Date: Time: Report: 01/11/17 13:45:00 1006171004 Minnesota Department of Health Environmental Health, FPLS P.O. Box 64975 St. Paul, MN 55164-0975 651-201-4500 Page 1 Location: 4011 Woodland Avenue Duluth, MN55803 St. Louis County, 69 Establishment Info: ID #: 0022394 Risk: Medium Announced Inspection: No License Categories: HOSP, FBLB, BTWO, FBME Operator: Sammy's Pizza - Woodland Phone #: 2187241277 Expires on: 12/31/17 ID #: 28128 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 on 08/10/15 have NOT been corrected. 2-400 Hygenic Practices 2-401.11 ** Critical Item ** MN Rule 4626.0105 Discontinue consuming food, use of unapproved beverage containers, or use of tobacco in any form in food preparation or utensil washing areas. OPEN TOPPED COFFEE MUGS WERE IN USE AS EMPLOYEE BEVERAGE CONTAINERS IN THE FOOD SERVICE AREA. USE BEVERAGE CONTAINERS WITH A LID OR CAP AND A STRAW OR HANDLE TO REDUCE THE CHANCES OF SPILLAGE AND HAND CONTACT WITH LIP PORTION OF CONTAINER. Issued on: 08/10/15 Comply By: 08/10/15 The following orders were issued during this inspection. 3-500B Microbial Control: hot and cold holding 3-501.16B ** Critical Item ** MN Rule 4626.0395 Maintain all cold, potentially hazardous foods at 41 degrees F (5 degrees C) or below under mechanical refrigeration. SEE COMMENTS 3-501.17B 3-500C Microbial Control: date marking ** Critical Item ** MN Rule 4626.0400 Date mark potentially hazardous food that is prepared in a food establishment and which is subsequently frozen: 1. when the food is thawed to indicate that the food must be consumed within 24 hours; or 2. when the food is placed in the freezer to indicate the length of time before freezing that the food is held refrigerated prior to freezing and when the food is removed from the freezer to indicate the date by which
Page 2 the food must be consumed as by rule. ESTABLISHMENT MAKES MEATBALLS, FREEZE, THEN USE AS NEEDED. NO DATE MARK WAS OBSERVED ON THE MEATBALLS. DATE WHEN PLACED IN FREEZER AND WHEN REMOVED TO THAW TO ENSURE THEY'RE USED IN 7 CALENDAR DAYS. 4-500 Equipment Maintenance and Operation 4-501.114C1 ** Critical Item ** MN Rule 4626.0805 Provide and maintain an approved chlorine chemical sanitizer solution that has a minimum concentration of 50 ppm and a minimum temperature of 75 degrees F (24 degrees C) for water with a ph of 8.1 to 10. The chlorine concentration must not exceed the amount specified on the manufacturer's label approved by the federal EPA. THE SANITIZER BUCKET UP FRONT WAS MEASURING 0 PPM. STAFF CHANGED OUT THE BUCKET AND MEASURED 200 PPM AFTER. SWITCH BUCKETS OUT ON A REGULAR BASIS TO MAINTAIN PROPER SANITIZING LEVELS. Corrected on Site 3-300C Protection from Contamination: equipment/utensils, consumers 3-304.13B MN Rule 4626.0285 Store wiping cloths clean and dry or in an approved sanitizing solution. ESTABLISHMENT HAD MULTIPLE TOWELS AROUND THE KITCHEN AND FRONT AREAS. SOME WERE SOILED AND DRY AND OTHERS WERE DAMP OUT OF THE SANITIZING SOLUTION. DISCUSSED WITH STAFF. 3-300C Protection from Contamination: equipment/utensils, consumers 3-305.11 MN Rule 4626.0300 Store all food in a clean, dry location; where it is not exposed to splash, dust or other contamination; and at least 6 inches above the floor. BO OF FLOUR WAS BEING KEPT ON THE FLOOR BY THE FRYER IN THE KITCHEN. STORE FLOUR AT LEAST 6 INCHES ABOVE THE FLOOR. 4-300 Equipment Numbers and Capacities 4-302.12 MN Rule 4626.0705 Provide a readily accessible food temperature measuring device. KITCHEN DID NOT HAVE A THERMOMETER, WHICH IS NECESSARY TO ENSURE PROPER COLD/HOT HOLDING, COOKING, REHEATING, AND COOLING TEMPERATURES.
