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 |
|
|
Food Establishment Inspection Report | |
Page 2 of ?????? | |
Establishment: PEMBROKE KOGER SENIOR CENTER | Establishment #: HP010 |
Water Supply: Public Private Waste Water System: Public Private |
Sanitizer Type: Chemical | PPM: CHLORINE 100 | Heat: NA °F |
IL Requirements: | Use of non-latex gloves for food handling and preparation 410 ILCS 180/10 - NO |
Appropriate default beverage for children's meal 410 ILCS 620/21.5 - N/A |
CFPM Verification (name, ID#, expiration date): | |||
VELSIE BRIDGES 24327014 07/27/2028 |
|
|
|
TEMPERATURE OBSERVATIONS |
Item/Location |
Temp |
Item/Location |
Temp |
Item/Location |
Temp |
Chicken/Refrigerator | 42.00°F | Ranch/Cooler | 36.00°F | /2 freezers | 0.00°F |
OBSERVATIONS AND CORRECTIVE ACTIONS |
Item Number |
Severity | Violations cited in this report must be corrected within the time frames below. |
55 | C |
6-501.11: PHYSICAL FACILITIES shall be maintained in good repair. The base tile next to the chest freezer in the kitchen is missing and damaged. Additionally, the repair to the floor tiles next to the oven has partially broken away. Repair and maintain by the next routine inspection. Repeat |
HACCP Topic: REHEATING COMMERCIALLY PACKAGED FOODS. |
Person In Charge:KIM BRIDGES |
Date:03/24/2025 |
Inspector:DANA JAMES |
Follow-up: Yes No Follow-up Date: |