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 #   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
X
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
  
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
X
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
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
  
2
 Containers or receptacles covered: adequate number, insect/rodent proof, frequency, clean
 
      
Sanitizer Requirement:  Chemical   QUAT 50-100 ppm                   Dishwasher Temperature   180F - LABEL ON REPORT °F or label
Food Temperatures:   BURGERS 160; CORN 160; HAM 0, 41; MILK 40
 
General Comments
HACCP CONCEPT DISCUSSED: KEEPING ALL PERSONAL BEVERAGES OUT OF KITCHEN AND ONLY IN BREAK ROOM OR DESIGNATED NON-FOOD NON FOOD STORAGE AREAS.

NO FOLLOW UP REQUIRED. 
Report and Instructions Received By   WHITNEY /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  08/28/2014 Time In  10:00 AM Time Out  11:15 AM Sanitation Score  83 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  88  
 
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
*12  OBSERVED EMPLOYEES DRINKS/DRINKING IN THE FOLLOWING LOCATION(S): 1) OPEN DRINK ON SHELF BELOW COUNTER WITH SINGLE SERVICE ITEMS AT FRONT COUNTER, 2) OPEN DRINK ON SHELVES WITH CLEAN PITCHERS IN BACK HALLWAY. THE CONSUMPTION OF FOOD/DRINK SHALL BE DONE IN A DESIGNATED AREA ONLY THAT IS SEPARATE FROM ALL COOKING, PREPPING OF FOOD; ALL AREAS THAT ARE USED FOR STORAGE OF FOOD EQUIPMENT AND SINGLE SERVICE ITEMS. DRINKS DISCARDED; EMPLOYEES INFORMED. (750.510) IMMEDIATE/ONSITE
15  OBSERVED THE FOLLOWING IMPROPER NON-FOOD CONTACT SURFACES: 1) CHIPPED PAINT ON METAL SHELVING IN FRONT COUNTER/SERVING AREA, 2) RUST ON RACKS IN CORNER AT FRONT SERVING AREA, 3) RUST ON RACKS IN 3-BAY AREA, 4) RUST ON RACKS WHERE CLEAN PITCHERS ARE STORED IN BACK HALLWAY, 5) RUST ON CHEMICAL STORAGE SHELVES IN UTILITY CLOSET, 6) RUST ON WIRE RACKS IN DRY STORAGE - SEVERAL RACKS ARE IN POOR CONDITION, 7) CARDBOARD USED AS LINER ON WIRE RACK IN BACK WHERE OATMEAL IS KEPT. PROVIDE FOR ALL FOOD CONTACT SURFACES TO BE SMOOTH, EASILY CLEANABLE, NON-ABSORBANT, CORROSIVE RESISTANT, AND LIGHT COLORED. (750.690) NEXT INSPECTION
16  OBSERVED EXTERIOR OF MECHANICAL DISH WASHING MACHINE TO BE IN POOR REPAIR, I.E. HEAVY LIME BUILD UP, LOWER PANEL BROKEN; EXTERIOR, LOWER PART OF DOORS ARE DIRTY. PROVIDE FOR THE DISH WASHING FACILITIES TO BE THOROUGHLY CLEANED AT LEAST ONCE DAILY AND PRIOR TO USE; REPAIRED AS NEEDED. ALSO, THE FACILITIES SHALL BE DE-LIMED AS NECESSARY. (750.830) NEXT INSPECTION
22  OBSERVED THE FOLLOWING FOOD CONTACT SURFACES TO BE UNCLEAN: 1) TABLE TOP CAN OPENER AROUND BLADE. CLEAN. (750.800) NEXT INSPECTION
23  OBSERVED THE FOLLOWING NON-FOOD CONTACT SURFACES TO BE UNCLEAN: 1) KITCHEN POT HOLDERS, 2) BOX FAN IN DRY GOOD STORAGE ROOM. CLEAN. (750.800) NEXT INSPECTION
24  OBSERVED CLEANED AND SANITIZED EQUIPMENT TO BE HANDLED IN A MANNER THAT IS CONDUSIVE TO CAUSING CONTAMINATION: 1) CLEAN UTENSILS IN 3-BAY AREA STORED UNCOVERED AND IN DIFFERENT DIRECTIONS. CLEANED AND SANITIZED EQUIPMENT AND UTENSILS SHALL BE HANDLED IN A WAY THAT PROTECTS THEM FROM CONTAMINATION. STORE IN ONE DIRECTION AND COVERED. (750.850) NEXT INSPECTION
32  OBSERVED THE FOLLOWING VESTIBULE(S) AND/OR TOILET FACILITIES TO BE UNCLEAN: 1) RESTROOMS FAUCETS. PROVIDE FOR ALL VESTIBULES AND/OR TOILET FACILITIES TO BE KEPT CLEAN AND IN GOOD REPAIR AND FREE FROM OBJECTIBLE ODORS. (750.1120) NEXT INSPECTION
34  OBSERVED THE DUMPSTER AREA TO BE UNCLEAN. PROVIDE FOR THE DUMPSTER AREA TO BE KEPT CLEAN SO AS TO NOT BE AN ATTACTIVE NUISANCE. (750.1130) OBSERVED THE DUMPSTER TO BE ON THE FOLLOWING IMPROPER SURFACE: 1) ONE DUMPSTER IS HALF ON THE GRASS AND HALF ON ASPHALT. PROVIDE FOR THE DUMPSTER OR REFUSE AREA TO BE ON A SMOOTH SURFACE CONSTRUCTED OF A NON-ABSORBENT MATERIAL, SUCH AS CONCRETE OR MACHINE-LAID ASPHALT. (750.1130) NEXT INSPECTION
36  OBSERVED THE FOLLOWING FLOOR AREAS TO BE IN POOR REPAIR: 1) BROKEN FLOOR TILE UNDERNEATH LARGE ICE MACHINE AT FRONT ENTRANCE TO KITCHEN, 2) BROKEN/NO FLOOR TILE UNDERNEATH 3-BAY SINK. 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) STAINED CEILING TILE IN DRY STORAGE ROOM. 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   WHITNEY /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  08/28/2014 Time In  10:00 AM Time Out  11:15 AM Sanitation Score  83 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  88  
 
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   WHITNEY /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  08/28/2014 Time In  10:00 AM Time Out  11:15 AM Sanitation Score  83 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  88