HomeMy WebLinkAboutHenderson Junior High School 11-9-23
Texas Department of State Health Services
Retail Food Establishment Inspection Report
Est. TypeRisk Category
Date:Time in:Time out:License/Permit #Page __of ___
220:034 2!pg!4
Purpose of Inspection: 1-Compliance 2-Routine 3-Field Investigation 4-Visit 5-OtherTOTAL/SCORE
Number of Repeat Violations: ____
Establishment Name:Contact/Owner Name:
Number of Violations COS: _____
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211
Follow-up: Yes
Physical Address:City/County:Zip Code:Phone:
No (circle one)
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Compliance Status: Out = not in compliance IN = in compliance NO= not observed NA= not applicable COS= corrected on site R= repeat violation
Mark the appropriate points in the OUTbox for each numbered item IN, NO,NA,COS R
Priority Items(3 Points)violations Require Immediate Corrective Actionnot to exceed 3 days
Compliance StatusCompliance Status
OINNCROINNCR
Time and Temperature for Food Safety
UNOAOUNOAO
EmployeeHealth
(F = degrees Fahrenheit)
TSTS
1. Proper cooling time and temperature12. Management, food employees and conditional employees;
knowledge, responsibilities, and reporting
2. Proper Cold Holding temperature(41°F/ 45°F)13.Proper use of restriction and exclusion; No discharge from
eyes, nose, and mouth
3. Proper Hot Holding temperature(135°F)
PreventingContamination by Hands
4. Proper cooking time and temperature14. Hands cleaned and properly washed/ Gloves used properly
5. Proper reheating procedure for hot holding (165°F in 2 15. No bare hand contact with ready to eat foods or approved
Hours)alternate method properly followed(APPROVED Y___N___)
6. Time as a Public Health Control; procedures & records
Highly Susceptible Populations
16. Pasteurized foods used; prohibited food not offered
Approved Source
Pasteurized eggs used when required
7. Food and ice obtained from approved source; Food in
good condition, safe, and unadulterated;parasite
Chemicals
destruction
8. Food Received at proper temperature17. Food additives; approved and properly stored; Washing Fruits
& Vegetables
Protection from Contamination18. Toxic substances properly identified, stored and used
9. Food Separated & protected,prevented duringfood
Water/ Plumbing
preparation, storage, display, and tasting
10. Food contactsurfacesand Returnables ; Cleaned and 19. Water from approved source; Plumbing installed; proper
Sanitized at_______ ppm/temperaturebackflow device
11. Proper disposition of returned, previously served or 20. Approved Sewage/Wastewater Disposal System, proper
reconditioneddisposal
Priority Foundation Items (2 Points)violations Require Corrective Action within 10 days
OINNCROINNCR
UNOAOUNOAO
Demonstration of Knowledge/ PersonnelFood Temperature Control/ Identification
TSTS
21. Person in charge present, demonstration of knowledge, 27. Proper cooling method used; Equipment Adequate to
and perform duties/ Certified Food Manager (CFM)Maintain Product Temperature
22.Food Handler/ no unauthorized persons/personnel28. Proper Date Marking and disposition
Safe Water, Recordkeeping and Food Package 29. Thermometers provided, accurate,and calibrated; Chemical/
LabelingThermal test strips
23. Hot and Cold Water available; adequate pressure, safePermit Requirement, Prerequisite for Operation
24. Required records available (shellstock tags; parasite
30. Food Establishment Permit(Current & Valid)
destruction); Packaged Food labeled
Conformance with Approved ProceduresUtensils, Equipment, and Vending
25. Compliance with Variance, Specialized Process, and
31. Adequate handwashing facilities: Accessible and properly
HACCP plan; Variance obtained for specialized
supplied, used
processing methods; manufacturer instructions
Consumer Advisory32. Food and Non-food Contact surfaces cleanable, properly
designed, constructed, and used
