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
X
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
  
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 100 ppm                   Dishwasher Temperature   180F see attached label on report in file °F or label
Food Temperatures:   eggs 41; chicken nuggets 23; chicken strips 160; ice cream 9; milk 35
 
General Comments
Haccp: discussed proper storage of utensils in food bins.

No follow up required. 
Report and Instructions Received By   Mary Savage /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/03/2007 Time In  9:45 AM Time Out  11:30 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 has 3 certified food handlers for day shift, but zero for 2nd shift. Facility has 15 days to show proof of registration to Certified Food Handler Course for at least one more 2nd shift kitchen employee. 15 Days
15  Observed the following non-food contact surfaces to be improper: 1. rust on racks in walk in cooler, 2. broken gasket on walk in freezer door, 3. rust on lower shelf of cart in front counter, 4. rust on shelves in front counter, 5. plastic peeling on push carts, 6. rust on lower shelf of clean dish cart in dish washing area, 7. built up frost on inside of ice cream freezer, 8. rust on racks in dry storage, 9. rust on inside bottom of milk cooler in dry storage room, 10. built up frost on cooling unit of milk cooler in dry storage, 11. rust on chemical racks. Please provide for all non-food contact surfaces to be smooth, easily cleanable and non-absorbent. Repair, replace, defrost. (750.690) Next Inspection
16  Observed the front panel of dish washing machine to be in ill repair; observed duct tape on handle of dish washing machine; observed faucet of wash sink to be leaking. Please maintain at all times. Please repair or replace. (750.830) Observed the spray nozzle and dish racks in need of cleaning. Please clean. (750.830) Next Inspection
22  Observed the following food contact surfaces in need of cleaning: 1. inside of microwave, 2. inside of ice machine, 3. inside of buckets used to store clean utensils by 3-bay sink. Please clean. (750.800) Utensils and bucket rewashed. Immediate/Onsite
23  Observed the following non-food contact surfaces in need of cleaning: 1. fan grill of walk in cooler, 2. inside all condiment holders, 3. push carts, 4. inside ovens and handles, 5. outside of all large bulk containers, 6. fan in dish washing area, 7. outside of single service bins located by ice cream freezer. Please clean. (750.800) Next Inspection
24  Observed clean dishware stored improperly; plates on front counter stored face-up; utensils by 3-bay stored in different directions. Please store clean dishware protected at all times and store clean utensils in one direction. (750.850) Next Inspection
34  Observed outside dumpster with lids off. Please keep lids on at all times to minimize flys, insects and other pests. (750.1140) Next Inspection
36  Observed floors throughout under equipment and around baseboards in need of a thorough cleaning. Please clean. (750.1220) Next Inspection
37  Observed the following surfaces to be improper: 1. cove base behind dish washing machine not adhered to wall; 2. hole in wall across from 3-bay sink behind metal rack, 3. broken ceiling tiles over door in dry storage room, 4. chipped paint on wall behind milk cooler in dry storage, 5. broken tile on corner of doorway by walk in cooler, 6. chipped paint on walls in chemical room. Please repair, repaint. (750.1210) Observed the following surfaces in need of cleaning: 1. hoods over stoves, 2. wall behind stoves, 3. wall behind and around 2-bay sink, 4. walls in mechanical dish washing room, 5. cove base in mechanical dish washing room, 6. walls in 3-bay sink area, 7. walls in dry storage, 8. walls outside of chemical storage room, 9. ceiling in kitchen and mechanical dish washing area. Please clean. (750.1220) Next Inspection
     
     
     
     
     
Report and Instructions Received By   Mary Savage /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/03/2007 Time In  9:45 AM Time Out  11:30 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   Mary Savage /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/03/2007 Time In  9:45 AM Time Out  11:30 AM Sanitation Score  90 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  90