Page 1 of 3

    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 #   SA030  
    Pre-opening
X Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  DOLLAR GENERAL STORE #13404 Address  171 W DIXIE HWY
Owner or Operator   DG CORPORATION City   SAINT ANNE Zip Code   60964
 
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
X
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
X
1
 Non-food contact surfaces of equipment and utensils clean
5
X
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
X
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 <41 FREEZERS HOLDING FROZEN
 
General Comments
HACCP: ENSURE TEMPERATURE CONTROL FOR SAFETY FOODS ARE MONITORED TO BE MAINTAINED BELOW 41 DEGREES 
Report and Instructions Received By   /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/17/2018 Time In  11:30 AM Time Out  12:30 PM Sanitation Score  92 (100 Minus Demerits)
By  Ryan Wheeler (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 #   SA030  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  DOLLAR GENERAL STORE #13404 Address  171 W DIXIE HWY
Owner or Operator   DG CORPORATION City   SAINT ANNE Zip Code   60964
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
*1  Observed the following food containers to be damaged to the extent in which the food product inside may be compromised
1.CANS FOUND TO BE SEVERELY DENTED ON SHELVES
Provide for all food products that have been compromised due to container damage to be either returned to supplier or destroyed		 Immediate/Onsite
*35  1. TRAPS NEED EMPTIED OF DEAD RODENTS. 2. THE INACCESSIBILITY OF MOST OF THE BACK ROOM MAY CONTRIBUTE TO THE HARBORAGE OF RODENTS AND OTHER PESTS. Next Inspection
5  Observed no thermometer to be available in the following units 1. RETAIL COOLER CONTAINING DELI MEAT NEEDS THERMOMETER
Provide for an accurate, conspicuous thermometer, that is accurate within +/- 3°F, to be available in all units holding potentially hazardous foods		 Next Inspection
23  observed the following contact surfaces to be unclean
1. COOLERS AND FREEZERS NEED CLEANED (MILK COOLER) Clean and maintain		 Next Inspection
25  PAPER TOWELS IN BACK ROOM STORED ON FLOOR Next Inspection
29  THE MOP SINK IS INACCESSIBLE AND IMPROPER SINKS ARE BEING USED TO FILL AND DUMP MOP WATER.

WATER FOUNTAIN NEEDS CLEANED

WATER FOUNTAIN SPRAYS ON FLOOR		 Next Inspection
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Report and Instructions Received By   /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/17/2018 Time In  11:30 AM Time Out  12:30 PM Sanitation Score  92 (100 Minus Demerits)
By  Ryan Wheeler (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 #   SA030  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  DOLLAR GENERAL STORE #13404 Address  171 W DIXIE HWY
Owner or Operator   DG CORPORATION City   SAINT ANNE Zip Code   60964
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
Report and Instructions Received By   /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/17/2018 Time In  11:30 AM Time Out  12:30 PM Sanitation Score  92 (100 Minus Demerits)
By  Ryan Wheeler (Sanitarian) Adjusted Score  92