State of Florid Department of Business and Potton Regulation Division of Hotels and R DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, vs. : MAMA SALLY'S ree Respondent. Cas { Administrative Com! The DEPARTMENT OF BUSINESS AND PROFESSIONAL RE RESTAURANTS, (“Petitioner”), files this Administrative Complai says: 1. Petitioner is the state agency charged with regulating the o public food service establishments, pursuant to Section 20. 2. Respondent is, and has been at all times material hereto, li Division of Hotels and Restaurants. The respondent's busi INGLIS, FLORIDA 34449.The mailing address of record is PATH, INGLIS, FLORIDA 34449. 3. Inspection of this establishment conducted pursuant to Sec the provisions of Chapter 509, Florida Statutes, and / or the' of the establishment. The violation(s) found and applicable and incorporated herein by reference. Inspection document herein by reference. M. B al staurants Number 4800599 ise se Type 2010 Number 2013043430 int ATION, DIVISION OF HOTELS AND int against MAMA SALLY'S, (“Respondent”), and eration of public lodging establishments and 65]and Chapter 509, Florida Statutes. enged by or subject to the jurisdiction of the ess address of record is 137 S US HWY 19, ARIA SALLY'S, at 12481 W FOSS GROVE 509.032, Florida Statutes, revealed violations of rules promulgated thereto governing operation af are described in Exhibit “A,” attached hereto e attached as Exhibit “B”, incorporated WHEREFORE, Petitioner respectfully requests entry of an Order irhposing one or more of the following penalties: administrative fine nat to exceed $1,000 per offense issued pursuant to this Chapter, and/or any other relief authorized promulgated thereto. Signed October 22, 2013 suspension, revocation, or refusal of a license yy Chapter 509, Florida Statutes, or the rules Department COUNSEL FOR THE DEPARTMENT: Marc Drexler, Lead Attorney Florida Bar No. 0487058 Department of Business & Professional Regulation 4940 North Monroe Street Tallahassee, Florida 32399-2202 Certificate of Service BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: We Siccken District Manager of|the Director, or designee & Restaurants siness & Professional Regulation 7196 9008 im 0036 9471 | 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 Title Case Number: 2013043430 File Number: 261557 License Number: 4800599 2010 MAMA SALLY'S Operator's Signature “Title District Number: 05 Form revised 01.01.13 Exhibit A License Number: 4800599 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2013043430 It is alleged that on March 20, 2013, July 26, 2013 Respondent was in violation of Florida Statute 509 (FS); the Rules of the Division of Hotels and Restaurants, Florida Admin ini Code (FAC); and/or specific provisions of the Food Code, Recommendations of the United States Public|H' as incorporated by Chapter 61C, FAC in the following particulars. Ith Service, Food and Drug Administration, 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. “ 4,03A-02-4 3-501.16(A)(2) FC High Priority: (A) Except|duting preparation, cooking, or cooling, or when time is used as the public health control as specified under section lardous food (time/temperature control for r ti safety food) shall be maintained: (2) At 41 degrees Fahrenheit or less. Paragraph (B) and in Paragraph (C) of this section, potentially Observed potentially hazardous (time/temperature control|for 3-501.19, and except as specified under safety) food cold held at greater than 41° F. In cookline reach-in cooler, ham 47° F, tuna salad 48° F| gyro sauce 55° F and chicken salad 48°F. Repeat violation. * 2.03A-04-4 3-501.16(B) FC High Priority: (B) Eggs that ha . Salmonellae shall be stored in refrigerated equipment that maintai Fahrenheit or less. ve not been treated to destroy all viable ns an ambient air temperature of 45 degrees Observed shell eggs held at room temperature with an ambient air temperature greater than 45-° F. Ambient air temperature 71° F. Case Number: 2013043430 File Number: 261557 License Number: 4800599 2010 MAMA SALLY'S District Number; 05 Form revised 01.01.13

Docket for Case No: 14-000505