Page 1 of 2

    Food Service Establishment
X 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 #   KK417  
    Pre-opening
    Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
X OtherCONSULTATATION
Name of Establishment  DOLLAR GENERAL STORE #17031 Address  1895 W STATION ST
Owner or Operator   DG RETAIL, LLC City   KANKAKEE Zip Code   60901
 
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
 
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
 
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     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   NA ppm                   Dishwasher Temperature   NA °F or label
Food Temperatures:   COOLERS 38, FREEZERS 0,-10°
 
General Comments
1. MAKE SURE WHEN YOU GET A HOSE FOR THE MOP SINK IT HAS A BACKFLOW PREVENTER DEVICE ON IT. 2. MAKE SURE ALL CONSTRUCTION MATERIAL SUCH AS CARD BOARD, PAPER, PLASTIC ETC. IS REMOVED FROM FLOOR, SHELVES ETC. 3. MAKE SURE REFERRAL FORM IS FILLED OUT & COMPLETED BEFORE PRE-OPENING INSPECTIONS. 
Report and Instructions Received By   /  
 
(Please Print)
 
(Signature of Owner or Representative)
Date  09/12/2016 Time In  2:00 PM Time Out  2:55 PM Sanitation Score  NA (100 Minus Demerits)
By  Steven Lamb (Sanitarian) Adjusted Score  NA