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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
    Original Inspection
    Reinspection
   Follow-Up
X 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
  
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
  
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
 
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
  
2
 Containers or receptacles covered: adequate number, insect/rodent proof, frequency, clean
 
      
Sanitizer Requirement:  Chemical   CHLORINE 100 ppm                   Dishwasher Temperature   CHLORINE 50 °F or label
Food Temperatures:   YOGURT 37-52* TIME/TEMP O.K.; MILK 38°; FREEZER -20°.
 
General Comments
RECEIVED DIRECTIVE FROM IDPH REGARDING SEVERAL RESIDENTS WHO ARE ILL AT MOMENCE MEADOWS NURSING HOME IN MOMENCE, IL.

UPON INPSECTION THE FOLLOWING WAS CHECKED:
1) SANITIZER BUCKET - CHLORINE 100 PPM,
2) MECHANICAL DISH WASHING MACHINE - CHLORINE 50 PPM,
*NOTE: THIS MACHINE DOES TAKE SEVERAL PASSES BEFORE IT STARTS DISPENSING SANITIZER. EMPLOYEES INSTRUCTED TO TEST PRIOR TO USE,
3) FOOD TEMPS* SEE ABOVE. YOGURT WAS OUT FOR ONE HOUR WHILE RESIDENTS WERE BEING SERVED.

FACILITIE'S KITCHEN SEEM TO BE IN GOOD ORDER, CLEAN AND EMPLOYEES HEALTHY, CLEAN UNIFORMS, HAIRNETS WORN; INCOMING FOOD ITEMS DELIVERED APPEARED TO BE WHOLESOME.

INSTRUCTED DIETARY MANAGE TO ENSURE ALL ILL EMPLOYEES STAY HOME, KEEP UNIFORMS CLEAN, CHANGE SANITIZERS EVERY HOUR, WASH HANDS PROPERLY AND OFTEN, MAKE SURE ALL FOOD IS KEPT WHOLESOME AND AT CORRECT TEMPERATURES.

NO FURTHER INVESTIGATION OF KITCHEN NEEDED AT THIS TIME. 
Report and Instructions Received By   JOHN CLAYTON /  
 
(Please Print)
  
(Signature of Owner or Representative)
Date  01/09/2013 Time In  12:40 PM Time Out  1:30 PM Sanitation Score  N/A (100 Minus Demerits)
By  Penny Suszycki (Sanitarian) Adjusted Score  N/A