Food and Beverage Establishment Inspection Report
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1 Date: Time: Report: 02/16/17 11:37: Minnesota Department of Health Food, Pools and Lodging Services Section P.O. Box St. Paul, MN Page 1 Location: 420 East 1st Street Duluth, MN55805 St. Louis County, 69 Establishment Info: ID #: Risk: Medium Announced Inspection: No License Categories: HOSP, FBLB, FBME Operator: SMDC Health System 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 08/18/15 have NOT been corrected Equipment Design and Construction MN Rule Provide non-food contact surfaces that are free of unnecessary ledges, projections and crevices and are designed and constructed to allow easy cleaning. The counter tops for the serving line need repair. If the laminate edging can not be repaired the counter tops must be replaced. Call for approved surfaces before replacing. Issued on: 08/18/15 Comply By: 08/18/ Physical Facility Numbers and Capacities B MN Rule Provide and maintain a fingernail brush at the handwashing sink used by employees. Provide a nailbrush at the main kitchen sink so staff use it the first time they wash their hands at the start of their shift. Issued on: 08/18/15 Comply By: 08/18/15 The following orders were issued during this inspection Food Manager Certification MN MN Rule Employ one full-time State certified food manager for the establishment. Jon has taken the course but needs to register with MDH. The application information will be ed with the report. Comply By: 03/16/17
2 Page E Microbial Control: time as a control EZ Other: Time as a control will now be used for the salad/yogurt/cold line. All food must be logged temp and time and discarded after 4 hours above 41F. Comply By: 02/16/17 Surface and Equipment Sanitizers Hot Water: = at 189 Degrees Fahrenheit Location: 3 Compartment sink Quaternary Ammonia: = 400 ppm at Degrees Fahrenheit Location: Spray bottle Hot Water: = at 161 Degrees Fahrenheit Location: Dish machine wash Hot Water: = at 183 Degrees Fahrenheit Location: Dish machine rinse Food and Equipment Temperatures Process/Item: Time/Temp Temperature: 44 Degrees Fahrenheit - Location: Watermelon 20 minutes Process/Item: Time/Temp Temperature: 48 Degrees Fahrenheit - Location: Blackberry salad 20 minutes Process/Item: Time/Temp Temperature: 46 Degrees Fahrenheit - Location: Garden salad 20 minutes Process/Item: Display Case Temperature: 35 Degrees Fahrenheit - Location: Egg salad sandwiches Process/Item: Display Case Temperature: 38 Degrees Fahrenheit - Location: Salami sandwich Process/Item: Display Case Temperature: 38 Degrees Fahrenheit - Location: to go salads
3 Page 3 Temperature: 35 Degrees Fahrenheit - Location: Sausage Temperature: 37 Degrees Fahrenheit - Location: Roasted tomatoes Temperature: 40 Degrees Fahrenheit - Location: Bottom-red peppers diced Temperature: 36 Degrees Fahrenheit - Location: Ham Temperature: 38 Degrees Fahrenheit - Location: Precooked chicken strips Temperature: 36 Degrees Fahrenheit - Location: Lettuce Temperature: 36 Degrees Fahrenheit - Location: Milk Temperature: 36 Degrees Fahrenheit - Location: Victory 4 door-salad dressing Temperature: 36 Degrees Fahrenheit - Location: Hard boiled eggs Process/Item: Under Counter Cooler Temperature: 40 Degrees Fahrenheit - Location: Bev air-cherry tomatoes Temperature: 45 Degrees Fahrenheit - Location: Grill-whole cherry tomatoes, 10 minutes Temperature: 48 Degrees Fahrenheit - Location: Hard boiled eggs,10 minutes Temperature: 40 Degrees Fahrenheit - Location: Bottom-lettuce
4 Page 4 Temperature: 40 Degrees Fahrenheit - Location: Victory-buttermilk Process/Item: Cooling Temperature: 46 Degrees Fahrenheit - Location: Breakfast sausage 45 minutes Temperature: 40 Degrees Fahrenheit - Location: Eggs Process/Item: Re-Heating Temperature: 189 Degrees Fahrenheit - Location: Chili Process/Item: Cooking Temperature: 167 Degrees Fahrenheit - Location: Chicken breasts Process/Item: Cooking Temperature: 172 Degrees Fahrenheit - Location: Turkey stir fry Temperature: 40 Degrees Fahrenheit - Location: Victory catering-salads Temperature: 40 Degrees Fahrenheit - Location: Sandwiches Process/Item: Beverage Cooler Temperature: 38 Degrees Fahrenheit - Location: Milk cartons Total Critical Orders This Report: Total Non-Critical Orders This Report: Notes 1. The grill prep table was just filled with ambient temperature tomatoes and black olives. This rose the temperature of the hard boiled eggs. The unit will be monitored to ensure all items are 41F or below within 4 hours. 2. Information on how to apply for the CFM will be ed with the report. 3. Example time as a control logs will be ed with the report. All temps/times must be recorded for the cold buffet line. 4. Discussed employee illness and excluding workers with vomiting and/or diarrhea for 24 hours after symptoms stop. 0 4
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. Certified Food Manager: I acknowledge receipt of the Minnesota Department of Health inspection report number of 02/16/17. Certification Number: Expires: / / Signed: Establishment Representative Signed: Sara Bents Environmental Health Specialist Duluth sara.bents@state.mn.us
6 Report #: Minnesota Department of Health Food, Pools and Lodging Services Section 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 420 East 1st Street Duluth, MN License/Permit # Permit Holder Purpose of Inspection Est Type SMDC Health System 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 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 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 X 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 /16/17 11:37:07 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 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 X 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 X Person in Charge (Signature) Date: 02/16/17 Inspector (Signature) Follow-up Needed: YES NO (Circle one) Follow-up Date: / /
Food and Beverage Establishment Inspection Report
Date: Time: eport: 21:15:30 7980171021 Minnesota Department of Health Food, Pools and Lodging Services Section P.O. Box 64975 St. Paul, MN 55164-0975 651-201-4500 Page 1 Location: 520 East 4th Street Duluth,
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Date: Time: Report: 08/31/17 15:00:00 8010171140 Minnesota Department of Health Food, Pools & Lodging Services Section PO Box 64975 St. Paul, MN 55164-0975 651-201-4500 Page 1 Location: 5135 North Shore
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Date: Time: Report: 03/30/17 14:50:35 7980171045 Minnesota Department of Health Food, Pools and Lodging Services Section P.O. Box 64975 St. Paul, MN 55164-0975 651-201-4500 Page 1 Location: 231 East Superior
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Date: Time: eport: 08/10/17 10:00:00 8010171131 Minnesota Department of Health Food, Pools & Lodging Services Section PO Box 64975 St. Paul, MN 55164-0975 651-201-4500 Page 1 Location: 428 N Central Avenue
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