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Kingston Residence 010718 10 17 17.pdf
Food Establishment Inspection Report Score: 96 KINGSTON RESIDENCE2018010718EstablishmentName:EstablishmentID: 904 2NDSTNELocationAddress: InspectionRe-Inspection HICKORYNC Date:10172017 StatusCode: City: State: amam12230149TimeIn:TimeOut: 2860118 Catawba pmpmZip: County: 1hr26minutesTotalTime: KINGSTON HEALTHCAREPermittee: IVCategory #: 828) 327-9955Telephone: FDAEstablishmentType: Municipal/CommunityOn-SiteSystemWastewaterSystem: No. ofRiskFactor/InterventionViolations: Municipal/CommunityOn-SiteSupplyWaterSupply: No. ofRepeatRiskFactor/InterventionViolations: FoodborneIllnessRiskFactors andPublicHealthInterventions GoodRetailPractices Contributing factorsthatincreasethechanceofdevelopingfoodborne illness. Riskfactors: GoodRetail Practices:Preventative measures tocontroltheadditionof pathogens, chemicals, andphysical objectsinto foods. Controlmeasurestopreventfoodborneillnessorinjury. PublicHealthInterventions: GoodRetailPractices: OUTCDIRVROUTCDIRVRINOUTN/A N/OIN OUT N/A N/OComplianceStatus Compliance Status Supervision.2652 SafeFoodandWater.2653, .2655, .2658 PICPresent; Demonstration-Certificationby 0.520101Pasteurizedeggsusedwhererequired28accreditedprogramandperformduties Employee Health.2652 210Waterandicefromapprovedsource29 Management, employeesknowledge; 1.5302 Varianceobtainedforspecializedprocessingresponsibilities & reporting 0.51030methods 1.5Properuseofreporting, restriction & exclusion 303 FoodTemperatureControl.2653, .2654 GoodHygienicPractices.2652, .2653 Propercoolingmethods used; adequate 0.51031equipmentfortemperaturecontrol210Propereating, tasting, drinking, ortobaccouse4 0.510Plantfoodproperlycookedforhotholding32 0.510Nodischargefromeyes, noseormouth5 0.510Approvedthawingmethodsused33PreventingContaminationbyHands.2652, .2653, .2655, .2656 0.510Thermometersprovided & accurate344206Handsclean & properlywashed FoodIdentification.2653NobarehandcontactwithRTEfoodsorpre- 1.5307approvedalternateprocedureproperlyfollowed 210Foodproperlylabeled: originalcontainer35 210Handwashingsinkssupplied & accessible8 PreventionofFoodContamination.2652, .2653, .2654, .2656, .2657 ApprovedSource.2653, .2655 Insects & rodentsnotpresent; nounauthorized 21036animals2109FoodobtainedfromapprovedsourceContaminationpreventedduringfood21037preparation, storage & display210Foodreceivedatpropertemperature10 0.510Personalcleanliness38 210Foodingoodcondition, safe & unadulterated11 0.510Wipingcloths: properlyused & stored39Requiredrecordsavailable: shellstocktags, 21012parasitedestruction 0.510Washingfruits & vegetables40ProtectionfromContamination.2653, .2654 ProperUseofUtensils.2653, .26541.530Foodseparated & protected13 0.510In-useutensils: properlystored41 1.530Food-contactsurfaces: cleaned & sanitized14 Utensils, equipment & linens: properlystored, 0.51042Properdispositionofreturned, previouslyserved,dried & handled21015reconditioned, & unsafefood Single-use & single-servicearticles: properly 0.51043PotentiallyHazardousFoodTIme/Temperature.2653 stored & used 1.5 0.5301016Propercookingtime & temperaturesGloves usedproperly44 UtensilsandEquipment.2653, .2654, .26631.530Properreheatingproceduresforhotholding17 Equipment, food & non-foodcontactsurfaces 210approved, cleanable, properlydesigned, 451.530Propercoolingtime & temperatures18 constructed, & used Warewashing facilities: installed, maintained, & 1.530Properhotholdingtemperatures19 0.51046used; teststrips 1.530Propercoldholdingtemperatures20 0.510Non-foodcontactsurfacesclean47 1.530 Physical Facilities.2654, .2655, .265621Properdatemarking & disposition 210Hot & coldwateravailable; adequatepressure48Timeasapublichealthcontrol: procedures & 21022records 210Plumbinginstalled; properbackflowdevices49ConsumerAdvisory.2653 Consumeradvisoryprovidedforrawor 0.51023 210Sewage & wastewaterproperlydisposed50undercookedfoods HighlySusceptiblePopulations.2653 Toiletfacilities: properly constructed, supplied 0.51051cleanedPasteurizedfoodsused; prohibited foodsnot 1.53024offered Garbage & refuseproperlydisposed; facilities 0.51052maintainedChemical.2653, .2657 0.50.5 1010Foodadditives: approved & properlyused Physicalfacilitiesinstalled, maintained & clean2553 Meetsventilation & lightingrequirements; 0.5Toxicsubstancesproperlyidentifiedstored, & used 