HomeMy WebLinkAboutDominos N Center St 020391 05 16 17Single-use & single-service articles: properly
Equipment, food & non-food contact surfaces
Toilet facilities: properly constructed, supplied
Garbage & refuse properly disposed; facilities
37
stored & used
approved, cleanable, properly designed,
& cleaned
equipment for temperature control
43
constructed, & used
2 1 0
Proper cooling methods used; adequate
1 0.5 0
31
Meets ventilation & lighting requirements;
1 0.5 0
Utensils, equipment & linens: properly stored,
Contamination prevented during food
preparation, storage & display
Insects & rodents not present; no unauthorized
Gloves used properly44
Non-food contact surfaces clean
45
46
47
Food additives: approved & properly used
Warewashing facilities: installed, maintained, &
24
Proper date marking & disposition
offered
Proper reheating procedures for hot holding
Sewage & waste water properly disposed
48
3 1.5 0
49
50Consumer advisory provided for raw or
Hot & cold water available; adequate pressure
Plumbing installed; proper backflow devices
Pasteurized foods used; prohibited foods not
Food separated & protected
Toxic substances properly identified stored, & used
Hands clean & properly washed
Compliance with variance, specialized process,
Food-contact surfaces: cleaned & sanitized
reduced oxygen packing criteria or HACCP plan
Physical facilities installed, maintained & clean
51
undercooked foods
52
Proper disposition of returned, previously served,
53
Time as a public health control: procedures &
Handwashing sinks supplied & accessible
records
reconditioned, & unsafe food
Proper cooking time & temperatures
Proper cooling time & temperatures
approved alternate procedure properly followed
Proper hot holding temperatures
Proper cold holding temperatures
54
Food obtained from approved source
Food received at proper temperature
Food in good condition, safe & unadulterated
Required records available: shellstock tags,
used; test strips
parasite destruction
maintained
No discharge from eyes, nose or mouth
designated areas used
Contributing factors that increase the chance of developing foodborne illness.
Establishment Name:
Foodborne Illness Risk Factors and Public Health Interventions
FDA Establishment Type:
Location Address:
City:
Zip:
Permittee:
Telephone:
Wastewater System:
Water Supply:
27
1
2
3
13
14
15
Food Establishment Inspection Report
16
17
18
19
20
21
Score:
22
23
25
26
Establishment ID:
Date:
Time In:
Category #:
Status Code:
Time Out:
Proper use of reporting, restriction & exclusion
State:
Compliance Status OUT CDI R VR
PIC Present; Demonstration-Certification byaccredited program and perform duties
responsibilities & reporting
County:
Risk factors:
Public Health Interventions:Control measures to prevent foodborne illness or injury.
Page 1 of Food Establishment Inspection Report, 3/2013
:ampm :ampm
//
Total Time:
Inspection Re-Inspection
Municipal/Community On-Site System No. of Risk Factor/Intervention Violations:
No. of Repeat Risk Factor/Intervention Violations:Municipal/Community On-Site Supply
Good Retail Practices
Good Retail Practices:
Preventative measures to control the addition of pathogens, chemicals,
and physical objects into foods.
Good Retail Practices:
IN OUT N/A N/O
No bare hand contact with RTE foods or pre-
4
5
6
7
8
9
10
11
12
Proper eating, tasting, drinking, or tobacco use
Management, employees knowledge;3 1.5 0
2 0
3 1.5 0
2 1 0
1 0.5 0
4 2 0
3 1.5 0
2 1 0
.2652Supervision
.2652Employee Health
Good Hygienic Practices .2652, .2653
.2652, .2653, .2655, .2656Preventing Contamination by Hands
.2653, .2655Approved Source
2 1 0
2 1 0
2 1 0
2 1 0
.2653, .2654Protection from Contamination
3 1.5 0
3 1.5 0
2 1 0
.2653Potentially Hazardous Food TIme/Temperature
3 1.5 0
3 1.5 0
3 1.5 0
3 1.5 0
3 1.5 0
3 1.5 0
2 1 0
1 0.5 0
.2653Highly Susceptible Populations
.2653Consumer Advisory
.2653, .2657Chemical
1 0.5 0
2 1 0
.2653, .2654, .2658Conformance with Approved Procedures
2 1 0
Approved thawing methods used
Thermometers provided & accurate
Water and ice from approved source
Variance obtained for specialized processing
Plant food properly cooked for hot holding
Pasteurized eggs used where required
Food properly labeled: original container
Personal cleanliness
Wiping cloths: properly used & stored39
Washing fruits & vegetables
In-use utensils: properly stored
dried & handled
28
29
30
32
33
34
35
36
38
40
41
42
Compliance Status OUT CDI R VRIN OUT N/A N/O
1 0.5 0
.2653, .2655, .2658Safe Food and Water
2 1 0
methods 1 0.5 0
.2653, .2654Food Temperature Control
1 0.5 0
1 0.5 0
1 0.5 0
.2653Food Identification
2 1 0
.2652, .2653, .2654, .2656, .2657Prevention of Food Contamination
animals 2 1 0
1 0.5 0
1 0.5 0
1 0.5 0
.2653, .2654Proper Use of Utensils
1 0.5 0
1 0.5 0
1 0.5 0
.2653, .2654, .2663Utensils and Equipment
2 1 0
1 0.5 0
1 0.5 0
.2654, .2655, .2656 Physical Facilities
2 1 0
2 1 0
2 1 0
1 0.5 0
1 0.5 0
1 0.5 0
1 0.5 0
Total Deductions:
DHHS is an equal opportunity employer.
