State of Florida Department of Business and Professional Regulation Division of Hotels and Restaurants DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, Vs. License Number 3800844 DOMINOS paz dent License Type 2010 espondent. Case Number 2012002370 / Administrative Complaint The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against DOMINOS PIZZA, ("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 or subject to the jurisdiction of the Division of Hotels and Restaurants. The respondent's business address of record is 2179 N US HWY 27, SEBRING, FLORIDA 338701886. The mailing address of record is DOMINOS PIZZA, at P O BOX 1765, ‘SEBRING, FLORIDA 33871, : 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 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. : 2 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, suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/or any other relief authorized by Chapter 509, Florida Statutes, or the rules promulgated thereto. : Signed January 17, 2012 Claudia Fields, Deputy District Manager By delegation of the Director, or designee Division of Hotels & Restaurants _ Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Mare Drexier, Lead Attorney Florida Bar No. 0487058 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-2202 Certificate of Service BY CERTIFIED U.S. MAIL, ARTICLE NUMBER:. 71969008911125883402 | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me-on this, day of , 2012. Received by: Inspector's Signature Operator's Signature Title Title Case Number: 2012002370 File Number: 120531 District Number: 07 - License Number; 3800844 2010 Form revised 09.10.11 DOMINOS PIZZA Filed August 27, 2012 12:57 PM Division of Administrative Hearings Exhibit A License Number: 3800844 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2012002370 “EC” as cited herein references specific provisions of the Food Code, Recommendations of the 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 Cade, and 61C-1.004(5), Florida Administrative Code. “" denotes a critical violation. Itis alleged that on October 25, 2011, Decamber 28, 2011 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. * 4A. 05-08-1 4-302.12'FC:; FOOD TEMPERATURE MEASURING DEVICES SHALL BE PROVIDED AND READILY ACCESSIBLE FOR USE IN ENSURING ATTAINMENT AND MAINTENANCE OF FOOD TEMPERATURES AS SPECIFIED UNDER CHAPTER 3. (B) A TEMPERATURE MEASURING DEVICE WITH A SUITABLE SMALL-DIAMETER PROBE THAT IS DESIGNED TO MEASURE THE TEMPERATURE OF THIN MASSES SHALL BE PROVIDED AND READILY ACCESSIBLE TO ACCURATELY MEASURE THE TEMPERATURE IN THIN FOODS SUCH AS MEAT PATTIES AND FISH FILETS. NO THERMOMETER PROVIDED TO CHECK FOOD TEMPERATURES. * 1B, 05-09-1 4-204.112 FC:: (A) INA MECHANICALLY REFRIGERATED OR'HOT FOOD STORAGE UNIT, THE SENSOR OF A TEMPERATURE MEASURING DEVICE SHALL BE LOCATED TO MEASURE THE.AIR TEMPERATURE OR A SIMULATED PRODUCT TEMPERATURE IN THE WARMEST PART OF A MECHANICALLY REFRIGERATED UNIT AND IN THE COOLEST PART OF A HOT FOOD STORAGE UNIT. (B) EXCEPT AS SPECIFIED IN PARAGRAPH (C) OF THIS SECTION, COLD OR HOT HOLDING EQUIPMENT USED FOR POTENTIALLY HAZARDOUS FOOD SHALL BE DESIGNED TO INCLUDE AND SHALL BE EQUIPPED WITH AT LEAST ONE INTEGRAL OR PERMANENTLY AFFIXED TEMPERATURE MEASURING DEVICE THAT IS LOCATED TO ALLOW EASY VIEWING OF THE DEVICE'S TEMPERATURE DISPLAY. (C) PARAGRAPH (B) OF THIS SECTION DOES NOT APPLY TO EQUIPMENT FOR WHICH THE PLACEMENT OF A TEMPERATURE MEASURING DEVICE IS NOT A PRACTICAL MEANS FOR MEASURING THE AMBIENT AIR SURROUNDING THE FOOD BECAUSE OF THE DESIGN, TYPE, AND USE OF THE EQUIPMENT, SUCH AS CALROD UNITS, HEAT LAMPS, COLD PLATES, BAINMARIES, STEAM TABLES, INSULATED FOOD TRANSPORT CONTAINERS, AND SALAD BARS. (D) TEMPERATURE MEASURING DEVICES SHALL BE DESIGNED TO BE EASILY READABLE. (E) FOOD TEMPERATURE MEASURING DEVICE AND WATER TEMPERATURE MEASURING DEVICE ON ’ WAREWASHING MACHINES SHALL HAVE A NUMERICAL SCALE, PRINTED RECORD, OR DIGITAL READOUT IN INCREMENTS NO GREATER THAN 2 DEGREES FAHRENHEIT IN THE INTENDED RANGE OF .USE. NO THERMOMETER IN HOLDING UNITS. PIZZA STATION & WALK IN (COOLER). Case Number: 2012002370 — File Number: 120531 District Number: 07 License Number: 3800844 2010 Form revised 09.10.11 DOMINOS PIZZA 2. 38-06-1 6-202.11 FC:: LIGHT BULBS, PROTECTIVE SHIELDING. (A) EXCEPT AS SPECIFIED IN PARAGRAPH (B) OF THIS SECTION, LIGHT BULBS SHALL BE SHIELDED, COATED, OR OTHERWISE SHATTER-RESISTANT IN AREAS WHERE THERE !S EXPOSED FOOD; CLEAN EQUIPMENT, UTENSILS, AND LINENS; OR UNWRAPPED SINGLE-SERVICE AND SINGLE-USE ARTICLES. (B) SHIELDED, COATED, OR OTHERWISE SHATTER-RESISTANT BULBS NEED NOT BE USED IN AREAS USED ONLY FOR STORING FOOD-IN UNOPENED PACKAGES, IF: (1) THE INTEGRITY OF THE PACKAGES CAN NOT BE AFFECTED BY BROKEN GLASS FALLING ONTO THEM; AND (2) THE PACKAGES ARE CAPABLE OF - BEING CLEANED OF DEBRIS FROM BROKEN BULBS BEFORE THE PACKAGES ARE OPENED. (C) AN INFRARED OR OTHER HEAT LAMP SHALL BE PROTECTED AGAINST BREAKAGE BY A SHIELD SURROUNDING AND EXTENDING BEYOND THE BULB SO THAT ONLY THE.FACE OF THE BULB IS EXPOSED. LIGHT SHIELD MISSING IN WALK IN COOLER. * 3.53B-08-1 509,049FS: 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 CHOSEN 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 PUBLIC 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 ACERTIFIED 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. NO PROOF OF REQUIRED EMPLOYEE TRAINING. ON CALLBACK INSPECTION 12/28/11, NO PROOF OF REQUIRED EMPLOYEE TRAINING PROVIDED. ‘ Case Number: 2012002370 File Number: 120531 District Number: 07 License Number: 3800844 2010 Form revised 09.10.11 DOMINOS PIZZA

Docket for Case No: 12-002867