Page 1 of 3

    Food Service Establishment
    Retail Food Store
    Temporary
    Mobile
KANKAKEE COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH
2390 W. STATION STREET
KANKAKEE, IL 60901
(815) 802-9410, (815) 802-9411 (FAX)

FOOD SERVICE SANITARY INSPECTION REPORT
 Establishment #   HP010  
    Pre-opening
X Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  PEMBROKE KOGER SENIOR CENTER Address  4019 WHEELER RD
Owner or Operator   PEMBROKE TOWNSHIP City   HOPKINS PARK Zip Code   60944
 
ITEM
X
WT
DESCRIPTION
ITEM
X
WT
DESCRIPTION
ITEM
X
WT
DESCRIPTION
 
FOOD
18
 
1
 Pre-flushed, scraped, soaked
34
  
1
 Outside storage area, enclosures properly constructed, clean: controlled incineration
*1
  
5
 Source, Wholesome, No Spoilage
19
  
2
 Wash, rinse after: clean, proper temperature
2
  
1
 Original Container, Properly Labeled
*20
X
4
 Sanitization rinse: Clean, temperature, concentration   INSECT, RODENT ANIMAL CONTROL
 
FOOD PROTECTION
*35
X
4
 Presence of insects/rodents - outer openings protected; no birds, turtles, or other animals
*3
  
5
 Potentially hazardous food meets temperature requirements during storage, preparation, display, service and transportation
21
  
1
 Wiping cloths: clean, use restricted
22
  
2
 Food contact surfaces of equipment and utensils clean, free of abrasives and detergents  
FLOORS WALLS AND CEILINGS
36
X
1
 Floor: constructed, drained, clean, good repair, covering installation, dustless cleaning methods
*4
  
4
 Facilities to maintain product temperature
23
X
1
 Non-food contact surfaces of equipment and utensils clean
5
X
1
 Thermometers provided and conspicuous
37
X
1
 Walls, ceiling, attached equipment: constructed good repair, clean surfaces, dustless cleaning methods
6
 
2
 Potentially hazardous food properly thawed
24
  
1
 Storage, handling of clean equipment utensils
*7
  
4
 Unwrapped and potentially hazardous food not re-served, Cross Contamination
25
  
1
 Single-service articles, storage, dispensing  
LIGHTING
26
  
2
 No re-use of single-service articles
38
X
1
 Lighting provided as required - Fixtures shielded
8
  
2
 Food protection during storage, preparation, display, service and transportation  
WATER
  
VENTILATION
*27
 
5
 Water source, safe: Hot and cold under pressure
39
  
1
 Rooms and equipment - vented as required
9
  
2
 Handling of food(ice) minimized, methods  
SEWAGE
  
DRESSING ROOMS
10
  
1
 Food(ice) dispensing utensils properly stored
*28
  
4
 Sewage and waste water disposal
40
  
1
 Rooms clean, lockers provided, facilities clean
 
PERSONNEL
  
PLUMBING
  
OTHER OPERATIONS
*11
  
5
 Personnel with infections restricted
29
  
1
 Installed, maintained
*41
  
5
 Toxic items properly stored, labeled and used
*12
  
5
 Hands washed and clean, good hygienic practices
*30
X
5
 Cross-connection, back siphonage-backflow
42
  
1
 Premises: maintained, free of litter, unnecessary articles, cleaning/maintenance equipment properly stored, authorized personnel
13
  
1
Clean clothes, hair restraints
  
TOILET AND HAND-WASHING FACILITIES
 
FOOD EQUIPMENT AND UTENSILS
14
X
2
 Food (ice) contact surfaces: designed, constructed, maintained, installed, located
*31
  
4
 Number, convenient, accessible, designed, installed
43
  
1
 Complete separation from living/sleeping quarters, laundry
32
 
2
 Toilet rooms enclosed, self-closing doors, fixtures, good repair, clean: Hand cleanser, sanitary towels/hand drying devices provided. Proper waste receptacles, tissue
15
X
1
 Non-food (ice) contact surfaces: designed, constructed, maintained, installed, located.
44
  
