HomeMy WebLinkAboutHams of Hickory Visit 011155 06 15 11.LS.pdf
Employee Health .2616 Good Hygiene Practices .2616 Preventing Contamination by Hands .2609,.2616,.2625 Approved Source .2608,.2610,.2612,.2615,.2622 Food Service Establishment Inspection
Food contact surfaces cleaned & sanitized; approved methods and sanitizers Protection from Contamination .2608,.2610,.2611,.2612,.2614,.2615,.2617,.2618,.2619,.2622 13 Potentially Hazardous
Food .2609,.2612 16 # 11 1 Proper hot holding temperatures 2345 Item 67 Temp 89 10 Location Temp City: Establishment Name: Item Email Address: NA Location Score: Lat. Long. Location
Address: NA = Not Applicable + NO = Not Observed NC Department of Environment & Natural Resources Division of Environmental Health Mailing Address: [.2606(b)] = City: State: Zip: State:
Permittee: Zip: Date: Status Code: County: Current Establishment ID: Previous Establishment ID: Seating: Name Change Wastewater Systems: Status Change Water sample taken today? Water
Supply: CRITICAL VIOLATION RISK FACTORS Critical Violation Risk Factors = Contributing factors factors that increase the chance of developing foodborne illness GC = General Comment CDI
= Corrected During Inspection R = Repeat Violation NO GC CDI R TEMPERATURE OBSERVATIONS Pts Personnel with infectious or communicable diseases restricted Proper employee beverage or
tobacco use Hands clean and properly washed Minimal bare hand contact with foods Handwashing facilities provided Food protected during storage, handling, display, service & transportation;
written notice for clean plates Proper handling of returned, previously served, and adulterated food Proper cooking time and temperature Proper cooling Proper reheating procedures Proper
cold holding temperatures Time as a public health control, procedures & records Food obtained from an approved source Food received at proper temperature Food in good condition, safe
and unadulterated Shellstock tags retained Temp Item COMMENTS: DENR 4007 (revised 01/08) Page 1 of 2 Location 12 14 15 17 18 Time: Municipal/Community On-Site System Municipal/Community
On-Site System Inspection Re-inspection Visit CV Visit CV Follow-up //Risk: I II III IV : 3 1.5 3 1.5 4 2 3 1.5 3 1.5 4 2 3 1.5 3 1.5 2 1 3 1.5 3 1.5 2 1 4 2 4 2 3 1.5 4 2 4 2 3 1.5
HAMS OF HICKORY 204 HWY 321 NW HICKORY NC 28601 DAVID PARSONS 204 HWY 321 NW HICKORY 0 6 1 5 2 0 1 1 0 0 0 1 H 18 2018011155 1 1 6
Establishment Name: Purpose: General Statute 130A-248 requires the Commission for Health Services to adopt rules governing the sanitation of facilities where food or drink is provided
or served for pay. 15A NCAC 18A .2604 specified the contents of an inspection form to record the results of inspections made of such facilities. This form is developed to be used in
making inspections of restaurants, food stands, drink stands, delicatessens, school lunchrooms, educational food services, commissaries, meat markets, and other similar establishments.
Preparation: Local environmental health specialists shall complete the form every time an inspection is conducted. Prepare an original and two copies for: 1. Original to be left with
the responsible person. 2. Copy for the local health department. 3. Copy for the Environmental Health Services Section. Disposition: This form may be destroyed in accordance with Standard-8.B.6.,
Inspection Records, of the Records Disposition Schedule, published by the N.C. Division of Archives and History. Additional forms may be ordered from: Division of Environmental Health,
1632 Mail Service Center, Raleigh, NC 27699-1632 (Courier 52-01-00) Consumer Advisory .2612 2 R 48 NA Original container for storage of milk & shellfish Food & non-food contact surfaces
easily cleanable & in good repair Consumer advisory provided Food Service Establishment Inspection NC Department of Environment & Natural Resources Division of Environmental Health 36
Approved warewashing facilities of sufficient size Current Establishment ID: 37 20 Warewashing facilities maintained; test strips usedDate: GOOD RETAIL PRACTICES 38 Preventitive measures
to control the introduction of pathogens, chemicals, and physical objects into foods COMMENTS: Food service equipment and utensils approved # 39 NO Non-food contact surfaces clean Pts
GC Toxic substances properly identified, stored, used 40 19 21 Source in accordance with 15A NCAC 18A .1700; hot & cold water available, under pressure 22 Refrigeration and freezer capacity
capacity sufficient 23 Proper cooling methods used 24 Proper thawing methods used 25 Thermometers provided and accurate 26 Dry food stored properly & labeled accordingly 27 28 Insects,
rodents, and animals not present 29 Clean clothes, hair restraints 30 Linens, cloths, & aprons properly used & stored 31 Washing fruits & vegetables 32 Not used for domestic purposes
33 In-use utensils properly stored 34 Utensils & equipment properly stored, air-dried, handled 35 Single-use/single-service articles properly stored, handled, used 41 Wastewater discharged
into approved, properly operating wastewater treatment & disposal system; other 42 No cross-connections 43 Toilet and lavatory facilities; supplied, properly constructed, clean, good
repair, signs provided 44 Garbage properly handled & disposed; containers properly maintained 45 Floors, walls, ceilings properly constructed, clean, in good repair 46 Meets illumination
requirements; shielded; lighting & ventilation clean & in good repair 47 Storage spaces clean, storage above floor; approved storage for mops, brooms, hoses, & other items Doors self-closing
where required; all windows screened 49 Successfully completed approved food safety training Total Deductions by-products disposed of properly Page 2 of 2 Food Safety Knowledge .2606
Utensils and Equipment .2612,.2613,.2617,.2618,.2619,.2620,.2621 Physical Facilities .2623,.2624,.2625,.2626,.2627,.2628,.2630,.2631,.2632,.2633 Prevention of Food Contamination .2609,.2616,.2617,.26
26,.2633 Proper Use of Utensils .2612,.2618,.2620,.2622 Food Temperature Control .2609 Food Storage .2610,.2612,.2615 Water Supply .2618,.2622,..2623 Chemical .2618,.2633 ATTACHMENTS:
Inspection by: Report Received by: EHS I.D. #: 3 1.5 2 1 3 1.5 1 .5 2 1 1 .5 1 .5 1 .5 1 .5 2 1 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 1 .5 3 1.5 3 1.5 2 1 1 .5 1 .5
1 .5 1 .5 1 .5 HAMS OF HICKORY 06/15/2011 2018011155 01896-Sears, Luke
Total Time: N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM Time In: Time Out: City: Street: ID: Name: : am pm : am pm HAMS OF
HICKORY 2018011155 204 HWY 321 NW HICKORY 0 0 0 1 0 0 0 3 2 minutes
N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: HAMS OF HICKORY 2018011155 204 HWY 321 NW HICKORY
N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: HAMS OF HICKORY 2018011155 204 HWY 321 NW HICKORY
N.C. Department of Environment and Natural Resources Division of Environmental Health COMMENT ADDENDUM City: Street: ID: Name: GCItem Location Temp Item Location Temp TEMPERATURE OBSERVATIONSTemp
Item Location HAMS OF HICKORY 2018011155 204 HWY 321 NW HICKORY