Food and Beverage Establishment Inspection Report

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1 Minnesota Department of Health Environmental Health, FPLS P.O. Box St. Paul, MN Type: Date: Time: eport: Follow-Up 06/01/17 09:00: Page 1 Location: 4767 West Arrowhead oad Hermantown, MN55810 St. Louis County, 69 Establishment Info: ID #: isk: High Announced Inspection: Yes License Categories: HOSP, FBLB, FBME, FBTW Operator: PK & JS Inc. Phone #: Expires on: 12/1/17 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 04/19/17 have NOT been corrected Equipment Design and Construction B MN ule Provide or replace food service equipment to meet NSF International Standards. 07 AP 2014: KENMOE UPIGHT FEEZE AND THE BLACK AND DECKE TOASTE AE FO HOUSEHOLD USE ONLY. 27 MA 2015: HOUSEHOLD TOASTE HAS BEEN EPLACED WITH AN NSF TOASTE. 4/19/17 THE KENMOE FEEZE IS STILL PESENT. Issued on: 04/07/14 Comply By: 04/07/15-500C Microbial Control: date marking A ** Critical Item ** MN ule 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. DATE MAKING HAS IMPOVED IN THE FACILITY, MOST OF THE ITEMS THAT WEEN'T DATE MAKED AE FOODS FO CHINESE NIGHT. DISCUSSED WITH THE OWNE TALKING TO THE COOK WHO PEPAES THE CHINESE FOOD TO DATE MAK ALL EFI. AND FOZEN FOODS HELD OVE 24 HOUS. Issued on: 04/25/16 Comply By: 04/25/ Sewage ** Critical Item ** MN ule 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. DAIN LINES FOM THE ICE BIN WEE DIECTLY IN THE PVC DAIN PIPE WITHOUT A 1

2 Page 2 INCH AI GAP. COECT BY CEATING A 1 INCH AI GAP. Issued on: 04/25/16 Comply By: 07/25/ Equipment Maintenance and Operation AB MN ule 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 COOLE IS PULLING AWAY AND THE CONE OF THE DOO HAS BEEN WAPED/BOKEN. EPAI DOO TO POVIDE A GOOD SEAL. Issued on: 04/19/17 Comply By: 10/19/ Physical Facility Maintenance/Operation and Pest Control MN ule Maintain the physical facilities in good repair. STEEL PANEL BEHIND THE FYES/STOVE IS STILL OUT OF PLACE AND OWNES AE LOOKING INTO EPLACING THE BA FLOOING. Issued on: 04/19/17 Comply By: 04/20/18 The following orders were issued during this inspection Equipment Maintenance and Operation C1 ** Critical Item ** MN ule 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 DISHWASHE WAS EGISTEING 0 PPM FO CHLOINE. DISCUSSED USING THE COMPATMENT SINK TO SANITIZE DISHES UNTIL THE DISHWASHE COULD BE FIED TO DISPENSE 50 PPM. Comply By: 06/01/ Food Manager Certification MN MN ule Ensure through the State certified food manager that: 1. hazards in the day-to-day operation of the food establishment are identified; 2. policies and procedures to prevent foodborne illness are developed and implemented;. employees are trained to ensure that there is at least one trained individual present at all times food preparation activities are conducted who can demonstrate the knowledge required in the Minnesota Food Code; 4. food preparation activities are directed and corrective action is taken, as needed, to protect the health of the consumer; and 5. in-house self-inspections of daily operations are conducted on a periodic basis to ensure that food safety policies and procedures are followed. ITEMS OF THE SELF-EVALUATION EPOTS THAT SHOULD BE DONE DAILY WEE NOT BEING DONE. THE CFM NEEDS TO BE MAKING SUE THAT DAY TO DAY POLICIES AND

