34 leafar/28e9 @4:15 8584146749 DEPR OGA PAGE @4/19 Exhibit A License Number. 2325994 License Type: 2010 PERMANENT FOOD SERVICE Gase Number: 2007061773 _ “FC" as cited hereln references specific provisians of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, incorporated by Chapter 810, Florida Administrative Code. "NFPA" as cited herein references specific provisions of the National Fire Protection Association Life Safety Code, incorporated by referance at Chapter 44-3, “Fire Prevention, General Provisions”, Florida Administrative Code, and 61C-1.004(5), Florida Administrative Code. : “*" denotes a critical violation. itis alleged that on August 8, 2007, and October 17, 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. * 4.530191 610-4.023(1) FAG: (1) ALL MANAGERS WHO ARE RESPONSIBLE FOR THE STORAGE, PREPARATION, DISPLAY, AND SERVING OF FOODS TO THE PUBLIC SHALL HAVE PASSED A GERTIFICATION TEST APPROVED BY THE DIVISION DEMONSTRATING A BASIC KNOWLEDGE OF FOOD PROTECTION PRACTICES AS ADOPTED IN THIS GHAPTER. THOSE MANAGERS WHO SUCCESSFULLY PASS AN APPROVED CERTIFICATION EXAMINATION SHALL BE ISSUED A CERTIFICATE BY THE CERTIFYING ORGANIZATION, WHICH IS VALID FOR A PERIOD OF FIVE YEARS FROM THE DATE OF ISSUANCE. OBSERVED EXPIRED FOOD MANAGER CERTIFICATION. Cage Number: 2007061772 Fille Number: 113732 District Nurnber: 01 License Number: 2325884 2010 . Form revised 07.07.07 DAIRY QUEEN

Docket for Case No: 09-005490