HomeMy WebLinkAboutBlackburn Elementary School 110004 05 23 11. LS.pdf.�j 1 iii 1 w ii jj1 1 Le,
Division of Environmental, Health
EstablishmentiName: BLACKBURN ELEMENTARY SCHOOL
Lyricaboin AddreSS- 4377 W NC 10 HWY
CrtyNEWTON SnateNC Z28658
Score: 99 + * [,2606(b)l= 1101
Date-, 05/ -13/2011TIme.0 0 0 1
Status Ctale Risk III IV
Per imittee: CATS WBA COUNTY SCHOOLS Courdy 18,
Mailing Address: Current Establishiment lD] 201,8110004,
Previous Estald6shment ID
Ernafl Address: Lat, Long
Iinspection 1:1 Name Change CV visit 0 Seating: y1+aslewater Sj stems-, E]htunicipavcommurflity [Eon -Site System
Re-instrection Slatus Change CV Follow-up -
Visa Water Supp�y: N]ksunicipancommunity []On -Site System
E], war& sample taken today`
CRITICAL VIOLAMON RISK FACTORS
Calico! Violation Risk Factors= Coninbuhng factors hilt mcrease the Chance of developing foodborne fliness
NA - Not Applicable NO - Not Observed: 6 C - General C orrimen I CDI - C rrectedi During Inspection R - R epreat Violation
tSG_C_FC_D_1T_R
Personnel with Infectious or communicable diseases restricted 1 31 1"5
Proper employee beverage or tobacco use 1 3 1,5
Hands clean and properly washed 4 2
It rnimm bare hand contact with foods —i—I 5
Handwashing facoldies prawlded 3 T.
Food oblamed from an approved source 4 2
Food received at proper temperature 3 1,5
Food in good condition, safe and unadulterated
Shellstoclk tags retained 2 1
Foad prolected during Storage, ftandflnqdrspiayiservice & transportation, writtlea notke for clean plates
Food Contact surfaces deanea & gonifted� approved rinethods and sainkfizers
Proper handling of returned, previousq sery ed, and aidurteratied food
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Proper cooKing time and temperature
Proper cooling
Proper rehleating procedures
I ....... . .... 11 ......... .. .. . ......... . . . . ...... ",'','""l ...........
Pir pier not holding tempefaluies
Proper cold hickling temperatures
Time as a icubfic heafth controL procedures& fecords
Item Locabon Tamp item Lociatmn Tamp Item Locafion Ternis
CHICKEN HOT HOLD 170
ONION RING HOT HOLD 150
SHRED COOLER 44
APPLE COOLER 38
DENR 4007 tievjsed 01108) Page 1 of 2
Food Service Establishment Inspection NC Department of Entalronme nt & Natural Resources
Division of Environmental Health
BLAMBLARN E"ENMY SCHWL
Estaitilishment Niarne'. Date � M3J2O I I Cuffent Establishmerill ID
GOOD RE TA IL PRA C TICE S
�WTO��ances properly Wenfified, stored, used
Consumer advoory provrided 2
Source in accordance with 15A rACA C 18A .1 7W hot & cold water av a0able, under Pressure 3 1,5
ReIngeration ana freezer capacpsufficient
Proper cooling methods used
Proper thawing methods used 1'_5
Thermometers, provided and: accurate 1 75
Ory food stored properly & labeled accordirnigly
Cr riginal conlaRner for storage of mflk & shellfish
0
Insects.,, rodents, and animals not present 2 1
dean clothes, hair restraints
Linens, cloths & aprons property need 8, stored 1 -5
--------------------
Wasill fruits vegetables 1 5
Not used to r domestic purposes —1-5
in -use utensils property stored 1 5
Utensils & eqWpment properly stored, air-dried, handled 1 -5
SMijile-ussisingle-service articles properly stored, handled, used 1 5
36
Food & non-food contact surfaces easTry cleanable & in good repair
371
1 1 Approved Wairewashing facRifles of suffilicient size
38
1 Warewashiling facirdes mairntalined, test stirlips used
1 '5
39
Food servioe ermlipment and ri approved
1 '5
40
-non-food contact surfaces clean
1 '5
Wastevraler arssidarged intir approved, properly operating wastewater treatment & dtsposaf systerni other I
by�prodiu site allisposed of property
No cross -connections
Toget and lavatory facirrffes� supplied, propi constructs d, clean, good repair, sons provIded ....................
Garbage, properly handled & dlispos&M containers properly maintained
Hool waft ceilings property constructed, clean, in good reparr
M eets Hluminalion re Ufternenis shieldied, Ughfing is ventillation clean in dead repailir
Storage spaces cie an, storage above floor,, approved storage for mops, brooms, hoses, & other items
Doors salf-cilosing where requtred; all end dows screened
Tsdall Deduicltllois
Successfully carripAVapproved
COMME'll
Inspection by:
Report Receive ay.
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ATTACHMENTS�
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N,C, Dep ail mtot of Ervviron men and N at wa I Resources I mitm BLALKSUMELEMENTARYSCHM Time In1 mjaptl
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Division of Enviucirtmental Heafth I 2018110004 Time Out, 0 0 0 a glam
1 11 p m
COMMENTADDENDUM Street' 4377 W NC 10 HWY Total Time: 1 minute
City: NEWTON
3,6 REPA11 REPLACE TORN GASKET ON REACH IN COOLER NEXT TO MILK COOLER.
CLEAN MOLD FROM GASKETS AS NEEDED.
N.C. Department of Environment and Natural Resources,
Division of Environmental Heafth
Name
ID. 2018110004
L*U* MUTIAAdU110194MLILTA
Street: 4377 W NC 10 HWY
QtY' -NE!59—Q—N
II
N.C, Department of Environment and Natural Resources
Division of Environmental Heafth
Name`
ID, 2018110004
Street. 4377 W NC 10 HWY
CrtY: NEWTON
IN
Name, SLACKBURtiELEM'CNTARY;mot
iOOL
N.C. Department of Enwonment and NaturM Resources
DIvision of Emronmental Heath
ID 2018,110004
Street 4377WNC10HWY
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Hem Locahon 7,emp Item LoCalion Temp Item Locafion 7ernp