State of Florida Department of Business and Professional Regulation Division of Hotels and Restaurants DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, vs, . . . License Number 4800599 MAMA SALLY S. License Type 2010 espondent. Case Number 2013018523 / Administrative Complaint The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against MAMA SALLY'S, (“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 137 S US HWY 19, INGLIS, FLORIDA 34449.The mailing address of record is MAMA SALLY'S, at 137 S US HWY 19, INGLIS, FLORIDA 34449. 3. 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. 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 Aprit 29, 2013 Citi tieckww Cathy H. Té@ker, District Manager 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 Certificate of Service BY CERTIFIED U.S. MAIL, ARTICLE NUMBER; _7196 9008 9111 5025 2082 | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this__-_ day of , 2013. Received by: Inspector's Signature Operator's Signature Title Title Case Number: 2013018523 — File Number: 261557 District Number: 05 License Number: 4800599 2010 Form revised 01.01.13 MAMA SALLY'S Exhibit A License Number: 4800599 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2013018523 It is alleged that on March 20, 2013, April 12, 2013 Respondent was in violation of Florida Statute 509(F S); the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (FAC), and/or specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug : Administration, as incorporated by Chapter 61C, 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. ** denotes a high priority violation. * denotes an intermediate priority violation. 4A, 03A-02-4 3°501.16(A)(2) FC-~ High-Priority: (A)-Except during-preparation; cooking; or-cooling;-or- when time is used as the public health control as specified under Section 3-501.19, and except as specified under Paragraph (B) and in Paragraph (C) of this section, potentially hazardous food (time/temperature control for safety food) shall be maintained: (2) At 41 ° F or less. Observed potentially hazardous (time/temperature control for safety) food cold held at greater than 44 °F, On counter, clam chowder 90° F and eggwash 82° F, In cookline reach-in, pancake batter 67° F, potato salad 63° F, stuffing 68° F, shrimp 66° F, ham 67° F and greek sauce 67° F. In cookline drawers, meatloaf 47° F, gyromeat 52° F, chicken 44° F, ham 52° F and turkey 51° F. {n walk-in cooler, fish 56° F, rice 48° F, soup 48° F, rice pudding 48° F, potatoes 47° F, meatloaf 48° F and turkey 49° F. ** 1B. 03A-04-4 3-501.16(B) FC High Priority: (B) Eggs that have not been treated to destroy alll viable Salmonellae shall be stored in refrigerated equipment that maintains an ambient air temperature of 45 ° F or less. Observed shell eggs held at room remperature with an ambient air temperature greater than 45° F. Ambient air 63° F. . District: 05 Case Number: 2013018523 License Type: 2010 License Number: 4800599 File Number: 261557 _MAMA SALLY'S

Docket for Case No: 13-002597