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 #   BB063  
    Pre-opening
X Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  CIRCLE K #4700173 Address  655 N CONVENT
Owner or Operator   MAC'S CONVENIENCE STORES City   BOURBONNAIS Zip Code   60914
 
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
  
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
X
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
  
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
 
1
 Thermometers provided and conspicuous
37
  
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
X
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
X
5
 Toxic items properly stored, labeled and used
*12
  
5
 Hands washed and clean, good hygienic practices
*30
 
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
  
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
  
2
 Dishwashing facilities: designed, constructed, maintained, installed, located, operated
*45
     Management personnel certified Yes X 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   Quat 300 ppm                   Dishwasher Temperature   xxx °F or label
Food Temperatures:   Milk: 39°, Freezer: 0°
 
General Comments
A follow-up inspection will occur in approximately 30 days. 
Report and Instructions Received By   Jackie Dean /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  12/22/2005 Time In  12:00 PM Time Out  12:50 AM Sanitation Score  85 (100 Minus Demerits)
By  Sean Guimond (Sanitarian) Adjusted Score  85  
 
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 #   BB063  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  CIRCLE K #4700173 Address  655 N CONVENT
Owner or Operator   MAC'S CONVENIENCE STORES City   BOURBONNAIS Zip Code   60914
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
*35  Observed the following outer openings to be improperly protected: 1. front door does not close properly 2. air gap at the bottom of the front door 3. air gap at the door by the car wash, bottom Provide for all openings that lead to the outside to be self closing and tight-fitting. (750.1170) 30 Days
*41  Observed cleaning chemicals being stored next to and above single service articles in the retail area. Provide for all food, equipment, utensils and single service to be stored either above or completely separate from all toxic chemicals. (750.1310) 30 Days
8  Observed boxes of pop, tea, and a container of milk on the floor in the walk-in cooler. Provide for all products to be stored at least 6" off of the floor. (750.130) Next Inspection
15  Observed the following improper non-food contact surfaces: 1. particle board shelves 2. door gasket on the walk-in cooler is torn 3. shelf paper on several shelves 4. door gaskets on the water and Gatorade coolers are torn 5. metal strip is coming off of several of the cooler door frames 6. towel lining a shelf with coffee cups 7. coffee lid holder is cracked 8. towel lining the shelf with Vanilla syrup Provide for all non-food contact surfaces to be smooth, easily cleanable, and nonabsorbent. (750.690) Next Inspection
21  Observed a wiping cloth hanging out of an employees pocket and in a holder in one of the coffee station cabinets. Provide for all wiping cloths to be stored completely submerged in an approved sanitizer solution when not being used. (750.810) Next Inspection
23  Clean the pringles display. (750.800) Next Inspection
38  Provide an end cap on the light shield in the food cooler. (750.1240) Next Inspection
43   
     
     
     
     
     
     
     
     
     
     
     
Report and Instructions Received By   Jackie Dean /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  12/22/2005 Time In  12:00 PM Time Out  12:50 AM Sanitation Score  85 (100 Minus Demerits)
By  Sean Guimond (Sanitarian) Adjusted Score  85  
 
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 #   BB063  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  CIRCLE K #4700173 Address  655 N CONVENT
Owner or Operator   MAC'S CONVENIENCE STORES City   BOURBONNAIS Zip Code   60914
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
     
     
Report and Instructions Received By   Jackie Dean /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  12/22/2005 Time In  12:00 PM Time Out  12:50 AM Sanitation Score  85 (100 Minus Demerits)
By  Sean Guimond (Sanitarian) Adjusted Score  85