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 #   MA018  
X Pre-opening
    Original Inspection
    Reinspection
   Follow-Up
    Possible FBI
    Complaint
   Other
Name of Establishment  CIRCLE K #4700183 Address  29 S LOCUST
Owner or Operator   MAC'S CONVENIENCE STORES City   MANTENO Zip Code   60950
 
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
  
2
 Food contact surfaces of equipment and utensils clean, free of abrasives and detergents  
FLOORS WALLS AND CEILINGS
36
  
1
 Floor: constructed, drained, clean, good repair, covering installation, dustless cleaning methods
*4
  
4
 Facilities to maintain product temperature
23
 
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
  
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
X
2
 Toilet rooms enclosed, self-closing doors, fixtures, good repair, clean: Hand cleanser, sanitary towels/hand drying devices provided. Proper waste receptacles, tissue
15
  
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
X
2
 Containers or receptacles covered: adequate number, insect/rodent proof, frequency, clean
 
      
Sanitizer Requirement:  Chemical   Quat 200 ppm                   Dishwasher Temperature   °F or label
Food Temperatures:   pepperoni 27°, pizza 19.5°, Infiniti pizza warmer 228°, Hunk-a-pizza warmer 167.5°, pizza 7.5°, Delfield refrigerator 31°, prep cooler 38.5°, pizza 16.5°, milk 33°, cream 34°, nacho cheese 149°, breakfast burrito 39°, ice cream 22°, smoked sausage 41.5°, cheese hot dogs -0.5°, dilly bar 13°
 
General Comments
Upon receipt of the completed Kankakee County Health Department Referral Form for Food establishments, this facility is hereby allowed to operate under authority of the Kankakee County Health Department. 
Report and Instructions Received By   Linda K. Hobbs /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  01/21/2011 Time In  9:10 AM Time Out  10:35 AM Sanitation Score  94 (100 Minus Demerits)
By  Bryan Kennedy (Sanitarian) Adjusted Score  98  
 
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 #   MA018  
X Pre-opening
    Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  CIRCLE K #4700183 Address  29 S LOCUST
Owner or Operator   MAC'S CONVENIENCE STORES City   MANTENO Zip Code   60950
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
32  OBSERVED NO SOAP AND/OR PAPER TOWELS AT THE FOLLOWING HANDSINK(S): PIZZA PREP AREA. PROVIDE FOR ALL HANDSINKS TO HAVE SUPPLY OF SOAP AND PAPER TOWELS TO ASSURE THAT PROPER HANDWASHING OCCURS. IMMEDIATE/ONSITE
33  OBSERVED THE DUMPSTER LID OPEN. PROVIDE THAT THE DUMPSTER LID BE KEPT CLOSED, EXCEPT WHILE THROWING AWAY TRASH. IMMEDIATE/ONSITE
34  OBSERVED THE DUMPSTER TO BE ON THE FOLLOWING IMPROPER SURFACE: GRAVEL. PROVIDE FOR THE DUMPSTER OR REFUSE AREA TO BE ON A SMOOTH SURFACE CONSTRUCTED OF A NON-ABSORBENT MATERIAL, SUCH AS CONCRETE OR MACHINE-LAID ASPHALT. NEXT INSPECTION
37  OBSEVED THE FOLLOWING WALL/CEILINGS, AND ATTACHED EQUIPMENT TO BE UNCLEAN: FAN COVERS IN WALK-IN COOLERS ARE DUSTY AND PIZZA WALK-IN WALLS AND CEILING ARE DIRTY. PROVIDE FOR ALL WALLS, CEILINGS, AND ATTACHED EQUIPMENT TO BE IN A CLEAN CONDITION. OBSERVED THE FOLLOWING WALL/CEILINGS AREA(S) TO BE IN POOR REPAIR: HOLES IN THE WALLS OF THE PIZZA WALK-IN COOLER FROM THE ICE CREAM LINES. NEXT INSPECTION
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Report and Instructions Received By   Linda K. Hobbs /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  01/21/2011 Time In  9:10 AM Time Out  10:35 AM Sanitation Score  94 (100 Minus Demerits)
By  Bryan Kennedy (Sanitarian) Adjusted Score  98  
 
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 #   MA018  
X Pre-opening
    Original Inspection
    Reinspection
    Follow-Up__________
    Possible FBI
    Complaint
    Other______________
Name of Establishment  CIRCLE K #4700183 Address  29 S LOCUST
Owner or Operator   MAC'S CONVENIENCE STORES City   MANTENO Zip Code   60950
 

ITEM
Remarks and Recommendations for Corrections
Corrected By
Report and Instructions Received By   Linda K. Hobbs /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  01/21/2011 Time In  9:10 AM Time Out  10:35 AM Sanitation Score  94 (100 Minus Demerits)
By  Bryan Kennedy (Sanitarian) Adjusted Score  98