Page 3 4-600 Cleaning Equipment and Utensils 4-601.11C MN Rule 4626.0840 Clean non-food contact surfaces of equipment and maintain free of accumulations of dust, dirt, food residue, and other debris. THE HOOD AND VENTS ABOVE THE PIZZA OVEN HAD AN ACCUMULATION OF DUST. CLEAN AT A FREQUENCY TO LIMIT THE BUILD UP. 5-200C Plumbing: Maintenance, fixture location 5-205.11 MN Rule 4626.1110 Maintain access to the handwashing sinks at all times and do not use for other purposes other than handwashing. A PREP COUNTER WAS IN FRONT OF THE HAND WASHING SINK IN THE KITCHEN. STAFF MOVED THE COUNTER. MAINTAIN EASY ACCESS TO THE HAND WASHING SINK AT ALL TIMES TO ENSURE HAND WASHING IS TAKING PLACE IN THE KITCHEN. 6-200 Physical Facility Design and Construction 6-202.11A MN Rule 4626.1375 Provide effective shielding or shatter-resistant bulbs for all light fixtures where there is exposed food, clean equipment, utensils and linens, and unwrapped single-service or single-use articles. TWO OF THE LIGHT SHIELDS IN THE KITCHEN AREA WERE RECENTLY BROKE AND REMOVED. JULIE CALLED SOMEONE AT TIME OF THE INSPECTION TO PICK UP REPLACEMENT SHIELDS. Comply By: 02/01/17 6-300 Physical Facility Numbers and Capacities 6-301.12AB MN Rule 4626.1445 Provide and maintain at each handwashing sink in the food preparation and warewash areas a supply of individual disposable towels or a continuous towel system that supplies the user with a clean towel. THE HAND WASHING SINK IN THE KITCHEN DID NOT HAVE ANY PAPER TOWELS. Surface and Equipment Sanitizers Quaternary Ammonia: = 400 PPM at Degrees Fahrenheit Location: SANITIZER SPRAY IN KITCHEN Hot Water: = 163 F at Degrees Fahrenheit Location: DISHWASHER
Page 4 Chlorine: = 0 PPM at Degrees Fahrenheit Location: SANITIZER BUCKET UP FRONT Chlorine: = 200 PPM at Degrees Fahrenheit Location: SANITIZER BUCKET UP FRONT AFTER REFILLED Food and Equipment Temperatures Temperature: 39 Degrees Fahrenheit - Location: COLESLAW- KITCHEN PREP TOP Temperature: 39 Degrees Fahrenheit - Location: SLICED TOMATOES- KITCHEN PREP TOP Temperature: 40 Degrees Fahrenheit - Location: SLICED TURKEY- KITCHEN PREP TOP Temperature: 42 Degrees Fahrenheit - Location: PRECOOKED NOODLES- KITCHEN PREP BOTTOM Temperature: 42 Degrees Fahrenheit - Location: MEATBALLS- KITCHEN PREP BOTTOM Process/Item: Upright Freezer Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- FREEZER IN KITCHEN Process/Item: Hot Holding Temperature: 162 Degrees Fahrenheit - Location: SPAGHETTI SAUCE Temperature: 44 Degrees Fahrenheit - Location: RANCH DRESSING NEAR TOP OF STACK- SALAD BAR PREP TOP Temperature: 41 Degrees Fahrenheit - Location: RANCH DRESSING NEAR BOTTOM OF STACK- SALAD BAR PREP Temperature: 46 Degrees Fahrenheit - Location: BLUE CHEESE DRESSING- SALAD BAR PREP
Page 5 Temperature: 41 Degrees Fahrenheit - Location: LETTUCE- SALAD PREP BOTTOM Temperature: 45 Degrees Fahrenheit - Location: MILK- SALAD PREP BOTTOM Temperature: 36 Degrees Fahrenheit - Location: MOZZARELLA CHEESE- PIZZA PREP TOP Temperature: 32 Degrees Fahrenheit - Location: DICED ONIONS- PIZZA PREP TOP Temperature: 36 Degrees Fahrenheit - Location: DICED TOMATOES- PIZZA PREP BOTTOM Process/Item: Upright Freezer Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- AVONTICO Process/Item: Upright Freezer Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- TRUE FREEZER Process/Item: Chest Freezer Temperature: Degrees Fahrenheit - Location: ALL FOODS FROZEN- FROZEN TO GO PIZZA FREEZER Process/Item: Walk-In Cooler Temperature: 70 Degrees Fahrenheit - Location: COOKED