210102654designatedareasused Conformance withApprovedProcedures.2653, .2654, .2658 Compliancewithvariance, specializedprocess, TotalDeductions: 21027reducedoxygenpackingcriteriaorHACCPplan NorthCarolinaDepartmentofHealth & HumanServices DivisionofPublicHealthEnvironmentalHealthSectionFoodProtectionProgram DHHSisanequalopportunityemployer. CR Off Page 1ofFoodEstablishmentInspectionReport, 3/2013 Comment Addendum toFood Establishment Inspection Report KINGSTON RESIDENCE 2018010718EstablishmentName:EstablishmentID: 904 2NDSTNE 10/17/2017Date: InspectionRe-InspectionLocationAddress: HICKORYNC CommentAddendumAttached? City:State: StatusCode: 2860118CatawbaIVCounty:Zip: Category #: WastewaterSystem:Municipal/CommunityOn-SiteSystem llaucks-smith@kingstonhealth.comEmail1: WaterSupply:Municipal/CommunityOn-SiteSystem SRAMIREZ@KINGSTONHEALTHCARE.COMKINGSTONHEALTHCAREEmail2: Permittee: 828) 327-9955Telephone: Email3: TemperatureObservations ItemTempLocationTempItemLocationItemLocationTemp BROCCOLIHOT HOLD125 BROCCOLIREHEAT180 TURKEYSANDWICH PREP57 HAMSANDWICH PREP56 LETTUCESANDWICH PREP53 SLICEDSANDWICH PREP51 TACO MEATWALK IN138 WALK IN38 ObservationsandCorrectiveActions Violationscitedinthisreportmust becorrected withinthetimeframesbelow, orasstatedinsections8-405.11ofthe food code. 6-301.12HandDrying Provision - PF PROVIDEPAPERTOWELSATEACHHANDWASHING STATION CDI: PROVIDEDBYOPERATOR 19 3-501.16 (A)(1) Potentially HazardousFood (Time/Temperature Control forSafetyFood), HotandColdHolding - P HOTHOLD ALLHEATED FOODSABOVE 135DEGF BROCCOLI CHEEESESOUP AT125INWARMER CDI: REHEATED TO180DEGFBYOPERATOR 20 AREMINDER: Allcoldfoods mustbeheldat41°Fbeginning JANUARY 1, 2019. 3-501.16 (A)(2) and (B) Potentially Hazardous Food (Time/TemperatureControlforSafetyFood), HotandColdHolding - P COLDHOLDALL REFRIGERATED FOODSBELOW41-45DEGF FirstLast MIS(TYWILLIAMSPersoninCharge (Print & Sign): FirstLast JASONHUFFMANRegulatoryAuthority (Print & Sign): 1654 - Huffman, JasonREHSID: VerificationRequiredDate:// REHSContactPhoneNumber: NorthCarolinaDepartmentofHealth & HumanServices DivisionofPublicHealthEnvironmentalHealthSectionFoodProtectionProgram DHHSisanequalopportunityemployer. FoodEstablishmentInspectionReport, 3/2013Page2of Comment Addendum toFood Establishment Inspection Report KINGSTON RESIDENCE 2018010718EstablishmentName:EstablishmentID: ObservationsandCorrectiveActionsObservationsandCorrectiveActions Violationscitedinthisreportmustbecorrected withinthetimeframesbelow, orasstatedinsections8-405.11ofthefood code. Violationscitedinthisreportmustbecorrected withinthetimeframesbelow, orasstatedinsections8-405.11ofthefood code. 53 6-501.12 Cleaning, Frequencyand Restrictions - C CLEAN/REPAIR FLOORS, WALLS ASNEEDED NorthCarolinaDepartmentofHealth & HumanServices DivisionofPublicHealthEnvironmentalHealthSectionFoodProtectionProgram DHHSisanequalopportunityemployer. Page3of FoodEstablishmentInspectionReport, 3/2013 Comment Addendum toFood Establishment Inspection Report KINGSTON RESIDENCE 2018010718EstablishmentName:Establishment ID: ObservationsandCorrectiveActions Violationscitedinthisreportmustbecorrected withinthetimeframesbelow, orasstatedinsections8-405.11ofthefood code. NorthCarolinaDepartmentofHealth & HumanServices DivisionofPublicHealthEnvironmentalHealthSectionFoodProtectionProgram DHHSisanequalopportunityemployer. N/A FoodEstablishmentInspectionReport, 3/2013Page4of Comment Addendum toFood Establishment Inspection Report KINGSTON RESIDENCE2018010718EstablishmentName:EstablishmentID: ObservationsandCorrectiveActions Violationscitedinthisreportmust becorrected withinthetimeframesbelow, orasstatedinsections8-405.11ofthe food code. NorthCarolinaDepartmentofHealth & HumanServices DivisionofPublicHealthEnvironmentalHealthSectionFoodProtectionProgram DHHSisanequalopportunityemployer. N/APage5ofFoodEstablishment InspectionReport, 3/2013 Comment Addendum toFoodEstablishment Inspection Report KINGSTON RESIDENCE2018010718EstablishmentName:Establishment ID: ObservationsandCorrectiveActions Violationscitedinthisreportmust becorrected withinthetimeframesbelow, orasstatedinsections8-405.11ofthe food code. NorthCarolinaDepartmentofHealth & HumanServices DivisionofPublicHealthEnvironmental HealthSectionFoodProtectionProgram DHHSisanequalopportunityemployer. N/APage6ofFood EstablishmentInspectionReport, 3/2013