Environmental Health Section Food Protection ProgramNorth Carolina Department of Health & Human Services Division of Public Health
97
DOMINO'S PIZZA 2018020391
1820 N CENTER ST
HICKORY NC
28601 18 Catawba
MACK PATTERSON
(704) 588-2611
0 5 1 6 2 0 1 7 A
1 2 3 7 0 1 2 8
51 minutes
II
1
3
2 CR
Off
REHS Contact Phone Number:
Permittee:
REHS ID:
Telephone:
Establishment Name:
Status Code:
Establishment ID:
Zip:
Inspection Re-Inspection
Regulatory Authority (Print & Sign):
Person in Charge (Print & Sign):
Wastewater System:
Water Supply:
Comment Addendum to Food Establishment Inspection Report
Date:
Category #:
Location Address:
City: State:
County:
Temperature Observations
Item Temp TempLocationItemLocation Temp Item Location
Email 1:
Email 2:
Email 3:
Observations and Corrective Actions
Violations cited in this report must be corrected within the time frames below, or as stated in sections 8-405.11 of the food code.
Verification Required Date:
()-
//
Food Establishment Inspection Report, 3/2013
DHHS is an equal opportunity employer.
Environmental Health Section Food Protection ProgramNorth Carolina Department of Health & Human Services Division of Public Health
Page 2 of
Municipal/Community On-Site System
Municipal/Community On-Site System
First Last
First Last
Comment Addendum Attached?
DOMINO'S PIZZA 2018020391
1820 N CENTER ST
HICKORY NC
18 Catawba 28601
MACK PATTERSON
(704) 588-2611
05/16/2017
A
II
MACK@PRAIRIEPIZZA.COM
WINGS LOWER PIZZA PREP 46
BONELESS LOWER PIZZA PREP 46
PEPPARONI LOWER PIZZA PREP 41
STEAK LOWER PIZZA PREP 46
PROVOLONE LOWER PIZZA PREP 45
ITALIAN LOWER PIZZA PREP 47
SHREDDED UPPER PIZZA PREP 41
PEPPAROIN UPPER PIZZA PREP 40
SAUSAGE UPPER PREP 40
CHEESE WALK IN 38
BONELESS WALK IN 38
1 •2-102.12 Certified Food Protection Manager - C
PERSON IN CHARGE TO BE ACCREDITED BY APPROVED FOOD SAFETY COURSE
46 4-501.16 Warewashing Sinks, Use Limitation - C
3 COMPARTMENT SINK TO BE CLEANED/SANITIZED BETWEEN CHANGE OF USE
DO NOT PREPARE FOODS ON SINK AT SAME TIME OF DISH WASHING/SOAKING
53 6-501.12 Cleaning, Frequency and Restrictions - C
CLEAN FLOORS, WALLS AS NEEDED
SUMNER PATTERSON• •
JASON HUFFMAN
1654 - Huffman, Jason
2
05/16/2017
1654 -05/16/2017
Establishment ID:Establishment Name:
Comment Addendum to Food Establishment Inspection Report
Observations and Corrective Actions
Violations cited in this report must be corrected within the time frames below, or as stated in sections 8-405.11 of the food code.Observations and Corrective Actions
Violations cited in this report must be corrected within the time frames below, or as stated in sections 8-405.11 of the food code.
Page 3 of Food Establishment Inspection Report, 3/2013
DHHS is an equal opportunity employer.
Environmental Health Section Food Protection ProgramNorth Carolina Department of Health & Human Services Division of Public Health
DOMINO'S PIZZA 2018020391
N/A
Establishment ID:Establishment Name:
Comment Addendum to Food Establishment Inspection Report
Observations and Corrective Actions
Violations cited in this report must be corrected within the time frames below, or as stated in sections 8-405.11 of the food code.
Page 4 of Food Establishment Inspection Report, 3/2013
DHHS is an equal opportunity employer.
Environmental Health Section Food Protection ProgramNorth Carolina Department of Health & Human Services Division of Public Health
DOMINO'S PIZZA 2018020391
N/A
Establishment ID:Establishment Name:
Comment Addendum to Food Establishment Inspection Report
Observations and Corrective Actions
Violations cited in this report must be corrected within the time frames below, or as stated in sections 8-405.11 of the food code.
Page 5 of Food Establishment Inspection Report, 3/2013
DHHS is an equal opportunity employer.
Environmental Health Section Food Protection ProgramNorth Carolina Department of Health & Human Services Division of Public Health
DOMINO'S PIZZA 2018020391
N/A
Establishment ID:Establishment Name:
Comment Addendum to Food Establishment Inspection Report
Observations and Corrective Actions
Violations cited in this report must be corrected within the time frames below, or as stated in sections 8-405.11 of the food code.
Page 6 of Food Establishment Inspection Report, 3/2013
DHHS is an equal opportunity employer.
Environmental Health Section Food Protection ProgramNorth Carolina Department of Health & Human Services Division of Public Health
DOMINO'S PIZZA 2018020391
N/A