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
  
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
  
5
 Hands washed and clean, good hygienic practices
*30
 
5
 Cross-connection, back siphonage-backflow
42
X
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
X
2
 Dishwashing facilities: designed, constructed, maintained, installed, located, operated
*45
     Management personnel certified Yes     No X 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 200; Quat 100 ppm                   Dishwasher Temperature   180F *see attached label on report in file °F or label
Food Temperatures:   corn 172; liver 8; beef 39; ice cream 5; milk 40
 
General Comments
Haccp: discussed proper hand washing techniques with use of plastic gloves.

No follow up required. 
Report and Instructions Received By   Alice Lee /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  06/07/2007 Time In  9:15 AM Time Out  11:00 AM Sanitation Score  90 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  90  
 
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
*45  Facility needs to obtain one more certified food handler for afternoon shift. Facility needs to either mail or fax a copy of the paid receipt for registration to the Certified Food Handler Course. 30 Days
15  Observed the following non-food contact surfaces to be improper: 1. rust on front counter shelf on left, 2. rust on table with microwave at front counter, 3. rust on table in corner in dish washing area, 4. broken gasket on walk in cooler, 5. rust on shelves in walk in cooler, 6. built up frost on ice cream freezer in back hallway, 7. rust on racks in dry storage, 8. rust on racks in chemical room. Provide for all non-food contact surfaces to be smooth, easily cleanable, non-corrosive, and non-absorbent. Repair or replace. (750.690) Next Inspection
16  Observed the spray faucets at 2-bay and dishwasher to be dirty; observed front and underneath dishwasher in need of a thorough cleaning; observed front panel of dishwasher to be broken; heavy corrosion inside and outside of dishwasher. Provide for all dish washing equipment to be clean and maintained. Thoroughly clean area and repair or replace dishwasher. (750.820/830) Immediate/Onsite
22  Observed inside of ice machine in need of cleaning. Please clean. (750.800) Immediate/Onsite
23  Observed the following non-food contact surfaces in need of cleaning: 1. inside of all single service containers that hold condiments, 2. inside of yellow bowl in front counter, 3. front shelves, 4. outside of double door oven, 5. both push carts used for coffee, 6. outside of ice machine, 7. inside of both ovens, including handles, 8. fan grill in dish washing area, 9. outside of large plastic containers. Please clean. (750.800) Immediate/Onsite
24  Observed the following clean dishware stored improperly: 1. plates on front counter by steam table, 2. utensils by 3-bay sink. Please store protected at all times. Invert clean plates on a dry, clean surface or covered; stored clean utensils in one direction w/handle presented. (750.850) Immediate/Onsite
36  Observed floors throughout kitchen, dish washing areas, and dry storage in need of thorough cleaning especially around baseboards and under equipment. Please clean. (750.1220) Immediate/Onsite
37  Observed the following surfaces to be improper: 1. broken corner by walk in cooler, 2. broken cove base on walls in 3-bay area, 3. missing ceiling tile over door in dry storage room, 4. loose cove base on wall by milk cooler in dry storage. Repair or replace. (750.1210) Observed walls and ceilings throughout kitchen, dish washing areas, back hallway, chemical room and dry storage in need of a thorough cleaning. Please clean. (750.1220) Immediate/Onsite
42  Observed soiled mops in mop sink and bucket in chemical room; observed mop sink to be dirty. Please store mops clean and hang after every use and keep mop sink clean. (750.1390) Immediate/Onsite
     
     
     
     
     
     
     
Report and Instructions Received By   Alice Lee /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  06/07/2007 Time In  9:15 AM Time Out  11:00 AM Sanitation Score  90 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  90  
 
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   Alice Lee /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  06/07/2007 Time In  9:15 AM Time Out  11:00 AM Sanitation Score  90 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  90