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 #   MA006  
    Pre-opening
X Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  HERITAGE WOODS OF MANTENO Address  355 DIVERSATECH DR
Owner or Operator   DSI DIVERSATECH OPERATOR City   MANTENO Zip Code   60950
 
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
X
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
  
1
 Floor: constructed, drained, clean, good repair, covering installation, dustless cleaning methods
*4
  
4
 Facilities to maintain product temperature
23
 
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
  
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
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
  
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 50-100 ppm                   Dishwasher Temperature   NA °F or label
Food Temperatures:   EGG SALAD 36, HAM SALAD 37, TOMATO SOUP 38, GRAVY 40, RICE 39
 
General Comments
HACCP CONCEPTS DISCUSSED: KEEP ALL CHEMICALS LABELED WITH THE ORIGINAL NAME OF THE CHEMICAL. 
Report and Instructions Received By   BRYAN A. STANLEY /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  06/09/2015 Time In  1:30 PM Time Out  2:30 PM Sanitation Score  92 (100 Minus Demerits)
By  Steven Lamb (Sanitarian) Adjusted Score  97  
 
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 #   MA006  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  HERITAGE WOODS OF MANTENO Address  355 DIVERSATECH DR
Owner or Operator   DSI DIVERSATECH OPERATOR City   MANTENO Zip Code   60950
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
*41  Observed the following toxic chemical container(s) to not be properly labeled: There is no label on pink chemical spray bottle. Provide for all chemical containers that no longer have the original label on them to be labeled with chemical content. Corrected. 750.1300 Immediate/Onsite
21  Observed the following wiping cloth(s) to be improperly stored: Soiled wiping cloth was found on table by the microwave. Provide for all wiping cloths to be stored completely submerged in an approved sanitizer solution while not being used. 750.820 Next Inspection
22  Observed the following food contact surfaces to be unclean. 1. Interior of fryer cabinet has grease & debris on it. 2. Top of microwave has food debris on it. 3. Dish tubs have food debris in them. 4. Interior of the ice machine has mold growth on it. Clean and maintain. 750.800 Next Inspection
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Report and Instructions Received By   BRYAN A. STANLEY /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  06/09/2015 Time In  1:30 PM Time Out  2:30 PM Sanitation Score  92 (100 Minus Demerits)
By  Steven Lamb (Sanitarian) Adjusted Score  97  
 
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 #   MA006  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  HERITAGE WOODS OF MANTENO Address  355 DIVERSATECH DR
Owner or Operator   DSI DIVERSATECH OPERATOR City   MANTENO Zip Code   60950
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
Report and Instructions Received By   BRYAN A. STANLEY /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  06/09/2015 Time In  1:30 PM Time Out  2:30 PM Sanitation Score  92 (100 Minus Demerits)
By  Steven Lamb (Sanitarian) Adjusted Score  97