HomeMy WebLinkAboutBlackburn Elementary School 110004 09 05 12.ls.pdfFood Establishment Inspection Report Score: 97
Establishment Name- BLACKBURN ELEMENTARY SCHOOL
Establishment ID: 2018110004
Date: 0 9 1 0 5 1 a 0 1� Status Code: A
am
Time In: 1 a: 3 9 0 Pm Time Out: 1 a: 1 0* Pm
Category #: 4
Establishment Type:
Instructions:
Location Address: 4377 W NC 10 HWY
City: NEWTON
State: NC Zip: 28668
County: 18
Permittee: CATAWBA COUNTY SCHOOLS
Telephone:
06 nspection
ORe-Inspection
Wastewater System:
OMunicipal/Community
On -Site System
Water Supply:
Municipal/Community
(__)On -Site System
North Carolina Department of Health & Human Services • Division of Public Health
Environmental Health Section • Food Protection Program
Pagel of Food Establishment Inspection Report, 712012
Compliance Status
OUT
4 0 O PIC Present; Demonstration -Certification by accredited
IN OUT NIA program and perform duties 2000 O O 0
2 O Management, employees knowledge; responsibilities O O O 0 0 0
IN OUT & reporting 3 1.5 0
0T Proper use of reporting, restriction & exclusion 000
3 I O O 0
4 NN
OUT
Proper eating, tasting, drinking, or tobacco use
2 9
Q
Q
Q
5
No discharge from eyes, nose, and mouth
000
O
O
0
INOT
Pry €enting +contamination by .2665,, . 656
6
0
Hands clean & properly washed
Q Q Q
O
O
O
IN
OUT
4 2 0
O O
7
No bare hand contact with RTE foods or pre -approved
0 O
0
0
0
IN OUT
i
alternate procedure properly allowed
1.5
$ IN
cT
Handwashing sinks supplied & accessible
O O O
Q
Q
Q
9
0T
Food obtained from approved source
O O O
O
O
O
IN
2 1 0
10
0 0 *
Food received at proper temperature
O O O
O
O
O
IN OUT N10
2 1 0
11
0T
Food in good condition, safe & unadulterated
O O 0
O
0
0
IN
2 1 0
00 O
Required records available: shellstock tags, parasite
Q Q Q
12
IN OUT NIA NIO
destruction
2 1 0
O
O
O
13 Se V V V Food separated & protected O O O
IN OUT N/A N10 3 1.5 0 Q Q Q
14 0 V Food -contact surfaces: cleaned & sanitized O* O O O O
IN OUT 3 1.5 0
5 Q Proper disposition of returned, previously served, Q Q Q Q Q Q
IN OUT reconditioned, & unsafe*%pd 2 1 0
16
0
Proper cooking time & temperatures
0 0
O
O
O
IN O0 !N
105
17
Q 0 0
Proper reheating procedures for hot holding
O O O
Q
Q
Q
NOUTNIA 1
3 1.5 0
18
0
cooling time & temperatures
0 0
O
O
0
1Proper
IN 00UT
1Q
19
IN O0 N0 1Proper
hot holding temperatures
O O O
O
O
O
3 1.5 0
20,N
OT O O
Proper cold holding temperatures
010 0
Q
Q
Q
21
0 0 0
Proper date markin disposition
00 0
Q
Q
Q
IN OUT NIA NIO
3 1.5 0
22
0
Time as a public health control: procedures & records
0 0 0
0
0
0
IN 00T N00
O O Consumer advisory provided for raw or undercooked (:1)Q (0:)23 IN OUT NIA foods 1 0.5 0 0 0 0
24 I 00 0 (Pasteurized foods used; prohibited foods not offered 010 0IN Q Q Q
0 0 Food additives: approved & properly used 000
25 IN OUT NIA 1 0.5 0 0 0 0
26 t DQ 0 Toxic substances properly identified storedN/A, & used 000
O O O
27 O O Compliance with variance, specialized process, Q Q Q
IN OUT N1A reduced oxygen packing criteria or HACCP plan 2 1 0 O O O
Food Establishment Inspection Report, continued
Establishment Name: BLACKBURN ELEMENTARY SCHOOL
Establishment ID: 2018110004
Instructions, continued:
Signature Block:
Person in Charge (Print)
Person in Charge {Si ture)
Regulatory Authority (Print)
Regulatory u Signature)
Contact Number: ( ) -
Verification Required Date:
REHS ID: 1896 - Sears, Luke
No. of Risk Factor
Intervention
Violations: 1
No. of Repeat Risk
Factor/Intervention
Violations:
... Retail Practices
Good Retail Practices: Preventative measures to control the addition of pathogens,
chemicals, and physical objects into foods.
