Food Establishment Inspection Report |
||||||||||||||||||||||||||
Page 1 of ????????? | ||||||||||||||||||||||||||
|
|
FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS |
Circle designated compliance status (IN, OUT, N/O, N/A) for each numbered item IN=in compliance OUT=not in compliance N/O=not observed N/A=not applicable Mark "X" in appropriate box for COS and/or R COS=corrected on-site during inspection R=repeat violation |
Risk factors are important practices or procedures identified as the most prevalent contributing factors of foodborne illness or injury. Public health interventions are control measures to prevent foodborne illness or injury. |
|
|
GOOD RETAIL PRACTICES |
Good Retail Practices are preventative measures to control the addition of pathogens, chemicals, and physical objects into foods. Mark "X" in appropriate box for COS and/or R COS=corrected on site during inspectionR=repeat violation |
|
|
IOCI 17-356
![]() |
Food Establishment Inspection Report |
|
Page 2 of ?????? | |
Establishments: ST. ANNE COMMUNITY HIGH SCHOOL | Establishment #: SA018 |
Water Supply: Public Private Waste Water System: Public Private |
Sanitizer Type: Chemical | PPM: CHLORINE 100 | Heat: 165 °F |
CFPM Verification (name, ID#, expiration date): | |||
JENNIFER SCHULTZ 21828981 05/04/2027 |
MISTEY MOORE 21706365 10/07/2025 |
ELIZABETH STATLER 25260083 02/22/2029 |
|
TEMPERATURE OBSERVATIONS |
Item/Location |
Temp |
Item/Location |
Temp |
Item/Location |
Temp |
Corn salsa/Walk-in cooler | 41.00°F | Corn salsa/Salad bar | 40.00°F | Milk/Milk cooler | 41.00°F |
Chicken/Cashier counter | 41.00°F | /Walk-in freezer | 0.00°F | French fries/Warming unit | 158.00°F |
OBSERVATIONS AND CORRECTIVE ACTIONS |
Item Number |
Severity | Violations cited in this report must be corrected within the time frames below. |
51 | P |
5-202.13: An air gap between the water supply inlet and the flood level rim of the PLUMBING FIXTURE, EQUIPMENT, or nonFOOD EQUIPMENT shall be at least twice the diameter of the water supply inlet and may not be less than 25 mm (1 inch). The PVC drain pipe from the dish washing machine terminates inside the floor drain with no air gap. Provide an air gap of at least 1". - (Correct By: Feb 5, 2024) |
HACCP Topic: HOT HOLDING TEMPERATURES. |
Person In ChargeMISTEY MOORE |
Date:02/02/2024 |
InspectorDANA JAMES |
Follow-up: Yes No Follow-up Date:02/05/2024 |