Apr 16 2010 15:11 @4/15/2818 89:54 8584146749 DEPR OGA PAGE 83/88 State of Florida Department of Business and Professional Regulation Diviston of Hotels and Restaurants DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, VS License Number 1819283 COLOMBOS MARKET dent License Type 2010 Pr Case Number 2010000651 } Administrative Gamplaint The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, OIVISION OF HOTELS AND RESTAURANTS, (“Petitioner”), files this Administrative Complaint against COLOMBOS MARKET, ("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 1s, and has been at all times material hereto, licensed by or subject to the junsdiction of the Division of Hotels and Restaurants The respondent's business address of record is 4490 N FEDERAL HWY, LIGHTHQUSE, FLORIDA 33064 The mating address df record ts COLOMBOS MARKET, at 4490 N FEDERAL HWY, LIGHTHOUSE, FLORIDA 33064 : 3. Inspection of this establishment conducted pursuant to Sec 609 032, Flonda Statutes, revealed violations of the provisions of Chapter 509, Florida Statutes, and / or the ules 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 Exhibit "B’, Incorporated herein by reference WHEREFORE, Petthoner respectfully requests entry of an Order imposing ond or more of the following penalties admimustrative fine not to exceed $1,000 per offense, suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/or any other rehef authorized by Chapter 509, Florida Statutes, or the tules promulgated thereto Signed January 08, 2010 () fw eed | Ken Buck, District Manager By delegation of the Director, jor designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT Mare Drexler, Lead Attorney Flonda Bar No 0487058 | Department of Business & Professianal Regulation 1940 North Monroe Street | Tallahassee, Florida 32399-2202 Certificate of Service | BY CERTIFIED U.S, MAIL, ARTICLE NUMBER: tHEREBY CERTIFY that a true and correct copy of the foregaing ADMINISTRATIVE COMPLAINT has been hand served by me on this, day of , 2040 Received by Inspector's Signature Operator's Signature Title Title Case Number 2010000651 Fila Number 106234 District Number 02 License Number 1619283 2070 | Form revised 10 15 09 COLOMBOS MARKET Apr 16 2010 15:11 @4/15/2818 89:54 8584146749 DEPR OGA PAGE @4/ae Exhibit A License Number 1619283 License Type 2010 PERMANENT FOOD SERVICE Case Number 2010000651 "FC" as cited herein references specific provisions of the Food Cdde, Recommendations of the United States Public Health Service, Food and Drug Administration, incorporated by Chapteri61C, Florida Administrative Code "NFPA" as cited herein references specific provisions of the National Fire Protection Association Life Safety Cade, incorporated by reference at Chapter 4A-3, “Fire Prevention, General Provisions", Florida Administratve Gede, and 61C-1 004(5), Flonda Adminstratve Code “ denotes a critical violation Its alleged that on October 5, 2009, December 11, 2009 the licensee was in violation of Florida Statute 509(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 1 1437-1 4.501 12FC CUTTING SURFACES SURFACES SUCH AS CUTTING BLOCKS AND BOARDS THAT ARE SUBJECT TO SCRATCHING AND SCORING SHALL BE RESURFACED IF THEY CAN NO LONGER BE EFFECTIVELY CLEANED AND SANITIZED, OR DISCARDED IF THEY ARE NOT CAPABLE OF BEING RESURFACED. OBSERVED CUTTING BOARD GROOVEDIPITTED AND NO LONGER GLEANABLE. 2 .21-12-1 3-304 14(B\(2) FC. (B) CLOTHS USED FOR WIPING FOOD SPILLS SHALL BE (2) WET ANO CLEANED AS SPECIFIED UNDER PARAGRAPH 4-802 11(D), STORED IN A CHEMICAL SANITIZER AT ACONCENTRATION SPECIFIED IN SECTION 4-501 114, AND USED FOR WIPING SPILLS FROM FOOD-CONTACT AND NONFOQOD-CONTACT SURFACES OF EQUIPMENT. OBSERVED WET WIPING CLOTH NOT STORED IN SANITIZING SOLUTION BETWEEN USES. * 3 °22-28-1 4-60111(A)FO EQUIPMENT FOOD-CONTACT SURFACES AND UTENSILS SHALL BE CLEAN TO SIGHT AND TOUCH A. OBSERVED BUILD-UP OF SOILED MATERIAL ON MIXER HEAD. B, OBSERVED ENCRUSTED SOILED MATERIAL ON SLICER. ¢, OBSERVED INTERIOR OF MICROWAVE SOJLED. 423-06-1 4-601 11(C) FC (C) NONFOOD-CONTACT SURFACES OF EQUIPMENT SHALL BE KEPT FREE OF AN ACCUMULATION OF DUST, DIRT, FOOD RESIDUE, AND OTHER DEBRIS OBSERVED BUILD-UP OF FOOD DEBRIS, DUST OR DIRT ONINONFOOD-CONTACT SURFACE (OBSERVED ON EQUIPMENT). : §.25-01-1 4-90411FG (A) SINGLE-SERVICE AND SINGLE-USE ARTICLES SHALL BE HANDLED, DISPLAYED, AND DISPENSED SO THAT CONTAMINATION OF FOOD AND LIP-CONTACT SURFAGES IS PREVENTED (B) KNIVES, FORKS, AND SPOONS THAT ARE NOT PREWRAPPED SHALL BE PRESENTED SO THAT ONLY THE HANDLES ARE TOUCHED BY EMPLOYEES’ AND BY CONSUMERS IF GONSUMER SELF- SERVICE IS PROVIDED (C) EXCEPT AS SPECIFIED UNDER PARAGRAPH (8) OF THIS SECTION, SINGLE-SERVICE ARTICLES THAT ARE INTENDED FOR FOOD- OR LIP-CONTACT SHALL BE FURNISHED FOR CONSUMER SELF- SERVICE WITH THE ORIGINAL INDIVIDUAL WRAPPER INTACT OR FROM AN APPROVED DISPENSER : OBSERVED SINGLE-SERVICE ARTICLES HANDLED, DISPLAYED, OR DISPENSED IN A MANNER THAT ALLOWS FOR CONTAMINATION. | Gase Number 2010000851 File Number 106234 District Number 02 License Number 1619283 2010 i Form revised 10 1505 COLOMAOS MARKET Apr 16 2010 15:12 @4/15/2818 89:54 8584146749 DEPR OGA PAGE @5/@8 6 36-17-7 6-10177FCG SURFACE CHARACTERISTICS (A) EXCEPT AS SPECIFIED IN PARAGRAPH (B) OF THIS SECTION, MATERIALS FOR INDOOR FLOOR, WALL, AND CEILING SURFACES UNDER CONDITIONS OF NORMAL USE SHALL BE: (1) SMOOTH, DURABLE, AND EASILY CLEANABLE FOR AREAS WHERE FOOD ESTABLISHMENT OPERATIONS ARE CONDUCTED, (2) CLOSELY WOVEN AND EASILY CLEANABLE CARPET FOR CARPETED AREAS, AND (3) NONABSORBENT FOR AREAS SUBJECT TO MOISTURE SUCH AS FOOD PREPARATION AREAS, WALK-IN REFRIGERATORS, WAREWASHING AREAS, TOILET ROOMS, MOBILE FOOD ESTABLISHMENT SERVICING