1
 Clean, soiled linen properly stored
 
CERTIFIED PERSONNEL
16
X
2
 Dishwashing facilities: designed, constructed, maintained, installed, located, operated
*45
     Management personnel certified Yes     No     Registered for class    
 
GARBAGE AND REFUSE DIPSOSAL
17
  
1
 Accurate thermometers, chemical test kits provided, gauge cook
33
  
2
 Containers or receptacles covered: adequate number, insect/rodent proof, frequency, clean
 
      
Sanitizer Requirement:  Chemical   ppm                   Dishwasher Temperature   °F or label
Food Temperatures:   polish sausage 14; fish 22; hot dogs 22
 
General Comments
 
Report and Instructions Received By   Corine Noble /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  07/28/2005 Time In  11:30 AM Time Out  12:30 PM Sanitation Score  77 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  100  
 
Page 2 of 3

    Food Service Establishment
    Retail Food Store
    Temporary
    Mobile
KANKAKEE COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH
2390 W. STATION STREET
KANKAKEE, IL 60901
(815) 802-9410, (815) 802-9411 (FAX)

FOOD SERVICE SANITARY INSPECTION REPORT
 Establishment #   HP010  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  PEMBROKE KOGER SENIOR CENTER Address  4019 WHEELER RD
Owner or Operator   PEMBROKE TOWNSHIP City   HOPKINS PARK Zip Code   60944
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
*20  Observed dish machine not working. (750.820) *Please repair.  
*30  Observed spray gun hanging below rim of dump sink. (750.1080) *please make sure spray gun is above rim of dump sink.  
*35  Observed air gap on bottom of door in dining room and back door has panels missing. (750.830i) *Please provide tight fitting doors and panels.  
5  Observed all three chest freezers and the storage room refrigerator to not have thermometers. (750.140) *Please provide accurate, conspicuous thermometers.  
14  Observed rusty cooking pans; cutting board and food strainer in poor condition. Repair or replace (750.600)  
15  Observed the following improper non-food contact surfaces: (750.690) Repair or replace 1. rusty chemical shelf 2. recaulk the steam table rim, caulk is missing 3. storage room shelves have rusty posts 4. bottom of freezer in storage area is rusty.  
16  Observed dish machine in need of cleaning. (750.830) *Please clean.  
23  Observed the following non-food contact surfaces in need of cleaning: (750.800) *Please clean 1. outside of drawers 2. can opener gear 3. chemical rack 4. slide tracks of the prep table doors 5. wooden cabinet 6. gasket on chest freezer 7. upright freezer 8. floor fans 9. door gaskets on the storage room chest freezers.  
36  Observed missing floor tile by refrigerator. (750.1200) *Please replace. (750.1200) Observed floor in storage room in need of cleaning. (750.1220) *Please clean.  
37  Observed vent in men's restroom in need of cleaning. *Please clean. (750.1220)  
38  Observed light shield in store room not on properly. *Please fix. Observed no light shield in back store room lights. *Please provide. (750.1240)  
     
     
     
     
     
     
     
     
     
     
Report and Instructions Received By   Corine Noble /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  07/28/2005 Time In  11:30 AM Time Out  12:30 PM Sanitation Score  77 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score    
 
Page 3 of 3

    Food Service Establishment
    Retail Food Store
    Temporary
    Mobile
KANKAKEE COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH
2390 W. STATION STREET
KANKAKEE, IL 60901
(815) 802-9410, (815) 802-9411 (FAX)

FOOD SERVICE SANITARY INSPECTION REPORT
 Establishment #   HP010  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  PEMBROKE KOGER SENIOR CENTER Address  4019 WHEELER RD
Owner or Operator   PEMBROKE TOWNSHIP City   HOPKINS PARK Zip Code   60944
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
Report and Instructions Received By   Corine Noble /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  07/28/2005 Time In  11:30 AM Time Out  12:30 PM Sanitation Score  77 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score