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: Report: 11/01/17 11:16: Page 1 Location: 2202 Mountain Shadow Drive Duluth, MN55811 St. Louis County, 69 Establishment Info: ID #: Risk: High Announced Inspection: No License Categories: FBLB, HOSP, FBC3, FBME Operator: Broman Enterprises 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 on 09/27/16 have NOT been corrected B Protection from Contamination: cross-contamination, eggs MN Rule Properly label all working containers holding food or food ingredients with the common name of the food. LABEL THE LARGE BINS CONTAINING DRY INGREDIENTS (EG. "FLOUR"). REPEAT Issued on: 09/27/16 Comply By: 09/28/16 The following orders were issued during this inspection Personal Cleanliness ** Critical Item ** MN Rule Food employees must thoroughly wash their hands and exposed portions of their arms: 1. before beginning or returning to work; 2. after touching body parts other than clean hands and clean, exposed portions of arms, after defecating, after contacting body fluids and discharges, after handling waste containing fecal matter, body fluids, or body discharges; 3. after using the toilet, at a handwash sink, in the toilet room; 4. after caring for, or handling support animals; 5. after coughing, sneezing, or using a handkerchief or disposable tissue; 6. after using tobacco, eating, or drinking; 7. after handling soiled equipment or utensils; 8. immediately before engaging in food preparation in the food preparation area; 9. during food preparation, as often as necessary to remove soil and contamination and to prevent cross-contamination when changing tasks; 10. when switching between working with raw foods and working with ready-to-eat foods; or
2 Page after engaging in other activities that contaminate the hands. OBSERVED EMPLOYEE HANDLING CLEAN DISHES WITHOUT WASHING THEIR HANDS AFTER HANDLING SOILED DISHES. ENSURE EMPLOYEES ARE WASHING HANDS IN BETWEEN CHANGING TASKS. Comply By: 11/01/ C Protection from Contamination: equipment/utensils, consumers A MN Rule Single-use gloves must be used for only one task and be discarded when damaged or soiled, or when interruptions occur in the operation. OBSERVED EMPLOYEES TOUCHING SPATULAS AND THEN DIRECTLY HANDLING READY-TO-EAT ITEMS SUCH AS TOAST. Comply By: 11/01/ C Plumbing: Maintenance, fixture location MN Rule Maintain access to the handwashing sinks at all times and do not use for other purposes other than handwashing. HANDWASHING SINK NEAR WALK IN COOLER IS BLOCKED WITH CHAIRS AND AN ICE BIN. Comply By: 11/01/17 Surface and Equipment Sanitizers Chlorine: > 100 ppm at Degrees Fahrenheit Location: Dishwasher Quaternary Ammonia: = 400ppm at Degrees Fahrenheit Location: ice cream area Quaternary Ammonia: = 400 ppm at Degrees Fahrenheit Location: kitchen Food and Equipment Temperatures Temperature: 159 Degrees Fahrenheit - Location: Cayenne warmer - gravy Temperature: 160 Degrees Fahrenheit - Location: Wells warmer - mashed potatoes Temperature: 189 Degrees Fahrenheit - Location: Cayenne #2 - soup
3 Page 3 Temperature: 189 Degrees Fahrenheit - Location: Cayenne #2 - tomato soup Temperature: 147 Degrees Fahrenheit - Location: kitchen line - gravy Temperature: 145 Degrees Fahrenheit - Location: kitchen line - holandaise Process/Item: cold holding Temperature: 40 Degrees Fahrenheit - Location: True - cooked chicken Temperature: 43 Degrees Fahrenheit - Location: lunchmeat Temperature: 43 Degrees Fahrenheit - Location: Turbo Air - chicken Process/Item: Cooling Temperature: 41 Degrees Fahrenheit - Location: freezer - chili Temperature: 38 Degrees Fahrenheit - Location: milk fridge - milk Temperature: 38 Degrees Fahrenheit - Location: salad station - cranberries Temperature: 37 Degrees Fahrenheit - Location: salad station - tarter sauce Temperature: 36 Degrees Fahrenheit - Location: True - bottom - ham salad Process/Item: Cooking Temperature: 185 Degrees Fahrenheit - Location: eggs Temperature: 185 Degrees Fahrenheit - Location: flat top - onions
4 Page 4 Process/Item: Walk-In Cooler Temperature: 37 Degrees Fahrenheit - Location: sausage Process/Item: Walk-In Cooler Temperature: 36 Degrees Fahrenheit - Location: par cooked chicken Process/Item: Prep Cooler Temperature: 40 Degrees Fahrenheit - Location: sundae station - milk COMMENTS: Total Critical Orders This Report: Total Non-Critical Orders This Report: 1 3 EGG SALAD AND HAM SALAD CONTAINERS IN PREP FRIDGE WERE VERY FULL. PREP LESS PRODUCT, MORE OFTEN. DOORWAY TO WALK-IN FREEZER IS IN DISREPAIR. PLEASE LOOK INTO COVERING EXPOSED INSULATION AND WOOD. DISCUSSED COOLING PROCEDURES WITH J. BROMAN. WILL FACT SHEET. DISCUSSED THE EMPLOYEE ILLNESS POLICY AND THE EXCLUSION OF EMPLOYEES SICK WITH SYMPTONS OF VOMITING AND/OR DIARRHEA UNTIL 24 HOURS AFTER THEIR LAST SYMPTON. ALSO CONTACT THE DEPARTMENT OF HEALTH IF ANY EMPLOYESS ARE DIAGNOSED WITH SALMONELLA, SHIGELLA, HEPATITIS A., OR E COLI OR IF THERE ARE ANY CUSTOMER ILLNESS COMPLAINTS. DISCUSSED THE IMPORTANCE OF FREQUENT HAND WASHING BY ALL STAFF, AS WELL AS LIMITING BARE HAND CONTACT WITH ALL READY TO EAT FOODS. STAFF HAVE GLOVES AVAILABLE. USE GLOVES WITH ALL READY TO EAT FOODS AND CHANGE GLOVES FREQUENTLY AND ANY TIME TASK ARE CHANGED.
5 Page 5 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 11/01/17. Certified Food Manager: Certification Number: Wayne A. Wennberg FM81487 Expires: 12/01/18 Signed: Jay Broman Signed: Clifford LaVigne Environmental Health Specialist
6 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 2202 Mountain Shadow Drive Duluth, MN License/Permit # Permit Holder Purpose of Inspection Est Type Broman Enterprises 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 "X" 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 /01/17 11:16:47 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 "X" in box if numbered item is not in compliance Mark "X" 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 34 Thermometers provided and accurate Food Protection 35 X 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 X 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 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: 11/02/17 Inspector (Signature) Follow-up Needed: YES NO (Circle one) Follow-up Date: / /
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