Food and Beverage Establishment Inspection Report
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1 Date: Time: Report: 04/19/17 14:15: Minnesota Department of Health Environmental Health, FPLS P.O. Box St. Paul, MN Page 1 Location: 4767 West Arrowhead Road Hermantown, MN55810 St. Louis County, 69 Establishment Info: ID #: Risk: High Announced Inspection: No License Categories: HOSP, FBLB, FBME, FBTW Operator: PK & JS Inc. Phone #: Expires on: 12/31/17 ID #: The violations listed in this report include any previously issued orders and deficiencies identified during this inspection. Compliance dates are shown for each item. The following orders previously issued between 04/07/14 and 04/25/16 have NOT been corrected Equipment Design and Construction B MN Rule Provide or replace food service equipment to meet NSF International Standards. 07 APR 2014: KENMORE UPRIGHT FREEZER AND THE BLACK AND DECKER TOASTER ARE FOR HOUSEHOLD USE ONLY. 27 MAR 2015: HOUSEHOLD TOASTER HAS BEEN REPLACED WITH AN NSF TOASTER. 4/19/17 THE KENMORE FREEZER IS STILL PRESENT. Issued on: 04/07/14 Comply By: 04/07/ Hygenic Practices MN Rule Discontinue consuming food, use of unapproved beverage containers, or use of tobacco in any form in food preparation or utensil washing areas. MULTIPLE BEVERAGE CUPS IN THE KITCHEN WERE USED WITHOUT LIDS. USE COVERED CONTAINERS FOR EMPLOYEE BEVERAGES. Issued on: 04/25/16 Comply By: 04/25/ A Microbial Control: cooling A MN Rule Cool cooked potentially hazardous food: 1. from 140 degrees F (60 degrees C) to 70 degrees F (21 degrees C) within two hours; and 2. from 70 degrees F (21 degrees C) to 41 degrees F (5 degrees C) or below, within four hours. 4/19/17 FRIED ONIONS MADE THAT AFTERNOON WERE STORED IN A CLOSED PLASTIC CONTAINER IN AN UPRIGHT COOLER AT 95 F. Issued on: 04/25/16 Comply By: 04/25/16
2 Page C Microbial Control: date marking A MN Rule Mark the date of preparation on all refrigerated, ready-to-eat potentially hazardous food prepared in the food establishment and held for more than 24 hours. This will help ensure the food is consumed by the "use by" date, which is seven calendar days from the date of preparation including the date of preparation. SOME ITEMS IN THE WALK-IN COOLER, 3-DOOR COOLER, AND TRAULSEN 3-DOOR FREEZER DID NOT HAVE DATES. ITEMS PREPARED THAT DAY WERE DATED OR THROWN OUT BY LUKE. 4/19/17 SAME AS PREVIOUS. Issued on: 04/25/16 Comply By: 04/25/ Sewage MN Rule Provide an approved indirect connection between the sewer system and any drain line originating from food storage, manufacturing and retail display equipment including portable equipment, ice bins, salad bars, cocktail stations, and running water dipper wells. DRAIN LINES FROM THE ICE BIN WERE DIRECTLY IN THE PVC DRAIN PIPE WITHOUT A 1 INCH AIR GAP. CORRECT BY CREATING A 1 INCH AIR GAP. Issued on: 04/25/16 Comply By: 07/25/ Physical Facility Maintenance/Operation and Pest Control A MN Rule Clean and maintain clean all physical facilities. FREEZERS HAD SOME FOOD/ SPILLAGE ON THE FLOOR, THE DRYING RACK WAS DIRTY, AND WALL/CEILING ABOVE STEAMER WAS DIRTY. CLEAN AND MAINTAIN EQUIPMENT AND FACILITY. Issued on: 04/25/16 Comply By: 05/09/16 The following orders were issued during this inspection A Protection from Contamination: limit hand contact, tasting MN Rule Use spatulas, tongs, deli tissue or other dispensing equipment to limit direct hand contact with food or ice. OBSERVED CHEF USING BARE HAND CONTACT WHEN GRABBING TOAST AND PUTTING SHREDDED CHEESE ONTO A FINISHED DISH. Comply By: 04/19/ Equipment Maintenance and Operation C3 MN Rule Provide and maintain an approved quaternary ammonium compound sanitizing solution in water with 500 ppm hardness or less, a minimum temperature of 75 degrees F (24 degrees C) and a concentration between ppm. THE 3 COMP SINK BEING USED TO HOLD SANITIZER AND TOWELS IN THE BAR WAS
