State of Florida Department of Business and Professional Regulation Division of Hotels and Restaurants DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, vs. . License Number 391547! CHARLIE'S PIZZA & WINGS License Type / 3010 ° Respondent. Case Number 2013026144 / Administrative Comptaint - The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (*Petitioner), files this Administrative Complaint against CHARLIE'S PIZZA & WINGS, (“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 4439 GUNN HWY, TAMPA, FLORIDA 33648.The mailing address of record is CHARLIE'S PIZZA & WINGS, at 4439 GUNN HIGHWAY, TAMPA, FLORIDA 33618. 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 offerise, 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 June 25, 2013 Joe Perez, * 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 32389-2202 Certificate of Service BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: | 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: 2013026144 File Number. 243981 District Number: 03 License Number: 3915470 2010 Form revised 01.01.13 CHARLIE'S PIZZA & WINGS Exhibit A License Number: 3915470 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2013026144 itis alleged that on March 29, 2013, May 29, 2013 Respondent was in violation of Florida Statute 509 (FS), 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. 1.14-36-4 4-501.11FC Basic: (A) Equipment shall be maintained in a state of repair and condition that meets the requirements specified under Parts 4-1 and 4-2, (B) Equipment components such as doors, seals, hinges, fasteners, and kick plates shalt be kept intact, tight, and adjusted in accordance with manufacturer's specifications. (C) Cutting or piercing parts of can openers shall be kept sharp to minimize the creation of metal fragments that can contaminate food when the container is opened. Interior lid of coffin freezer in distepait/has exposed insulation. * 9 29-28-4 5-205.13FC Intermediate: A device such as a waier treatment device or backflow preventer shall be scheduled for inspection and service, in accordance with manufacturer's instructions and as necessary io prevent device failure based on local water conditions, and records demonstrating inspection and service shall be maintained by the person in charge. Water treatment device has not been inspected or serviced according to manufacturer's instructions. 3, 36-62-4 6-501.11FC Basic: Physical facilities shall be maintained in good repair. Light not functioning in dry storage area. * 4 53B-05-4 509.049(5) FS _ Intermediate: It shall be the duty of each public food service establishment to provide training in accordance with the described rule to all food service employees of the public food service establishment. The public food service establishment may designate any certified food service manager to perform this function. Food service employees must receive certification within 60 days after employment. Certification pursuant to this section shall remain valid for 3 years. All public food service establishments must provide the division with proof of employee training upon request, including, but not limited to, at the time of any division inspection of the establishment. Proof of training for each food service employee shail include the name of the trained employee, the date of birth of the trained employee, the date the training occurred, and the approved food safety training program used. Required employee training expired for all employees, no current state approved employee training. Case Number, 2013026144 File Number: 243981 District Number: 03 License Number: 3915470 2010 Form revised 01.01.13 CHARLIE'S PIZZA & WINGS

Docket for Case No: 13-003612