HAMABURGER @ 1.5 HOURS Process/Item: Walk-In Cooler Temperature: 41 Degrees Fahrenheit - Location: ITALIAN SAUSAGE COMMENTS: Total Critical Orders This Report: Total Non-Critical Orders This Report: INSPECTION WAS ACCOMPANIED IN PART BY AND EIT INTERVIEW DONE WITH STORE MANAGER JULIE DALY. THE PREP COOLER IN THE BACK WAS RUNNING A LITTLE WARM, THIS WAS AFTER LUNCH SO UNIT COULD HAVE BEEN OPENED A LOT. COOLERS SHOULD BE ABLE TO KEEP FOODS AT 41 F OR BELOW, MEATBALLS AND NOODLES WERE AT 42 F. JULIE TURNED DOWN THE COOLER AT THE TIME OF THE INSPECTION. 4 7
Page 6 ITEMS IN THE SALAD BAR PREP COOLER UP FRONT WERE ABOVE 41 F (RANCH 44 F, BLUE CHEESE 46 F, AND MILK 45 F). THIS COULD BE DUE TO SOME EMPLOYEE ERROR, THE DRESSINGS WERE STACKED OVER THE FILL LINE, THE TOP HAD REMAINED OPENED QUITE A BIT DURING LUNCH, AND LARGE CONTAINERS OR DRESSING WERE STORED IN FRONT OF THE COOLER VENT RESTRICTING AIR FLOW. STAFF TOOK OUT SOME OF THE DRESSING CONTAINERS SO THEY WEREN'T STACKED AS HIGH, SHUT TOP LID, AND MOVED THE CONTAINERS OF DRESSING TO THE LOWER PART OF THE UNIT. DISCUSSED EMPLOYEE ILLNESS LOGS AND THE ECLUSION OF EMPLOYEES SICK WITH SYMPTOMS OF VOMITING AND/OR DIARRHEA UNTIL 24 HOURS AFTER THE LAST SYMPTOM. DISCUSSED COOLING METHODS WITH THE MANAGER. PRECOOKED NOODLES CAN BE RUN UNDER COLD WATER TO COOL QUICKLY. WHEN COOLING SAUCES, SOUPS, PRECOOKED BURGER, ETC. ITEMS WILL COOL QUICKER WHEN PLACED IN A SHALLOW METAL PAN, PLACED IN A FREEZER TO BEGIN COOLING QUICKER, AND THE LID CAN BE CRACKED TO ALLOW HEAT TO ESCAPE. DISCUSSED RE-HEATING METHODS USED FOR SPAGHETTI SAUCES AND SOUPS. SAUCE IS HEATED IN THE MICROWAVE PRIOR TO BEING PUT IN THE HOT HOLDING UNIT AND SHOULD REACH 165 F. BAGGED SOUPS ARE BOILED IN WATER AND SHOULD REACH 140 F BEFORE BEING PUT IN THE HOT HOLDING UNIT. REPORT EMAILED TO: PATHDALY27@GMAIL.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 1006171004 of 01/11/17. Certified Food Manager: Certification Number: Samuel Jospeh Perrella FM47502 Expires: 08/04/18 Inspection report reviewed with person in charge and emailed. Signed: Sam Perrella Owner Signed: Callie Bursch Public Health Sanitarian Duluth District Office 218-302-6173 callie.bursch@state.mn.us
Report #: 1006171004 Minnesota Department of Health Environmental Health, FPLS P.O. Box 64975 St. Paul, MN 55164-0975 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 4011 Woodland Avenue Duluth, MN 55803 2187241277 License/Permit # Permit Holder Purpose of Inspection Est Type 0022394 Sammy's Pizza - Woodland 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 M 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 3 4 5 6 7 8 9 10 11 12 13 14 15 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 20 21 22 N/A Consumer Advisory 23 N/A in MN Consumer advisory for raw or undercooked foods 24 25 26 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 5 1 01/11/17 13:45:00 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 29 30 31 32 33 34 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 37 38 39 40 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 42 43 45 46 47 49 50 51 52 Proper Use of Utensils Utensils, equipment & linens: properly stored, dried, & handled Single-use & single service articles: properly stored & used 44 Gloves used properly 48 53 54 55 56 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 Garbage & refuse properly disposed; facilities maintained 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: 01/12/17 Inspector (Signature) Follow-up Needed: YES NO (Circle one) Follow-up Date: / /