Compliance Status OUT CDI R
VR
,Safe Food and:Water
28
IN OT
Pasteurized eggs used where required
0 DO 0
O O
O
29
OUT
Water and ice from approved source
O O O
O O
O
30
ION OU0 �M1J1A
Variance obtained for specialized processing methods
O O O
O O
O
Food Temperature
crntrol .. 2 63,1,1664
31
it O
Proper cooling methods used; adequate equipment for
O O O
O
O
0
IN OUT
temperature control
1 0.5 0
32
Plant food properly cooked for hot holding
O O O
O
O
0
IN OUT NO/A NO
33
'y 0 O O
Approved thawing methods used
O
O
O
IN OUT NIA N/C
1 0.5 0
34
4 O0
1 INFood
Thermometers provided & accurate
O O O
O
O
O
ldsnti{ication,,..
_ 65 ...
35
O
Food properly labeled: original container
O O O
0
0
0
IN OUT
2 1 0
Prevention
of Food
Contamination �� :26�2R . 653,' :266 4, ,6,�P,2657
....
36
O (A
OUT
Insects & rodents not present; no unauthorized animals
O O OIN
O
O
O
37
O
Contamination prevented during food preparation,
O O O
O
O
O
IN OUT
storage & display
2 1 0
38
GOUT
Personal cleanliness
O O O
O
O
O
39
O0
Wiping cloths: properly used & stored
O O O
O
O
O
40
0
Washing fruits & vegetables
O O O
O
O
O
Proper
Use of Utensils
... .2653, :2654
41
( O0
In -use utensils: properly stored
O O O
O
O
O
42
O
Utensils, equipment & linens: properly stored, dried
O O O
O
O
O
IN OUT
& handled
1 0.5 0
43
* O
Single -use & single -service articles: properly
O O O
0
0
0
IN OUT
stored & used
1 0.5 0
44
(* O0
Gloves used properly
O O O
O
O
O
Utensils and Equipment
265; .265„266
Equipment, food & non-food contact surfaces approved, O O O
45
O
O
O
O
IN OUT
cleanable, properly designed, constructed, & used 2 1 0
46
O
Warewashing facilities: installed, maintained, & used;
O O O
O
O
O
IN OUT
test strips
1 0.5 0
47
IN OOUT
Non-food contact surfaces clean
1.5 O
O
O
O
Physical
Faeiiitiea
48
� OUT
Hot & cold water available; adequate pressure
O O O
O
O
0
48
IN GOUT
Plumbing installed; proper backflow devices
O O O
O
O
O
50
% IN O0
Sewage & waste water properly disposed
O O O
O
O
O
51
O O
Toilet facilities: properly constructed, supplied
O O O
0
0
0
IN OUT
& cleaned
1 0.5 0
52
O
Garbage & refuse properly disposed;
O O O
0
0
0
IN OUT
facilities maintained
1 0.5 0
53
O '*"
Physical facilities installed, maintained & clean
0 0 0
O
O
O
IN OUT
1 0.5 0
54
O
Meets ventilation & lighting requirements;
O O O
O
O
O
IN OUT
designated areas used
1 0.5 0
Total Deductions:
North Carolina Department of Health & Human Services* Division of Public Health
Environmental Health Section • Food Protection Program
Food Establishment Inspection Report, 712012 1 of
Comment Addendum to Food Establishment Inspection Report
Establishment Name: BLACKBURN ELEMENTARY SCHOOL
Location Address: 4377 W INC10 HWY
City: NEWTON State: NC
County: 18 Zip: 28658
Wastewater System: 0 MunicipallCommunity On -Site System
Water Supply: S MunicipallCommunity 0 On -Site System
Permittee: CATAWBA COUNTY SCHOOLS
Telephone:
Establishment ID: 2018110004
Item Location Temp Item Location
Date: 09/05/2012
Status Code: A
Category #: 4
Email 1:
Email 2:
Email 3:
Temp Item Location Temp
North Carolina Department of Health & Human Services • Division of Public Health • Environmental Health Section *Food Protection Program
Page 3 of Food Establishment Inspection Report, 712092 N_C. Department of Health and Human Services is an equal opportunity employer and provider
Comment Addendum to Food Establishment Inspection Report
Establishment Name: eL cKguRN ELEMENTARY SCHOOL Establishment ID: 201811000
W"
Spell
North Carolina Department of Health & Human Services • Division of Public Health • Environmental Health Section • Food Protection Program
A C_ Department of Health and Human Services is an equal opportunity employer and provider.
Page of Food Establishment Inspection Report, 712012
Comment Addendum to Food Establishment Inspection Report
Establishment Name: BLACKS RN ELEMENTARY SCHOOL Establishment ID: 201811000
W"
Spell
North Carolina Department of Health & Human Services • Division of Public Health • Environmental Health Section • Food Protection Program
N_C. Department of Health and Human Services is an equal opportunity employer and provider -
PageSof Food Establishment Inspection Report,712092