HomeMy WebLinkAboutAmalfis Pizza 011089 03 08 12.jh.pdfNA NO
.2616Employee Health
.2616Good Hygiene Practices
.2609,.2616,.2625Preventing Contamination by Hands
.2608,.2610,.2612,.2615,.2622Approved Source
Food Service Establishment Inspection
Food contact surfaces cleaned & sanitized; approved methods and sanitizers
.2608,.2610,.2611,.2612,.2614,.2615,.2617,.2618,.2619,.2622Protection from Contamination
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.2609,.2612Potentially Hazardous Food
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1
Proper hot holding temperatures
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5
Item
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7
Temp
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9
10
TempLocation
City:
Establishment Name:
Item
Email Address:
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:Wastewater Systems:Name Change
Status Change
Water sample taken today?
Water Supply:
CRITICAL VIOLATION RISK FACTORSCritical Violation Risk Factors = Contributing factors that increase the chance of developing foodborne illnessGC = General Comment CDI = Corrected During Inspection R = Repeat Violation
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
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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
:
31.5
31.5
4 2
3 1.5
31.5
42
31.5
31.5
21
31.5
31.5
21
42
42
31.5
42
42
31.5
AMALFIS PIZZA
104N THORNBURG DR
CONOVER NC 28613
VINCENZO INC
104N THORNBURG DR
CONOVER
96 96
0 3 0 8 2 0 1 2 0 2 4 4
A
18
2018011089
5 6
PEPPARONI PIZZA PREP 43
CHEESE PIZZA PREP 41
CUT SANDWICH PREP 43
TURKEY SANDWICH PREP 43
PROVIDE NSF SURFACES FOR FOODS (SICILIAN CRUST IN NON-NSF STORAGE DRAWER); INVERT SINGLE SERVICE TO
PROTECT FROM CONTAMINATION; PROVIDE GLOVES FOR FOOD PREP--DO NOT ALLOW BARE HAND CONTACT OF
READY TO EAT FOODS (NO VIOLATION FOUND DURING INSPECTION, BUT THERE WERE NO OTHER GLOVES AVAILABLE
IN ESTABLISHMENT)
48
36
37
20
38
#
39
Establishment Name:
40
19
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)
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.2612
29
30
Consumer Advisory
31
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34
2
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41
R
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49
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
Approved warewashing facilities of sufficient size
Current Establishment ID:
Warewashing facilities maintained; test strips used
Date:
GOOD RETAIL PRACTICESPreventitive measures to control the introduction of pathogens, chemicals, and physical objects into foods
COMMENTS:
Food service equipment and utensils approved
NO
Non-food contact surfaces clean
GCPts
Toxic substances properly identified, stored, used
Source in accordance with 15A NCAC 18A .1700; hot & cold water available, under pressure
Refrigeration and freezer capacity sufficient
Proper cooling methods used
Proper thawing methods used
Thermometers provided and accurate
Dry food stored properly & labeled accordingly
Insects, rodents, and animals not present
Clean clothes, hair restraints
Linens, cloths, & aprons properly used & stored
Washing fruits & vegetables
Not used for domestic purposes
In-use utensils properly stored
Utensils & equipment properly stored, air-dried, handled
Single-use/single-service articles properly stored, handled, used
Wastewater discharged into approved, properly operating wastewater treatment & disposal system; other
No cross-connections
Toilet and lavatory facilities; supplied, properly constructed, clean, good repair, signs provided
Garbage properly handled & disposed; containers properly maintained
Floors, walls, ceilings properly constructed, clean, in good repair
Meets illumination requirements; shielded; lighting & ventilation clean & in good repair
Storage spaces clean, storage above floor; approved storage for mops, brooms, hoses, & other items
Doors self-closing where required; all windows screened
Successfully completed approved food safety training
Total Deductions
by-products disposed of properly
Page 2 of 2
.2606Food Safety Knowledge
Utensils and Equipment .2612,.2613,.2617,.2618,.2619,.2620,.2621
.2623,.2624,.2625,.2626,.2627,.2628,.2630,.2631,.2632,.2633Physical Facilities
.2609,.2616,.2617,.2626,.2633Prevention of Food Contamination
Proper Use of Utensils .2612,.2618,.2620,.2622
.2609Food Temperature Control
.2610,.2612,.2615Food Storage
.2618,.2622,..2623Water Supply
.2618,.2633Chemical
ATTACHMENTS:
Inspection by:
Report Received by:
EHS I.D. #:
31.5
21
31.5
1.5
21
1.5
1.5
1.5
1.5
21
1.5
1.5
1.5
1.5
1.5
1.5
1.5
1.5
1.5
1.5
1.5
1.5
31.5
31.5
21
1.5
1.5
1.5
1.5
1.5
AMALFIS PIZZA 03/08/2012 2018011089
4
1654-Huffman, Jason
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
AMALFIS PIZZA
2018011089
104N THORNBURG DR
CONOVER
0 2 4 4
0 2 4 5
1 minute
10
18
23
PROTECT FOODS DURING STORAGE/PREP: COOKED CHICKEN WINGS PLACED BACK INTO BOX RAW CHICKEN WAS
ORIGINALLY PACKAGED IN. SOURCE OF CONTAMINATION. COOKED WINGS REHEATED TO 165 DEG F IN FRYER.
FOLLOW TILT PLAN BY PROVIDING COOK TIMES/TEMPERATURES--PIZZAS ON SERVICE LINE WITHOUT LABELED
TIMES--PIZZAS REHEATED TO 165 DEG F, TIMES LABELED ACCORDINGLY
COOL FOODS USING LOOSELY COVERED SHALLOW PANS--BAGS OF HOT CHICKEN WINGS STORED IN DEEP TUBS
(PREPARING DURING INSPECTION)
N.C. Department of Environment and Natural Resources
Division of Environmental Health
COMMENT ADDENDUM City:
Street:
ID:
Name:AMALFIS PIZZA
2018011089
104N THORNBURG DR
CONOVER
N.C. Department of Environment and Natural Resources
Division of Environmental Health
COMMENT ADDENDUM City:
Street:
ID:
Name:AMALFIS PIZZA
2018011089
104N THORNBURG DR
CONOVER
N.C. Department of Environment and Natural Resources
Division of Environmental Health
COMMENT ADDENDUM City:
Street:
ID:
Name:
GC
Item Temp TempLocationItemLocation
TEMPERATURE OBSERVATIONS
Temp Item Location
AMALFIS PIZZA
2018011089
104N THORNBURG DR
CONOVER
PROVIDE NSF SURFACES FOR FOODS (SICILIAN
CRUST IN NON-NSF STORAGE DRAWER); INVERT
SINGLE SERVICE TO PROTECT FROM
CONTAMINATION; PROVIDE GLOVES FOR FOOD
PREP--DO NOT ALLOW BARE HAND CONTACT OF
READY TO EAT FOODS (NO VIOLATION FOUND
DURING INSPECTION, BUT THERE WERE NO OTHER
GLOVES AVAILABLE IN ESTABLISHMENT) -