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 #   MM025  
    Pre-opening
X Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  MOMENCE MEADOWS NURSING & REHABILITATION Address  500 S WALNUT
Owner or Operator   INFINITY HEALTHCARE City   MOMENCE Zip Code   60954
 
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
  
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
X
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
 
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
X
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
  
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
X
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
 
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
X
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
X
2
 Containers or receptacles covered: adequate number, insect/rodent proof, frequency, clean
 
      
Sanitizer Requirement:  Chemical   Chlorine 100-200 ppm                   Dishwasher Temperature   180 - label attached to report °F or label
Food Temperatures:   Puree Chicken 180; baked chicken 180+; eggs 40; milk 38-40; walk in freezer 2
 
General Comments
Haccp:discussed proper hand washing techniques when using rubber gloves.Hands should be washed before putting on gloves, changing tasks, and removing gloves.No follow up required. 
Report and Instructions Received By   Christine Gray /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  08/08/2006 Time In  9:00 AM Time Out  12:00 PM Sanitation Score  87 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  87  
 
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 #   MM025  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  MOMENCE MEADOWS NURSING & REHABILITATION Address  500 S WALNUT
Owner or Operator   INFINITY HEALTHCARE City   MOMENCE Zip Code   60954
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
9  Observed Styrofoam cup being used to dispense thickener.Provide a proper scoop with handle stored in food with handle presented.(750.160)Styrofoam cup removed. Immediate/Onsite
15  Observed the following non-food contact surfaces to be improper:1.Rust on shelves below and near steam table2.torn gaskets on walk in cooler3.torn gaskets on walk in freezer4.rust on shelves in walk in cooler5.rust on shelf in dry storage room used for salad dressing*Please repair, replace, repaint - all non-food contact surfaces must be smooth, easily cleanable and non-absorbent. (750.690) Next Inspection
16  Observed the top of the dishwasher and the 3-bay sink in need of cleaning.*Please clean (750.820/830) Immediate/Onsite
22  Observed the following the food contact surfaces in need of cleaning:*Please clean (750.800)1.meat slicer2.inside of rubber container that has mixer parts in it - located in dish washing room on lower shelf by wall Immediate/Onsite
23  Observed the following non-food contact surfaces in need of cleaning:*Please clean (750.800)1.condiment baskets on lower shelf by steam table2.front of steam table3.outside of microwave4.microwave table5.inside and out of double oven6.inside and out of ovens7.all push carts8.condiment containers by coffee pot9.outside of toaster10.shelf above meat slicer11.large plastic containers below meat slicer12.fan in dish washing room13.dish carts in dish washing room14.inside of chest freezer - facility is removing this chest freezer15.inside and out of single service containers by chest freezer16.dry storage room crates17.tops of canned goods in dry storage room18.shelf with salad dressing in dry storage room Immediate/Onsite
24  Observed clean plates on steam table and clean cups in dish washing room stored improperly.*Please store protected or inverted on a clean, dry surfaces.(750.840) Immediate/Onsite
33  Observed trash cans throughout kitchen in need of cleaning on exterior of cans.*Please clean.(750.1130) Immediate/Onsite
36  Observed the following floors in need of cleaning:1.Floor under dish machine including pipes2.walk-in cooler floor3.floor under racks in dry storage room*Please clean (750.1220) Immediate/Onsite
37  Observed the following area's in need of repair:1.ceiling by vent in dish machine area with chipped paint2.various cove base repair - in need of reattaching to wall3.broken chunk on wall by walk in cooler3.wet and moldy ceiling tile in dry storage room - replaced on site4.recaulking needed around hand sink in employee restroom*Please repair or replace (750.1210)Observed the following walls in need of cleaning:*Please clean (750.1220)1.wall by hand sink2.wall by coffee pot3.all walls in dish washing room4.wall by 3-bay sink5.door frame by hand sink6.all walls in dry storage room Immediate/Onsite
     
     
     
     
     
     
     
     
Report and Instructions Received By   Christine Gray /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  08/08/2006 Time In  9:00 AM Time Out  12:00 PM Sanitation Score  87 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  87  
 
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 #   MM025  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  MOMENCE MEADOWS NURSING & REHABILITATION Address  500 S WALNUT
Owner or Operator   INFINITY HEALTHCARE City   MOMENCE Zip Code   60954
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
     
     
     
     
Report and Instructions Received By   Christine Gray /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  08/08/2006 Time In  9:00 AM Time Out  12:00 PM Sanitation Score  87 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  87