HomeMy WebLinkAbout8th Av 430093 06 22 12.ls.pdfN,C, Nso
nay 1-160th ` 4 H calth Department 18,
Demerit 'q Core,
Inspection of Date ofInsp/Chg 0 6 1 2 j1 1 2 Curnint F aritity ID 2018430093
Residential Care Facility
(For farillbies,as deffivd.with Status Code, A Old Facility ID
not more tIon 12 residents)
W iii� ----MNon�Transle�ntt4on-r-ornmuntly W"saimpletakeiitoday-7 Inspection Name Change
a r C-�----ItY�
DIT'ransient Moir- Community [ENon-Pubhe Water SuppIy [:]yes No Re-tnspechon Verificalion of Gresure
Wastewater System, F*')-- ommuney F2flon-site syslern vivt tabus Change
ffEm
Rrttitt UNKNOWN
Nimber of Resrdents�
LocationAddresiz 212 8TH AV NW
City: HICKORY scata,ip, 2,8601 Mailling Addr.
Classification
City., Starr.- Zip,-
ff]Approved I or less demerits, and no 6-point ,anent 'I E] Disapproved (more than 40 demerits a, failure to improve lonsvision al classification)
Elprovisjonai (more than 20, Wt 40 or less dements, or a &parl dement) Demerits Comments
1, WATER SUPPLY; Public supply,prMte suit ply approved 6, (1,611),.
SEE COMMENT SHEET ATTACHED
2, LIQUIDWASTES: Spwage mid odteir° UqWA waift di ray of by q PMVW modod 6
(1613)
1 FOOD SUPPLIES AND PROTECTION:
Supplies: food cleitti, whalesonw, no spoilage, 6 (1619)
Protection: Adequate during storage, prepration ZTserving, potentially hazardous food 457
or bdow. or 1401 ora'OoVe 51 all rethgerators vath thernoorat ders 2, pork, ground beef products,
poultry andstuffings, etc., thoroughly cooked meat and poultry salad, potato salad, etc,, handled
as required, no re -saving orportorts once ;;�sed to an individ,%W JL fbod contain mired above
floor and, protected front rnrd r 6en 2, pds and other artinials nor allowed wbere food rs
prepared or stored, nor in mrviergret (unless caged or otheroasereAricted) 4 (1620)
4 FOOD SERVICE UTENSILS AND EQUIP1m4E14T, Faod service utensilsand equiluxtnt timid
t,epair and kept clean 4. eating mid drinking utensils clean I,* sight and touch, cleaned after each
use, approved ficithit.,ts 4t dean utensils properly stortol 2; substances couWaftpoise nous
materialnut u.,W for clewing or indisling eating or cooking, ritensiltd; disposable itelts
proptely, stored =,d haaf0el, used only once 2 ( 1618)—.
5 FOOD SER. VICEPER. SONS, Cim., clothes, harrds, and woA habits 4(1621)
6 DEMING WATFR FACLITES-1 ICE HANDLING: C ornnoin durdang cups not used 4, ice, if
provided. hantiled and dispensed in a saratarynrtreter 2 ( 1612)........
7 . H 0 T AND C OLD WATE R: Adequat e hot and cold viater pip ed to p orrits o f us e 4 1, 611)
8, TO ET HAFDWASH ING: LAUNDRY A14D B ATH 1140 F;LITIES: Toilet, laory an, d
bathin g facilifi es adequat e 4 " fixtures in go o drepairr and kept clean 2, soap, and towd s provi ded
9, BEDS L-REF4 FUPNITLTREAH fin-ruture, rccatresses, linen, drapes,, blinds and atnilar itarts in
good repaur and dean'2, bed linen changed as requirtil 2„ dean -and oiled linens properly stored'
and handled 2 (1617),,
10, STORAGE: MISCELLANEOUS: Rooms orareasproviOd for storage of dothespersonal effects.
lu&pge, supplies and equi,M, ent kept clean 21 ruedications, cleaning, supplies, pesticides and other
h=dous praducts properly stored as required 4 (1616)
11, FLOORS: In good repair I r kept clean 2 ( 1607) ..........
12 WALLS AND CEIL114GS: In good repair 1kept dewt 2 (1608),—
t3 LIGHTRITO AND VENTILATION: Windows and txturs's in goodrepsar % kept of (1609)
14. VERPAIN CONTROL. PREMISE& Outside openrigs efkctivdy screened or oath se PrGtedred
othervennin 4, approved pesticidesproperlyused 4, prenises neat, clean, drained and free of litter
and vernin harbaragem% and breedingareag 2 (1615) . ............. ............ ........ .... - -- ......... .. --
15. SOLID WASTE& Garbargem, standard containers, properly covered and stored, approved disposal Comr-nent Sheet Attached
4, containers, storagearea, kept clean 2, dry rubbish in suitablerereptades, approved storage and El Yes A] N 0
ilppOW2 t.I I ......
Re Received TOTALDEMIRIT SCORE4
1896 -Seam, Luke
EHS, I.D.9 Inspectinji'', I I
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DEN R W,94 (Revi5td 07X35) TTwiKmmnta1 Health S ervk*s Section (Review COMS)
N-(--. Department of Environment and Natural ResourseS Name, 8TH AV Time W 0 0 0 1 L11 :ern
— 1—o
Divisbn of EnvironmenHeaftpm
tal h IU 2018430093 Time Out, 0 o 0 Mam
Street! 212 8TH AV NW Total Tirn1 minute Oprn
COMMENT ADDENDUM Citil I'll CKORY
ii CLEAN FLOORS AS NEEDED IN CORNERS