SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES

Transcription

1 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 360 Yaphank Avenue, Suite 2A Yaphank, NY Food (631) Temporary Residences (631) Fax: (631) Permit Number Establishment Class Facility Name Facility Code Facility Address Address Food Establishment Temporary Residence Swimming Pool Migrant Farmworker Housing Campground Childrens Camp Mobile Home Park Day Care Operator's Name Activity Code 3 0 Facility open and operating Electricity Electricity operational Electricity interrupted Duration of electrical interruption Generator in use Systems on generator: Time of Inspection AM - PM Hrs. Town Risk Inspection Date Violations Phone # ( ) - Time spent conducting service Hrs. Mins. Mins. Corrective Action Water Supply Name of water district Potable water supply Potable water supplied at time of inspection Potable water supply interrupted Water pressure loss Duration of water pressure loss Sewage / Flooding / Structural Sewage exposed to atmosphere Flooding present Location of sewage/flooding Structural Damage Food Establishment Serving/preparing foods TCS foods on site Mechanical refrigeration operational Commodity Embargoed Fire Safety (Temporary Residences Only) Fire alarm system Fire alarm system type Fire alarm system operational Fire watch implemented Fire watch log maintained Exit/Emergency Lights Maintained Bathing Facility Bathing facility on site Bathing facility in use Filtration and chlorination system operational Number of bathers observed Signature of Person Receiving Report Public. Well Hrs. Central. Local Water Deck Title The marked items above are violations found during an inspection of the operation of this facility which must be corrected as indicated. Failure to comply may result in the initiation of legal action against this facility as provided for in Articles 2 and 13 of the Suffolk County Sanitary Code, including a hearing, possible suspension of your permit to operate and or the publication of the violations and fines. Embargo Order Embargo Order Number Items Under Embargo: This commodity is not to be removed or used until authorized by the Suffolk County Department of Health Services Embargoed Under Authority of Section Article 13, Suffolk County Sanitary Code Quantity Embargoed Owner/operator shall contact this Department between the hours of 8:30am and 4:30pm Monday through Friday to update the status of the facility as well as inform this Department as to the status and disposition of food placed under embargo. Failure to adhere to the embargo placed on this facility may result in legal action being taken against this facility. Signature of Sanitarian Food Discarded San ID # lbs. Emerg. Status PAGE 1 OF.

2 FS1 FS3 FS5 FS14 FS16 FS24 FS25 FS27 TR4 TR8 TR9 TR11 SP3 CC3 CC8 CC12 MW17 CG4 MH2 MH19 Food Service: Article 13 (Red Critical Items) Food, including ice, which is determined, or has probable cause to be adulterated, misbranded, unwholesome, or unfit for human consumption. Food container in such condition as may render the product unwholesome, i.e., leaking, dented, swollen. Water/ice for human consumption from approved source, protected from contamination and cross connection. Hot and cold running water provided to all necesary areas. Temperature controlled for safety foods are maintained at or below 41 F or at or above 140 F. Sufficient number of refrigerators and hot food storage facilities available for the service, storage, display, and transportation of temperature controlled for safety foods. Food processing in public areas free from sewage. No bare hand contact with any ready-to-eat foods. Proper use of single use gloves. Adequate handwashing facilities. Proper handwashing procedures. Temporary Residences: Subpart 7-1 (Red Critical Items) Sewage plant inoperable. Sewage exposed to the atmosphere; toilets, sinks and showers do not drain because sewage system inoperable or sewage overflow noted at XYZ location. Facility occupied with an inoperable fire alarm; fire watch shall be maintained. Emergency and/or exit lights inoperable. Facility occupied with inoperable emergency and/or exit lights or emergency and/or exit lights not provided. Swimming pools in operation while filtration/chlorination system inoperable. Children's Camp: Subpart 7-2 (Red Critical Items) Sewage plant inoperable. Sewage exposed to the atmosphere; toilets, sinks and showers do not drain because sewage system inoperable or sewage overflow noted at XYZ location. Facility occupied with an inoperable fire alarm; fire watch shall be maintained. Swimming Pools: Subpart 6-1 (Red Critical Items) Migrant Farm Worker Housing: Part 15 (Red Critical Items) Campgrounds: Subpart 7-3 (Red Critical Items) Mobile Home Parks: Part 17 (Red Critical Items) Sewage plant inoperable. Sewage exposed to the atmosphere; toilets, sinks and showers do not drain because sewage system inoperable or sewage overflow noted at XYZ location. Facility occupied with an inoperable fire alarm.

3 Embargo Notice SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Emergency Inspection Report 360 Yaphank Avenue, Suite 2A Yaphank, NY Food (631) Temporary Residences (631) Fax: (631) Date: / /. As a result of a fire, power failure, refrigeration failure, flood, or actual (and/or potential) contamination, foods in your establishment have been placed under embargo. Article 13, Section of the Suffolk County Sanitary Code makes it unlawful for any person to remove or alter an embargo order, notice, or tag placed on food by the department, and neither such food, nor the containers thereof, shall be relabeled, repacked, reprocessed, altered, disposed of, or destroyed without permission of the department, except by order of a court of competent jurisdiction. The operator may resume operations only upon meeting the following conditions: - Electric power, either through the public utility or by generator, is operating to supply adequate refrigeration, hot water, and light as required by the Suffolk County Sanitary Code, and, - Disposal of all foods that have been damaged, adulterated, or contaminated due to the emergency, including Temperature Controlled for Safety foods that have been held above 41 F for more than 2 hours or held above 50 F for any amount of time, and, - The water supply is safe and meets the requirements of Part 5 of the New York State Sanitary Code. (Establishments with non-community water supply systems must get approval from this department prior to re-opening if they have been without electric power for more than 4 hours), and, - The establishment submits to this department, by mail, fax, or , a statement of when it met these requirements and the date and time it reopened, and an inventory of all foods discarded. (See reverse side for a sample inventory form.) If premise has sustained structural and/or flood damage, you must contact the department prior to opening. Contact either the Food Control Unit at (631) or Temporary Residences at (631) Facility Name: Address: Permit # Embargo Order # Commodity under Embargo: All temperature controlled for safety food items. All non-temperature controlled for safety food items. Other Facility Code 51 - Inspector San ID # Quantity

