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 #   BB227  
    Pre-opening
X Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  RIVERSIDE SENIOR LIFE DBA BOURBONNAIS GROVE Address  85 E BURNS RD
Owner or Operator   RIVERSIDE SENIOR LIVING CENTER City   BOURBONNAIS Zip Code   60914
 
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
X
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
  
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
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   QUAT 200-400 ppm                   Dishwasher Temperature   180 °F or label
Food Temperatures:   CHEESE 51, RANCH 52, CHEDDAR CHEESE SOUP 187, CHEESE 35, PEARS 35, RAW HAMBURGER 39, CHICKEN 40,PEACHES 38
 
General Comments
HACCP CONCEPTS DISCUSSED: WASH HANDS FOR 20-30 SECONDS WITH SOAP AND WARM WATER THOROUGHLY AND DRY WELL WITH PAPER TOWELS. 
Report and Instructions Received By   LORIBETH RUSH /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  03/15/2018 Time In  1:30 PM Time Out  3:10 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 #   BB227  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  RIVERSIDE SENIOR LIFE DBA BOURBONNAIS GROVE Address  85 E BURNS RD
Owner or Operator   RIVERSIDE SENIOR LIVING CENTER City   BOURBONNAIS Zip Code   60914
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
*3  Observed the following potentially hazardous foods to be held at improper temperatures. 1. Cheese found at 51F at salad bar. 2. Ranch was found at 52F. Will bring cheese and ranch out only at lunch and dinner time and place on ice at salad bar, then will place in cooler afterwards. Provide for all cold potentially hazardous foods to be held at 41°F or below at all times except during necessary periods of preparation. Immediate/Onsite
15  Observed the following improper non-food contact surfaces. 1. Repaint and seal shelf under hand sink and also in drawers in Memory West. 2. Repaint and seal drawer in Memory East. Provide for all food contact surfaces to be smooth, easily cleanable, non-absorbent, corrosive resistant, and light colored Next Inspection
22  Observed the following food contact surfaces to be unclean. Black rack has mold on it in the walk-in cooler. Clean and maintain. Next Inspection
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Report and Instructions Received By   LORIBETH RUSH /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  03/15/2018 Time In  1:30 PM Time Out  3:10 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 #   BB227  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  RIVERSIDE SENIOR LIFE DBA BOURBONNAIS GROVE Address  85 E BURNS RD
Owner or Operator   RIVERSIDE SENIOR LIVING CENTER City   BOURBONNAIS Zip Code   60914
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
Report and Instructions Received By   LORIBETH RUSH /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  03/15/2018 Time In  1:30 PM Time Out  3:10 PM Sanitation Score  92 (100 Minus Demerits)
By  Steven Lamb (Sanitarian) Adjusted Score  97