3 Page 3 READING 0 PPM. STAFF USE A CONCENTRATED QUAT SANITIZER THAT WAS ALMOST EMPTY. CHEMICAL CAN WEAKEN OVER TIME, DISCUSSED TESTING THE 3 COMP SINK REGULARLY TO ENSURE PROPER LEVELS. Comply By: 04/19/ Equipment Numbers and Capacities MN Rule Provide an appropriate test kit to accurately measure sanitizer concentration. ESTABLISHMENT NEEDS NEW TEST STRIPS FOR THE CHLORINE DISHWASHER. HAVE STAFF USE TEST STRIPS FOR THE DISHWASHER AND QUAT. DISPENSERS TO ENSURE PROPER SANITIZING LEVELS ARE BEING MET. Comply By: 04/26/ Equipment Maintenance and Operation AB MN Rule All equipment and components shall be in good repair and maintained and adjusted in accordance with manufacturer's specifications. THE GASKET ON THE WALK-IN COOLER IS PULLING AWAY AND THE CORNER OF THE DOOR HAS BEEN WARPED/BROKEN. REPAIR DOOR TO PROVIDE A GOOD SEAL. ALSO THE SPRAY HOSE HANDLE WAS FIED WITH DUCT TAPE WHICH ISN'T EASILY CLEANABLE. A NEW HANDLE HAS BEEN ORDERED. Comply By: 10/19/ Physical Facility Maintenance/Operation and Pest Control MN Rule Maintain the physical facilities in good repair. SEE COMMENTS. Comply By: 04/20/18 Surface and Equipment Sanitizers Chlorine: = 100 PPM at Degrees Fahrenheit Location: DISHWASHER Quaternary Ammonia: = 400 PPM at Degrees Fahrenheit Location: SANITIZER DISPENSER Quaternary Ammonia: = 0 PPM at Degrees Fahrenheit Location: BAR TOWELS IN 3 COMP SINK Violation Issued: Yes Food and Equipment Temperatures Process/Item: Prep Cooler Temperature: 37 Degrees Fahrenheit - Location: DICED TOMATOES- SERVICE LINE TOP
4 Page 4 Process/Item: Prep Cooler Temperature: 39 Degrees Fahrenheit - Location: SLICED TOMATOES- SERVICE LINE TOP Process/Item: Prep Cooler Temperature: 38 Degrees Fahrenheit - Location: DICED HAM- SERVICE LINE BOTTOM Process/Item: Steam Table Temperature: 178 Degrees Fahrenheit - Location: CHILI Process/Item: Steam Table Temperature: 181 Degrees Fahrenheit - Location: MASHED POTATOES Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- TRAULSEN Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- FRIGIDAIRE Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- KENMORE Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- ABC CHINESE FOOD FREEZER Temperature: 40 Degrees Fahrenheit - Location: BEEF STROGANOFF- 3 DOOR Temperature: 41 Degrees Fahrenheit - Location: DYNOMITE CHICKEN WRAP MI- 3 DOOR Temperature: 40 Degrees Fahrenheit - Location: ALFREDO SAUCE- 3 DOOR Process/Item: Cooling Temperature: 95 Degrees Fahrenheit - Location: FRIED ONIONS- 3 DOOR HOURS Process/Item: Hot Holding Temperature: 170 Degrees Fahrenheit - Location: CABBAGE HAM SOUP
