HomeMy WebLinkAboutBlackburn Elementary School 110004 03 15 10 KM.pdf11M.
Division of Environmental Healith
Establishment Name: BLACKBURN ELEMENTARY SCHOOL
Locaborn AddreSe� 4a77 W NO 10 HWY
CjtyNEWTON St�aleN(; Zip2MM
Score + * [.2606(b)j= 100
Date-, 03/ 15/a0loTime, 1 0 1 0
Status Code. A Risk [] 11 [3 11 [:] ti I [E IV
Permittere: CATS WBA COUNTY SCHOOLS County: 18
Mailing Address Current Establishment 01 201,81,10004
Previous Establishment ID-
Ernad Address:Lat, Long.
inspection E] Marne ctiange CV visit 0 Seating: Waste waterSystemsrt E]uunrcipakfCommuritty [E..0n,81te System
Re-rrispection 0 Start HCV Foltow-up - Water Supply: RhimirciparriCommunity []0n-,SjIe System
E] Water sample taken today?
CRITICAL EPIC ON RISK FACTORS
CrilicalViolation is Factors -_ Conlrtburmg factors that Increase tare Chance of developing foodinorne krIneSS
NA - Not Applicable NO - Not Observed 6 C - Gen erat Comment CD1, -Corrected During inspection R - Repeal: Violation
_ T 7_ T_ R Pt GC CDIT
Personnel with infectious or communicatle diseases restricted
Proper employee beverage or torracco use
Hands cleaft and property washat!
M rnbnia� bar@ hand contact with foods
Handwash011 facflMes provrded
Food obtalfted fmm an approved somce
Food received atproper temperature
Food in good condition, safe and unadufterated
Sh ellstock I a tic r sla M e d
FOad Pro1*C19d during Stbfagshai`idfirngdioptay, strAce & transponation, wrAten notice for ewan plate
Food conlact surfaces dearled & sanitized" auproved MethOdS and sariffizers
C of returned, previously served, and aduRerated food
Proper cookino time anditemperature
Proper reheafing orritedufes
roper luil horkirrig lempetirtuf eis
Proper cold pointing temperatures
Time as a Public heafth control, procedures & record. s
Itern Location re Item Location Tern, P "ern Locabon Ternp
GREEN HOT LINE 196 MILK COOLER 45
MASHED HOT LINE 167
HAMBURGES WARMER 153
CHICKEN WARMER 156
COMMENTS-.
DEN R 4007 neaten 01108) Page 1 at 2
Food Service Establishment Inspection NC Department of Environment & Natural Resources
Division of Environmental Health
-------- - ---------
Establishment Name; BLACKBU N ELEMENTARY Date- 03115QOIO Cuffent Establishmerit ID,--ZO-181,10004
00010 RETAIL PRACTICES
NAIN01 I Pt s [GC I R
Toxic substances properly identified, stored, used 1 3 1-5,
Consumer advlsory provided 1 2 1
Source In accordance with 15A NCAC 18A .1700� hot & cold rater avaifaWe, under Pressure 1 3 1.5
Refrigeration and freeZrer capacity sull4dent 1 5
Proper cooling methods used 2 1
Proper thawing methods used 1 5
Thermometers provided and accurate 1 5
Dry food stored properly & labeled accordingly i 5
Original contaRner for storage of rnflk & stiMlInsh 1 '5
Insects, rodents, and, animals not present
2 1
Clean clothes, hMr restralnts
7_5
Linens, Cloths, & aprons properly used & stored
1 5
Wa,shkng fruits & vegetables
1 '5
fast used lof domest Purposes
1 '5
In -use uttrtsits properly stored
Ulenstis & eqWpment properly stored, air-cifled, handled
Single-uWsingle-service arfides properly stored, handled. used 1 '5
Food " no"nlood COnlact
h
4Tr "e re'a Ing
-- ------ . .... . - -------- --------------------- -------------------------------- ------ ------- I
WargwaShlng faCHIHOS rdakfralne& IfeA StflPS used
Food SeTV�C@ eQulpfllerd and UteflMN aP;sr0V ed
NoWfood Contact Surfaoel; Clean
JIM
0
ma�
No cross-cannections
Toffet and �avatory facflftfes� suptifled, properly constructed, stood, good reflaO, signs provided ......................
Garbage properly handWd & disposed" containers properly maintained,
Floors, waft, ceilings properly constructed, clean, In good, repair
Is eats ffluminahion requftements shieldeld; Ughfing & ventilation clean & m good re par
Storage spaces c�ean, storage above floar: approved storage far mops, brooms, fidses, & othef items
Elders seffclasfng where resiuked� all WVndows screened
Total DeducttoTs
COMMENTS:
Inspection by:
Report Recetvedl !by: � '�Z
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ATTACHMENTS: 1:1
ENS LD. #: 22%Michaud, Kenneth
Page 2 of 2
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N,C. Department of Environment and Natural Resources Name: BLACKBURN ELEMENTARY Time In, 1 0 1 0
1 ZrIAMIII -[:]Pm
0iI of Environmental Health ID: 2018110004 Time Out Dam
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Street' 4377 W NC 10 HWY- Total TIirne:
COMMENT ADDENDUM City, NEWTON
Sniolkrng Establishment? Heart Heafth Survey
[:]Yes No DYes L]No
Saw
F 1 11:13 M 01P WE I I 111 111
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