Page 1 of 3

X 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 #   HP008  
    Pre-opening
X Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  LORENZO R SMITH SCHOOL Address  4120 S WHEELER RD
Owner or Operator   PEMBROKE COMMUNITY CONSOLIDATED SCHOOL DISTRICT #259 City   PEMBROKE TWP. Zip Code   60958
 
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
  
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
 
1
 Thermometers provided and conspicuous
37
X
1
 Walls, ceiling, attached equipment: constructed good repair, clean surfaces, dustless cleaning methods
6
X
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
  
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
 
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
X
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   CHLORINE 0* ppm                   Dishwasher Temperature   180F *SEE LABEL ON REPORT IN FILE °F or label
Food Temperatures:   BROCOLI 0, 140; RICE 190; BEEF 200°+; MILK 27-41; CHICKEN 0, 34-39; CHEESE 37; PANCAKES 0; LUNCH MEAT 40
 
General Comments
HACCP: DISCUSSED HAVING SANITIZER SET UP AT ALL TIMES.

NO FOLLOW UP REQUIRED. 
Report and Instructions Received By   DONALD /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/01/2013 Time In  10:30 AM Time Out  11:30 AM Sanitation Score  88 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  92  
 
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 #   HP008  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  LORENZO R SMITH SCHOOL Address  4120 S WHEELER RD
Owner or Operator   PEMBROKE COMMUNITY CONSOLIDATED SCHOOL DISTRICT #259 City   PEMBROKE TWP. Zip Code   60958
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
*20  OBSERVED THE FACILITY TO BE ENGAGED IN FOOD OPERATIONS WITHOUT HAVING A PROPERLY MIXED SANITIZER SOLUTION AVAILABLE. PROVIDE FOR A PROPERLY MIXED SANITIZER SOLUTION TO BE AVAILABLE DURING ALL FOOD PREPARATION/SERVICE HOURS. (750.830) IMMEDIATE/ONSITE
6  OBSERVED THE FOLLOWING POTENTIALLY HAZARDOUS FOODS TO BE IMPROPERLY THAWED: 1) RAW CHICKEN ON COUNTER IN BACK. PROVIDE FOR ALL POTENTIALLY HAZARDOUS FOODS TO BE PROPERLY THAWED IN ONE OF THE FOLLOWING WAYS: 1) IN A REFRIGERATOR UNIT IN A WAY THAT THE TEMPERATURE DOE NOT EXCEED 41°F 2) UNDER POTABLE RUNNING WATER AT A TEMPERATURE OF 70°F OR BELOW 3) IN A MICROWAVE OVEN ONLY WHEN IT IS A PART OF THE COOKING PROCESS 4) AS A PART OF THE CONVENTIONAL COOKING PROCESS. RAW CHICKEN PLACED BACK IN COOLER. (750.120) NEXT INSPECTION
15  OBSERVED THE FOLLOWING IMPROPER NON-FOOD CONTACT SURFACES: 1) RUST ON RACKS OF 3-DOOR FREEZER IN BACK, 2) PEELING PAINT ON INSIDE OF 2-DOOR FREEZER IN BACK, 3) RUST ON PLATE TO TABLE TOP CAN OPENER IN BACK. PROVIDE FOR ALL FOOD CONTACT SURFACES TO BE SMOOTH, EASILY CLEANABLE, NON-ABSORBANT, CORROSIVE RESISTANT, AND LIGHT COLORED. (750.690) NEXT INSPECTION
23  OBSERVED THE FOLLOWING CONTACT SURFACES TO BE UNCLEAN: 1) GASKETS OF MILK COOLERS, 2) CAN RACKS IN BACK ROOM. CLEAN. (750.800) NEXT INSPECTION
32  OBSERVED THE FOLLOWING VESTIBULE(S) AND/OR TOILET FACILITIES TO BE UNCLEAN: 1) TOILET AND HAND SINK. PROVIDE FOR ALL VESTIBULES AND/OR TOILET FACILITIES TO BE KEPT CLEAN AND IN GOOD REPAIR AND FREE FROM OBJECTIBLE ODORS. (750.1130) NEXT INSPECTION
36  OBSERVED THE FOLLOWING FLOOR AREAS TO BE UNCLEAN: 1) WALK IN FREEZER FLOOR. PROVIDE FOR ALL FLOORING AREAS TO BE IN A CLEAN CONDITION. (750.1220) OBSERVED THE FOLLOWING FLOOR AREAS TO BE IN POOR REPAIR: 1) RUST ON FLOOR TO WALK IN COOLER, 2) CHIPPED/MISSING FLOOR TILES IN BACK ROOM. PROVIDE FOR ALL FLOORING AREAS TO BE SMOOTH, EASILY CLEANABLE, NON-ABSORBENT, DURABLE SURFACES, AND BE MAINTAINED IN GOOD REPAIR. (750.1200) NEXT INSPECTION
37  OBSERVED THE FOLLOWING WALL/CEILINGS AREA(S) TO BE IN POOR REPAIR: 1) SCREEN TO SCREEN DOOR IN NEED OF REPAIR. PROVIDE FOR ALL WALLS AND CEILINGS TO BE SMOOTH, EASILY CLEANABLE, NON-ABSORBENT, DURABLE, AND LIGHT COLORED AND BE MAINTAINED IN GOOD REPAIR. (750.1210) NEXT INSPECTION
     
     
     
     
     
     
     
     
     
     
Report and Instructions Received By   DONALD /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/01/2013 Time In  10:30 AM Time Out  11:30 AM Sanitation Score  88 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  92  
 
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 #   HP008  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  LORENZO R SMITH SCHOOL Address  4120 S WHEELER RD
Owner or Operator   PEMBROKE COMMUNITY CONSOLIDATED SCHOOL DISTRICT #259 City   PEMBROKE TWP. Zip Code   60958
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
     
     
     
     
Report and Instructions Received By   DONALD /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/01/2013 Time In  10:30 AM Time Out  11:30 AM Sanitation Score  88 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  92