3 Page POCEDUES THAT PEVENT FOODBONE ILLNESS AE BEING DONE. Comply By: 06/01/17 Surface and Equipment Sanitizers Chlorine: = 0 PPM at Degrees Fahrenheit Location: DISHWASHE Violation Issued: Yes Food and Equipment Temperatures Process/Item: Cooking Temperature: 17 Degrees Fahrenheit - Location: CHICKEN BEAST Process/Item: e-heating Temperature: 119 Degrees Fahrenheit - Location: 1.5 HOUS Process/Item: Upright Cooler Temperature: 41 Degrees Fahrenheit - Location: SLICED TUKEY Process/Item: Walk-In Cooler Temperature: 6 Degrees Fahrenheit - Location: PIME IB Process/Item: Walk-In Cooler Temperature: 6 Degrees Fahrenheit - Location: GALIC MASHED POTATOES Process/Item: Upright Freezer Temperature: Degrees Fahrenheit - Location: FOODS IN ALL UPIGHT FEEZES WEE FOZEN Total Critical Orders This eport: Total Non-Critical Orders This eport: FOLLOW-UP WAS ACCOMPANIED BY OWNE PETE KILOY. 4 A ISK CONTOL PLAN WAS IMPLEMENTED TO HELP FACILITY KEEP DAY TO DAY OPEATIONS IN CHECK. THE FACILITY WAS TO FILL OUT DAILY SELF-EVALUATION EPOTS TO ENSUE THE KEY POCESSES FO THE ESTABLISHMENT WEE BEING DONE COECTLY O MEETING TIME O TEMPEATUE EQUIEMENTS. THE EPOTS WEE FILLED OUT SPOADICALLY, WITH SOME SECTIONS NOT FILLED OUT AT ALL, INCLUDING SANITIZE LEVELS, DATE MAKING CHECKS, COOKING TEMPEATUES, AND COSS CONTAMINATION PEVENTION CHECKS. DISCUSSED WITH THE OWNE THE IMPOTANCE OF MAKING SUE THESE DAILY OPEATION PACTICES AE BEING DONE COECTLY. A NEW FOM WILL BE MADE THAT IS MOE ESTABLISHMENT SPECIFIC AND WILL TY THE PLAN AGAIN. THANK YOU FO STEPS THAT HAVE BEEN TAKEN AND FEEDBACK TO HELP WITH ISK CONTOL PLANS.

4 Page 4 OVEALL DATE MAKING HAS IMPOVED, HOWEVE ESTABLISHMENT HAS A CHINESE MENU WED. AND THUS. NIGHTS, AND THE COOK THAT PEPAES THE CHINESE FOOD IS NOT DATE MAKING HIS FOODS. DISCUSSED WITH THE OWNE FINDING A WAY FO THE COOK TO DATE ALL POTENTIALLY HAZADOUS FOODS THAT AE KEPT OVE 24 HOUS AND AE EFIGEATED O FOZEN. OWNE HAS POVIDED STAFF WITH THEI OWN INDIVIDUAL WATE BOTTLE TO KEEP AT WOK TO PEVENT OPEN BEVEAGE CONTAINES FOM BEING USED IN THE KITCHEN. COOLING DOES APPEA TO BE DONE COECTLY WITHIN TIME AND TEMPEATUE EQUIEMENTS. ESTABLISHMENT USES AN ICE BATH TO COOL PODUCTS, HAS THEM IN SHALLOW METAL CONTAINE, AND PLACES IN THE WALK-IN COOLE. FOODS THAT AE E-HEATED FO HOT HOLDING AE E-HEATED IN THE ALTO SHAAM. DISCUSSED WITH OWNE THAT FOODS NEED TO EACH 165 F IN 2 HOUS. SOME ITEMS, INCLUDING FOODS LIKE THE GAVY, NEED TO BE STIED TO DISTIBUTE HEAT WHILE E-HEATING. EPOT ED TP 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 06/01/17. Certified Food Manager: Certification Number: Pete M. Kilroy FM50968 Expires: 10/27/18 Inspection report reviewed with person in charge and ed. Signed: Pete Kilroy and John Schuman Owners Signed: Callie Bursch Public Health Sanitarian Duluth District Office callie.bursch@state.mn.us

5 eport #: Minnesota Department of Health Environmental Health, FPLS P.O. Box St. Paul, MN Food Establishment No. of F/PHI Categories Out No. of epeat F/PHI Categories Out Legal Authority MN ules Chapter 4626 Address City/State Zip Code Telephone 4767 West Arrowhead oad Hermantown, MN License/Permit # Permit Holder Purpose of Inspection Est Type PK & JS Inc. Follow-Up FOODBONE ILLNESS ISK FACTOS AND PUBLIC HEALTH INTEVENTIONS Circle designated compliance status (IN, OUT, N/O, N/A) for each numbered item Date Time In Mark "" in appropriate box for and/or Time Out isk Category H IN= in compliance OUT= not in compliance N/O= not observed N/A= not applicable = corrected on-site during inspection = repeat violation Compliance Status 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 TE 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 equired 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 2 N/A in MN Consumer advisory for raw or undercooked foods GOOD ETAIL PACTICES 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 1 06/01/17 09:00:00 isk factors (F) 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 etail 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 and/or =corrected on-site during inspection = 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 5 Food properly labled; original container 6 Insects, rodents, & animals not present; no unauthorized persons N/A N/A Food ecalls: Contamination prevented during food prep, storage & display Personal cleanliness Wiping cloths: properly used & stored Washing fruits & vegetables 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 5 Physical facilities installed, maintained, & clean Adequate ventilation & lighting; designated areas used Compliance with MCIAA & Choking Poster Compliance with licensing & plan review Person in Charge (Signature) Date: 06/05/17 Inspector (Signature) Follow-up Needed: YES NO (Circle one) Follow-up Date: / /

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