AREAS, AND AREAS SUBJECT TO FLUSHING OR SPRAY CLEANING METHODS (8)IN A TEMPORARY FOOD ESTABLISHMENT (1) IF GRADED TO DRAIN, A FLOOR MAY BE CONCRETE, MACHINE-LAID ASPHALT, OR DIRT OR GRAVEL IF IT 1S COVERED WITH MATS, REMOVABLE PLATFORMS, DUCKBOARDS, OR OTHER SUITABLE APPROVED MATERIALS THAT ARE EFFECTIVELY TREATED TO CONTROL DUST AND MUD, AND (2) WALLS AND CEILINGS MAY BE CONSTRUCTED OF A MATERIAL THAT PROTECTS THE INTERIOR FROM THE WEATHER AND WINDBLOWN DUST AND DEBRIS OBSERVED FLOORS NOT MAINTAINED SMOOTH AND DURABLE. 7 37-05-1 61C-1004(6) FAC (8) ALL BUILDING STRUCTURAL COMPONENTS, ATTACHMENTS AND FIXTURES SHALL BE KEPT IN GOOD REPAIR, CLEAN AND FREE OF OBSTRUCTIONS OBSERVED WALL SOILED WITH ACCUMULATED FOOD DEBRIS. . * 8 534-04-2 509039 FS AND 61C-4023(1) FAC ALL MANAGERS EMPLOYED BY A FOOD SERVICE ESTABLISHMENT MUST HAVE PASSED (THE FOOD SERVICE MANAGER] TEST AND RECEIVED A CERTIFICATE ATTESTING THERETO MANAGERS HAVE A PERIOD OF 30 DAYS AFTER EMPLOYMENT TO PASS THE REQUIRED TEST 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, WHICH IS VALID FOR A PERIOD OF FIVE YEARS FROM THE DATE OF ISSUANCE ALL PUBLIC FOOD SERVICE ESTABLISHMENTS MUST PROVIDE THE DIVISION WITH PROOF OF FOOD SERVICE MANAGER CERTIFICATION UPON REQUEST OBSERVED MANAGER LACKING PROOF OF FOOD MANAGER CERTIFICATION, * 9 538-084 509049FS, FOOD SERVICE EMPLOYEE TRAINING THE DIVISION SHALL ADOPT, BY RULE, MINIMUM FOOD SAFETY PROTECTION STANDARDS FOR THE'TRAINING OF ALL FOOD SERVICE EMPLOYEES WHO ARE RESPONSIBLE FOR THE STORAGE, PREPARATION, DISPLAY, OR SERVING OF FOODS TO THE PUBLIC IN ESTABLISHMENTS REGULATED UNDER THIS CHAPTER THESE STANDARDS SHALL NOT INCLUDE AN EXAMINATION, BUT SHALL PROVIDE FOR A FOOD SAFETY TRAINING CERTIFICATE PROGRAM FOR FOOD SERVICE EMPLOYEES TO BE ADMINISTERED BY A PRIVATE NONPROFIT PROVIDER GHOSEN BY THE DIVISION ANY FOOD SAFETY TRAINING PROGRAM ESTABLISHED AND ADMINISTERED TO FOOD HANDLER EMPLOYEES PRIOR TO THE EFFECTIVE DATE OF THIS ACT SHALL BE SUBMITTED BY THE OPERATOR TO THE DIVISION FOR ITS REVIEW AND APPROVAL IT SHALL BE THE DUTY OF THE LICENSEE OF THE PUBLIG FOOD SERVICE ESTABLISHMENT TO PROVIDE TRAINING IN ACCORDANCE WITH THE DESCRIBED RULE TO ALL EMPLOYEES UNDER THE LICENSEE'S SUPERVISION OR CONTROL THE LICENSEE MAY DESIGNATE A CERTIFIED FOOD SERVICE MANAGER TO PERFORM THiS FUNCTION AS AN AGENT OF THE LICENSEE FOOD SERVICE EMPLOYEES MUST RECEIVE CERTIFICATION PURSUANT TO THIS SECTION BY JANUARY 1, 2001. FOOD SERVICE EMPLOYEES HIRED AFTER NOVEMBER 1, 2000, MUST RECEIVE CERTIFICATION WITHIN 60 DAYS AFTER EMPLOYMENT: CERTIFICATION PURSUANT TO THIS SECTION SHALL REMAIN VALID FOR 3 YEARS OBSERVED NO PROOF OF REQUIRED EMPLOYEE TRAINING PROVIDED, Case Number 2010000851 Fila Number 106234 Custrict Number 02 Licansea Number 1619283 2010 Form revised 10 15 09 COLOMBOS MARKET

Docket for Case No: 10-002081