lafl7/2ele 11:89 8584146749 DEPR OGA Oct 18 2010 16:32 PAGE State of Florida Department of Business and Professional Regulation Division of Hotels and Restaurants DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, v8. License Number. 3908032 CHAVEZ AT HOME ent License Type 2010 espondent. Case Number 2009060958 —_—_ Administrative Complaint The DEPARTMENT OF BUSINESS ANO PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Petitioner"), files this Administrative Complaint against CHAVEZ AT HOME, (‘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. 2, Respondent is, and has been at all times material hereto, licensed by of subject to the jurisdiction of the Division of Motels and Restaurants. The respondent's business address of record is 1350 S HOWARD AVE, TAMPA, FLORIDA 336068.The mailing address of record is CHAVEZ AT HOME, at 1350 5 HOWARD AVE, TAMPA, FLORIDA 33606. 3. Inspection of this establishment conducted pursuant to Sec, 509.032, Florida Statutes, revealed violatians 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 described in Exhibit "A,” attached hereto and incorporated herein by reference, Inspection documents are attached as Exhibit "8", incorporated herein by reference. WHEREFORE, Petitioner respectfully requests entry of an Order imposing one or more of the following penalties: administrative fine not fo exceed $1,000 per offense, suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/ar any other relief authorized by Chapter 509, Florida Statutes, or the rules promulgated thereto. Signed November 23. 100! e cate Joe Perez, Distric ager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Marc Drexler, Lead Attorney Florida Bar No. 0487058 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-2202 WE 83? 8779 Certificate of Service 7 ae j BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: a on ce | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE GOMPLAINT has beeti , 2009. hand served by me on this day af r Received by: Inspector's Signature Operator's Signature Title Title Case Numban 2008060958 Fila Number; 192400 Distrlet Number, 03 Licensa Number: 3808032 2010 Form revised 10.15.09 CHAVEZ AT HOME a3/@5 Oct 18 2010 16:32 lafl7/2ele 11:89 8584146749 : DEPR OGA PAGE @4/@5 Exhibit A License Number: 3906032 License Type: 2010 PERMANENT FOOD SERVICE Case Number. 2009060058 "EC" as cited herein references specific provisions of the Food Gode, Recommendations of tha United States Public Health Service, Food and Drug Administration, incorporated by Chapter 61C, Florida Administrative Code. ‘“NFPA" as cited herein references specific provisions of the National Fire Protection 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. Ibis alleged that on September 9, 2009, November 10, 2009 the licensee was in violation af Florida Statute 509(FS) and/or the Rules of the Division of Hotels and Restaurants, Florida Administrative Cade (FAC), in the following particulars. Copy(s) of the report(s) for the above referenced ingpection(s) are attached hereto and incorporated by reference as Exhibit B. * 4. 08A-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, ORY 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 SPECIFIED 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 IS CLEAN AND NOT EXPOSED TO FLOOR MGISTURE. OBSERVED FOOD STORED ON FLOOR. * 222-291 4-601.11(A) FO: EQUIPMENT FOOD-CONTACT SURFACES AND UTENSILS SHALL BE CLEAN TO SIGHT AND TOUCH. OBSERVED ENCRUSTED MATERIAL ON GAN OPENER, 3. 36-13-14 6-501.12(A) FC: (A) CLEANING, FREQUENCY AND RESTRICTIONS, THE PHYSICAL FACILITIES SHALL BE CLEANED AS OFTEN AS NECESSARY TO KEEP THEM CLEAN. OBSERVED GREASE ACCUMULATED UNDER COOKING EQUIPMENT. Cage Number: 2009060055 File Number: 192400 District Number: 03 License Number: 3906032 2010 Form revised 19, 15.08 CHAVEZ AT HOME

Docket for Case No: 10-009756