4 COUNTY OF SUFFOLK STEVEN BELLONE SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES JAMES L. TOMARKEN, MD, MSW, MPH, MBA Commissioner Job Action Plan Temporary Residences: Subpart 7-1 Potable water not provided to facility violation shall be written as critical item #4: Potable water not Sewage treatment plant inoperable - violation shall be written as critical item #8: Sewage exposed to the atmosphere; toilets, sinks and showers do not drain because sewage system inoperable or sewage overflow noted at XYZ location. Fire watch not being conducted (for hotels with interior corridors only and/or public assembly areas) - violation shall be written as critical item #9: Facility occupied with an inoperable fire alarm system; fire watch shall be maintained. Provide fire watch procedures to operator. Emergency and/or exits lights inoperable - violation shall be written as critical item #11: Facility occupied with inoperable emergency and/or exit lights or emergency and/or exit lights not provided. Swimming Pools: Subpart 6-1 Swimming pool/spa pool in operation - violation shall be written as critical item #3: Swimming pool in operation while filtration/chlorination system inoperable. Indicate if pool(s) voluntarily closed or posted closed. Children s Camps: Subpart 7-2 Sewage treatment plant inoperable - violation shall be written as critical item #2: Sewage exposed to the atmosphere; toilets, sinks and showers do not drain because sewage system inoperable or sewage overflow noted at XYZ location. Potable water not provided to facility violation shall be written as critical item #3: Potable water not Fire watch not being conducted (for camps with interior corridors only and/or public assembly areas) - violation shall be written as critical item #12: Facility occupied with an inoperable fire alarm system; fire watch shall be maintained. Provide fire watch procedures to operator. Migrant Farmworker Housing: Part 15 Potable water not provided to facility violation shall be written as critical item #5: Potable water not Campgrounds: Subpart 7-3 Potable water not provided to facility violation shall be written as critical item #4: Potable water not

5 COUNTY OF SUFFOLK STEVEN BELLONE SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES JAMES L. TOMARKEN, MD, MSW, MPH, MBA Commissioner Job Action Plan (Continued) Mobile Home Parks: Part 17 Sewage treatment plant inoperable - violation shall be written as critical item #2: Sewage exposed to the atmosphere; toilets, sinks and showers do not drain because sewage system inoperable or sewage overflow noted at XYZ location. Fire watch not being conducted (for mobile home parks with public assembly areas) - violation shall be written as blue item #19: Facility occupied with an inoperable fire alarm system; fire watch shall be maintained. Provide fire watch procedures to operator. Food Establishment: Article 13 Food and/or ice contaminated-violation shall be written as a critical item #1: Food and/or ice is determined to be or has probable cause to be unfit for human consumption.. Indicate if discarded or embargoed. Severely damaged food containers-violation shall be written as a critical item #3: Food container observed in a leaking, dented, swollen condition rendering product unwholesome. Indicate if discarded or embargoed. Potable water not available or contaminated water/ice Violation shall be written as 5. Water/ice for human consumption from an unapproved source protected from contamination and cross connection. Indicate if discarded, voluntarily closure. Hot and cold running water not provided to all necessary areas. Indicate if voluntarily closure. Temperature Controlled for Safety Foods out of temperature- Violation shall be written as critical item # 14. Temperature Controlled for Safety Foods are not maintained at or below 41 F. or at or above 140 F. Indicate if discarded. No working refrigeration or hot holding equipment. Violation shall be written as critical items # 16. Insufficient number of refrigerators and hot food storage facilities available for the service, storage, display, and transportation of Temperature Controlled for Safety Foods. Indicate if embargoed. Sewage Exposed Violation shall be written as critical item # 24. Food processing and public area observed with evidence of sewage. Indicate if voluntary closure. Bare Hand Contact with ready to eat foods Violation shall be written as critical item # 25. Direct bare hand contact observed with ready to foods / drink ice (List food items). Indicate if voluntarily discarded and gloves provided. Hand washing facilities available violation shall be written as critical item # 27. Adequate hand washing facilities not available. Proper hand washing procedures not followed. Indicate if corrected/provided at time of inspection.

6 COUNTY OF SUFFOLK STEVEN BELLONE SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES JAMES L. TOMARKEN, MD, MSW, MPH, MBA Commissioner Supply List for Emergency Response Go Pack - 4 Pens - 1 Packaging tape and Dispenser - 24 Sanitary gloves - 1 Chlorine test strip kit - 2 Digital thermometers - 1 Laser thermometer Alcohol swab packets - 1 Flashlight + spare batteries - 50 EIR - 1 Job action plan - 50 Embargo notice/official notice Person receiving supplies: Date: Date returned: BUREAU OF PUBLIC HEALTH PROTECTION 360 Yaphank Avenue, Suite 2A, Yaphank NY (631) FAX (631)