5 Page 5 Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- SUPERIOR Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- ABC Process/Item: Counter Top Cooler Temperature: 35 Degrees Fahrenheit - Location: RANCH DRESSING- STARBUCKS COOLER Process/Item: Walk-In Cooler Temperature: 37 Degrees Fahrenheit - Location: THOUSAND ISLAND DRESSING Process/Item: Walk-In Cooler Temperature: 40 Degrees Fahrenheit - Location: COLESLAW Process/Item: Walk-In Cooler Temperature: 38 Degrees Fahrenheit - Location: HAM Temperature: 35 Degrees Fahrenheit - Location: BEANS- PEPSI COOLER IN BAR Temperature: 36 Degrees Fahrenheit - Location: MILK- KEG COOLER IN BAR COMMENTS: Total Critical Orders This Report: Total Non-Critical Orders This Report: DISCUSSED WITH STAFF THE IMPORTANCE OF LIMITING BARE HAND CONTACT WITH ALL READY TO EAT FOODS BY USING GLOVES, TONGS, DELI TISSUE, ETC. ALSO TO SWITCH GLOVES WHEN CHANGING DIFFERENT TASKS AND GOING FROM RAW FOODS TO COOKED. DISCUSSED EMPLOYEE ILLNESS AND THE ECLUSION OF EMPLOYEES SICK WITH SYMPTOMS OF VOMITING AND/OR DIARRHEA UNTIL 24 HOURS AFTER THEIR LAST SYMPTOM. PHYSICAL FACILITIES IN NEED OF MAINTENANCE: THE STAINLESS STEEL PANEL BEHIND THE FRYERS/STOVE TOP HAS POPPED OUT OF PLACE LEAVING A LARGE GAP. RE-SEAL THE PANEL TO PROVIDE A SMOOTH AND EASILY CLEANABLE SURFACE. THE FLOORING IN THE BAR IS ALSO IN NEED OF REPLACEMENT. THE VINYL HAS WORN AWAY IN MULTIPLE SPOTS AND BARE CONCRETE FLOORING IS EPOSED AROUND THE KEG COOLERS AND BACK WALL. 6 5
6 Page 6 DISCUSSED COOLING WITH STAFF AND OWNER AND FACT SHEET AND COOLING LOGS WERE LEFT AT TIME OF INSPECTION. DISCUSSED USING SHALLOW METAL CONTAINERS, CRACKING CONTAINERS TO ALLOW HEAT TO ESCAPE, AND USING AN ICE BATH WHILE STIRRING WHILE IN THE ICE BATH TO COOL EVENLY. TEMP THE FOODS TO ENSURE THEY ARE COOLING FROM 140 F-70 F IN 2 HOURS THEN FROM 70 F- 41F IN 4 ADDITIONAL HOURS. DISCUSSED DATE MARKING WITH STAFF AND FACT SHEET LEFT AT TIME OF INSPECTION. DATE MARK ALL POTENTIALLY HAZARDOUS FOODS PREPARED IN THE ESTABLISHMENT AND KEPT LONGER THAN 24 HOURS OR FROZEN TO ENSURE FOODS ARE USED OR DISCARDED IN 7 CALENDAR DAYS. REPORT ED TO PKTWINS@HOTMAIL.COM NOTE: All new food equipment must meet the applicable standards of NSF International. Plans and specifications must be submitted for review and approval prior to new construction, remodeling or alterations. I acknowledge receipt of the Minnesota Department of Health inspection report number of 04/19/17. Certified Food Manager: Certification Number: Pete M. Kilroy FM50968 Expires: 10/27/18 Inspection report reviewed with person in charge and ed. Signed: Pete M. Kilroy Owner Signed: Callie Bursch Public Health Sanitarian Duluth District Office callie.bursch@state.mn.us
7 Report #: Minnesota Department of Health Environmental Health, FPLS P.O. Box St. Paul, MN Food Establishment No. of RF/PHI Categories Out No. of Repeat RF/PHI Categories Out Legal Authority MN Rules Chapter 4626 Address City/State Zip Code Telephone 4767 West Arrowhead Road Hermantown, MN License/Permit # Permit Holder Purpose of Inspection Est Type PK & JS Inc. FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS Circle designated compliance status (IN, OUT, N/O, N/A) for each numbered item Date Time In Mark "" in appropriate box for COS and/or R Time Out Risk Category H IN= in compliance OUT= not in compliance N/O= not observed N/A= not applicable COS= corrected on-site during inspection R= repeat violation Compliance Status COS R 1A N/A Demonstration of Knowledge Certified food manager, duties 1B PIC knowledgeable; duties & oversight Employee Health 2 Management awareness; policy present Proper use of reporting, restriction & exclusion Good Hygenic Practices N/O Proper eating, tasting, drinking, or tobacco use N/O No discharge from eyes, nose, and mouth Preventing Contamination by Hands N/O Hands clean & properly washed N/A N/O Hand contact with RTE foods restricted Adequate handwashing facilities supplied & accessible