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 #   BR085  
    Pre-opening
X Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  SUPERMERCADO LA SIESTA Address  245 W BROADWAY ST
Owner or Operator   TREVINO, ARTURO City   BRADLEY Zip Code   60915
 
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
X
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
X
1
 Wiping cloths: clean, use restricted
22
  
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
X
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
  
1
 Storage, handling of clean equipment utensils
*7
X
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
X
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
X
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
  
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   Chlorine 100-200 ppm                   Dishwasher Temperature   not in use at time of inspection °F or label
Food Temperatures:   sausage 39; cxn 39-40; shrimp 12; fish 10; pork 41; cheese 39-41; ice cream 14; milk 49
 
General Comments
Haccp: discussed sanitizer concentration.

No follow up required. 
Report and Instructions Received By   Diva Trevino /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/08/2009 Time In  1:15 PM Time Out  2:45 PM Sanitation Score  85 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  85  
 
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 #   BR085  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  SUPERMERCADO LA SIESTA Address  245 W BROADWAY ST
Owner or Operator   TREVINO, ARTURO City   BRADLEY Zip Code   60915
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
*7  Observed raw eggs stored above produce; raw sausage on cheese. Please store either below or separate from ready to eat foods. (750.120) COS. Immediate/Onsite
2  Observed various food in upright freezer and walk in cooler not properly labeled. Label all foods with item and date once removed from original packaging. (750.100) Next Inspection
5  Observed thermometer broken in 2-door freezer and no thermometer in upright freezer. Please provide. (750.140) Next Inspection
8  Observed ice directly on chicken and bulk uncovered sausage stored in green grate in walk in cooler. Ice cannot be placed directly on meat; provide food grade bags for raw meats. (750.130) Next Inspection
10  Observed scoop lying in ice in ice bin. Please store w/handle presented. (750.280) Next Inspection
15  Observed the following non-food contact surfaces to be improper: 1. rust on racks of meat case, 2. rust on bottom shelf of table under meat slicer, 3. defrost upright freezer, 4. rust on racks in dry storage, 5. rust on lower shelf of table in back, 6. rust on racks in walk in cooler and push cart, 7. rust on store shelves. Please repair, repaint or replace. (750.690) Next Inspection
21  Observed wiping cloths on tables and counters. Please store in sanitizer solution when not in use or soiled, non-absorbent laundry bag. (750.810) Next Inspection
23  Observe inside, bottom of meat case and plastic holders in Pepsi cooler in need of cleaning. Please clean. (750.800) Next Inspection
36  Please clean floor in walk in cooler. (750.800) Next Inspection
37  Please clean ceiling vent and walls in restroom. (750.1220) Next Inspection
42  Observed boots on top of freezer and mops, buckets stored in with dry goods. Please store separately. (750.1390) Next Inspection
     
     
     
     
     
     
     
     
     
     
Report and Instructions Received By   Diva Trevino /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/08/2009 Time In  1:15 PM Time Out  2:45 PM Sanitation Score  85 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  85  
 
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 #   BR085  
    Pre-opening
X Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  SUPERMERCADO LA SIESTA Address  245 W BROADWAY ST
Owner or Operator   TREVINO, ARTURO City   BRADLEY Zip Code   60915
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
Report and Instructions Received By   Diva Trevino /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  10/08/2009 Time In  1:15 PM Time Out  2:45 PM Sanitation Score  85 (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  85