26. Posting of Consumer Advisories; raw or under cooked 33. Warewashing Facilities; installed, maintained, used/
foods (Disclosure/Reminder/Buffet Plate)/ Allergen LabelService sink or curb cleaning facility provided
Core Items (1 Point)Violations Require Corrective Action Not to Exceed 90 Days or Next Inspection , Whichever Comes First
OINNCROINNCR
UNOAOUNOAO
Prevention of Food ContaminationFood Identification
TSTS
34. No Evidence of Insect contamination, rodent/other 41.Original containerlabeling(Bulk Food)
animals
35. Personal Cleanliness/eating, drinking or tobacco use
Physical Facilities
36. Wiping Cloths; properly used and stored42. Non-Food Contact surfaces clean
37.Environmental contamination43.Adequate ventilation and lighting; designated areas used
38. Approved thawing method44. Garbage and Refuse properly disposed; facilities maintained
45. Physical facilities installed, maintained, and clean
Proper Use of Utensils
39. Utensils, equipment, & linens; properly used, stored, 46.Toilet Facilities; properly constructed, supplied, and clean
dried, & handled/ In use utensils; properly used
40. Single-service & single-use articles; properly stored 47. Other Violations
and used
Received by:Print:Title: Person In Charge/ Owner
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(signature)
Business Email:
Inspected by:Print:
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(signature)
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Texas Department of State Health Services
Retail Food Establishment Inspection Report
Corrective Actions to Ensure Safe Food Page __ of __
Item No.
1Cooling
TCS* food cooled from 135° F to 70° F more than 2 hours OR 135° F to 41° F (45° F)
More than 6 hours; OR prepared food cooled to 41° F (45° F) more than 4 hours:
Action: Voluntary destruction, rapid reheating of cooked foods if less than 4 hours
2 Cold Hold
TCS food held above 41° F (45° F) more than 4 hours:
Action: Voluntary destruction
TCS food held above 41° F (45° F) less than 4 hours:
Action: Rapid cool (e.g. ice bath)
3 Hot Hold
TCS food held below 135° F more than 4 hours:
Action: Voluntary destruction
TCS food held below 135° F less than 4 hours:
Action: Rapid reheats to 165°F or more
4 Cooking
TCS food undercooked:
Action: Re-cook to proper temperature
5 Rapid Reheating
TCS food improperly reheated:
Action: Reheat rapidly to 165° F
7 Approved Source/Sound Condition
Foods from unapproved sources/unsound condition:
Action: Voluntary destruction
9 Cross-Contamination of Raw/Cooked Foods
Ready-To-Eat food contaminated by raw TCS food:
Action: Voluntary destruction of ready-to-eat foods
14 Handwashing
Food employees observed not washing hands:
Action: Instruct employees to wash hands as specified in the Rules.
15 Proper Handling of Ready-to-Eat Foods
Employee did not properly wash and sanitize hands before touching ready-to-eat food with
Bare hands:
Action:Voluntary destruction
19, 23 Water Supply
Facility does not have water for washing hands, preparing food, or cleaning equipment/utensils:
Action: Voluntary suspension of food preparation
* Time/Temperature Control for Safety (TCS)
Texas Department of State Health Services
Retail Food Establishment Inspection Report
Establishment Name:Physical Address:City/State:License/Permit #Page __ of __
Ifoefstpo!Kvojps!Ijhi!Tdippm!
Tufqifowjmmf-!UY
38:9!X!Gsfz!
4!pg!4
TEMPERATURE OBSERVATIONS
Item/LocationTempItem/LocationTempItem/LocationTemp
OBSERVATIONS AND CORRECTIVE ACTIONS
Item
AN INSPECTION OF YOUR ESTABLISHMENT HAS BEEN MADE. YOUR ATTENTION IS DIRECTED TO THE CONDITIONS OBSERVED AND
Number
NOTED BELOW:
Received by:Print:Title: Person In Charge/ Owner
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(signature)
Inspected by:Print:
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Samples: Y N # collected ____
(signature)
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