Approved Source Food obtained from approved source N/A N/O Food received at proper temperature N/A N/O N/A N/A Food in good condition, safe, & unadulterated Required records available; shellstock tags, parasite destruction Protection from Contamination Food separated/protected from cross contamination Food contact surfaces: cleaned & sanitized Proper disposition of returned, previously served, reconditioned, & unsafe food Compliance Status Potentially Hazardous Food Time/Temperature 16 N/A N/O Proper cooking time & temperature 17 N/A N/O Proper reheating procedures for hot holding 18 N/A N/O Proper cooling time & temperature 19 N/A N/O Proper hot holding temperatures N/A Consumer Advisory 23 N/A in MN Consumer advisory for raw or undercooked foods GOOD RETAIL PRACTICES Proper cold holding temperatures N/A N/O Proper date marking & disposition N/A N/O Time as a public health control: procedures & record N/A in MN N/A Highly Susceptible Populations Pasteurized foods used; prohibited foods not offered Chemical Food additives: approved & properly used Toxic substances properly identified, stored, & used Conformance with Approved Procedures 27 N/A Compliance with HACCP plan and variance /19/17 14:15:00 Risk factors (RF) are improper practices or proceedures identified as the most prevalent contributing factors of foodborne illness or injury. Public Health Interventions (PHI) are control measures to prevent foodborne illness or injury. Good Retail Practices are preventative measures to control the addition of pathogens, chemicals, and physical objects into foods. Mark "" in box if numbered item is not in compliance Mark "" in appropriate box for COS and/or R COS=corrected on-site during inspection R= repeat violation Safe Food and Water 28 Pasteurized eggs used where required Water & ice from approved source Variance obtained for specialized processing methods, documentation on file Food Temperature Control Proper cooling methods used; adequate equipment for temperature control Plant food properly cooked for hot holding Approved thawing methods used Thermometers provided and accurate Food Protection 35 Food properly labled; original container 36 Insects, rodents, & animals not present; no unauthorized persons N/A N/A Food Recalls: Contamination prevented during food prep, storage & display Personal cleanliness Wiping cloths: properly used & stored Washing fruits & vegetables COS R 41 In-use utensils: properly stored Proper Use of Utensils Utensils, equipment & linens: properly stored, dried, & handled Single-use & single service articles: properly stored & used 44 Gloves used properly Utensil Equipment and Vending Food & non-food contact surfaces cleanable, properly designed, constructed, & used Warewashing facilities: installed, maintained, & used; test strips Non-food contact surfaces clean Physical Facilities Hot & cold water available; adequate pressure Plumbing installed; proper backflow devices Sewage & waste water properly disposed Toilet facilities: properly constructed, supplied, & cleaned 52 Garbage & refuse properly disposed; facilities maintained 53 Physical facilities installed, maintained, & clean Adequate ventilation & lighting; designated areas used Compliance with MCIAA & Choking Poster Compliance with licensing & plan review COS COS R R Person in Charge (Signature) Date: 04/20/17 Inspector (Signature) Follow-up Needed: YES NO (Circle one) Follow-up Date: / /
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