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Esta b I is hm e nt N a M e: BLACKBURN ELEMENTARY SCHOOL Establishment ID: 2018110004
Location Address: 4377 W NC 10 HWY [Einspection EIRe-Inspection
City: NEWTON State: NC Date: 0 9 0 4 ;Z 0 1 3 Status Code: A
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Zip: 28658 County: 18 Catawba Tim e I n: 1 0 Pm Tim e Ou t: 1 1 : 1 .1 t Pm
. CATAWBA COUNTY SCHOOLS Total Time: 1 minute
Permittee.
Telephone: Category #: IV
Wastewater System: E]Municipal/Community RdOn-Site System FDA Establishment Type:
No. of Risk Factor/intervention Violations:
WaterSupply: HI]Municipal/Community E]On-SiteSupply No. of Repeat Risk Factor/intervention Violations:
Foodborne Illness Risk Factors and Public Health Interventions
Risk factors: Can tribut in g factors that increase the Chan. ce ufdeveloping fDodbDrne illness.
Public Health Interventions: Control measures to prevent fGiadborne illness or injury.
Good Retail Practices
Good Retail Practices: Preventative measuresto control the addition ofpathogens, chemicals,
and physical objects into foods.
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I Compliance Status
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supervisfolt
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.............. 1952, I945,,� 295S .........................................
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C sent. Demonstration -Certification by
0 Pcicre'dreited program and perduties
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28
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Pasteurized eggs used where required
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Water and ice from approved source
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0
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2❑Managementisemplayees
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lnowledge�
responsib litie & reporting
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0
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30
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0
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Variance obtained for specialized processing
methods
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0 0
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3
0
Proper use of re porting. restriction & exclusion
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7,
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patats
31
Tamer
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satire
Oetrvl ............. 2,143, 1144 ........................
roper cooling methods used. adequate
pequipment for temperature control
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400d
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s n1spt4etisas................
1452-2853
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Proper eating . tasting. drinking. or tobacco use
32
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0
0
0
Plant food properly cooked for hot holding
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0
0
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FIX
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No dischargefrom eyes. nose or mouth
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0
0
0
Approved thawing methods used
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0
0
fr%vejaujill
centamixtation
by 'Oftds .... ;952_2fS;,,, 1956, 144
Hands clean & properly washed
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0
0
0
31
!JVFOI
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Thermometers provided & accurate
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0
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No bare hand ntapct with RTE foods or pre-
roved Ite te d.,e p ope
a alternate roo rlVfollowed
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......................... . 26,54 ....................................................
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Food properly labeled . original container
JEI�OOJO
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Handwashing sinks supplied & accessible
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0
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Pfeveraten
I 36
0
of
Food
Pe;tteinfooeirk 1954,, IS, ,It4
Insects & rodents not present. no unauthorized
animals
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0
IfSZ, .76-55,
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Food obtained from approved source
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Contamination prevented during food
preparation. storage & display
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0
10
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Food received at proper temperature
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0
0
38
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Personal cleanliness
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0
0
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0
Food in good condition . safe & unadulterated
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0
0
0
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39
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Wiping cloths � properly used & stored
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0 0
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12
[E]
0
0
Required records available � shellstock tags.
parasite destruction
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0
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0
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Washing fruits & vegetables
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0 0
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Pr
'ateatiltathrom
13
Ed
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contamixtefloa
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1652, 1954
Food separated & protected
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.................. I834 ........................
41
0
In -use utensils: properly stored
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0
0
14
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Food contact surfaces- cleaned & sanitized
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0
0
0
0
42
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Utensils
Utensils. equipment& linens: properlystored
dried & handled
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0
0
15
0
Proper disposition of returned previously served.
reconditioned. & unsafe food
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0
0
0
43
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Single use & single -service articles: properly
stored & used
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0 0
0
0
pate'Ifflaffy
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its, F*pdT1m,*/,T'em pe
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Proper cooking time & temperatures
ET 00
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44
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Gloves used properly
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0
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17
HE
0
0
0
Proper reheating procedures for hot holding
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0
0
0
0
'Ute-aslisand
Squipm
ent 1952, 194, I6f3
45
0
Equipment. food & non-food contact surfaces
approvedcleanable, properly designed,
constructed, & used
11 t
0 El
El
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IS
V
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F-1
Proper cooling time & temperatures
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0
0
0
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19
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F
Proper hot holding temperatures
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46
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Wusarde:washng facilities installed; manta ined . &
etest strips
71 �
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E
20
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F-1
Proper cold holding temperatures
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0
14
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47
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Non food contact sir faces clean
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21
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Proper date marking & disposition
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f
IVSka
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F tittles
.................... 204, ISSj5,_2#Sj1 .....................
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�Time as public health control: procedures&
records
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48
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Hot& cold water available adequate pressure
71 E
0 0
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,004-M-Advisely
.......................... 2653
49
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Plumbing installed. proper backflow devices
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0 El
0
0
23�
0
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Consumer advisory w provided for raor
undercooked food
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10
50
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Sewage & wastewater properly disposed
71 E
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sus
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pti, We,?,
ttpoa Non s ........... ZkSI
51
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Toilet facilities� properly constructed . supplied
& cleaned
71100
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0
24�
0
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offered Pasteurized foods used . pro hibited food s n o t
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PTE
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5
52
1
0
Garbage & refuse properly disposed. facilities
maintained
11
0 El
0
0
.......... _2143, 1147 .......................❑
25
0
0
IN
Food additives: approved & properly used
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0
0
0
53
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Physical facilities installed, maintained & clean
El
0 El
0
0 0
26
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TGxicsubstances Properly identifed stored, & used
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54
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Meets ventilation & lighting requirements:
designated areas used
0
0
rma!r
with APPir*yed,,?,;,**e#ures _ .2643_2644, ISS& . ..............................
Total Deductions:
2
27�
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Compliance with variance. specialized �process,❑❑❑
reduced oxygen packing criteria or HACCP plan
North Carolina Departmentof Health & Human Services * Division of Public Health 0 Environmental Health Section * Food Protection Program
'�hoh's' DHHSis an equal opportunity employer.
Page I of _ Food E stabtishment Inspection Report, 312013
Comment Addendum to Food Establishment Inspection Report
Establishment Name: BLACKBURN ELEMENTARY SCHOOL Establishment ID: 2018110004
Location Address: 4377 W NC 10 HWY
City: NEWTON State: NC
County- 18 Catawba Zip: 28658
Wastewater System: El Municipal/Community 0 On -Site System
Water Supply: [E Municipal!C o mm unity F-1 On -Site System
Permittee: CATAWBA COUNTY SCHOOLS
Rd Inspection F-IRe-Inspection Date: 09104/2013
Email 1:
Email 2:
M.
Telephone: Email 3:
1 Temperature Observations
Item Location Temp Item Location Temp Item Location Temp
SLAW COLD LINE 57
HOT DOG HOT LINE 138
BEANS HOT LINE 145
Observations and Corrective Actions
Violations cited in this report must be corrected within the time frames below, or as stated in sections 8-40511 of the food code-
li;LAW WAS 57F. MUST HOLD AT OR BELOW 45F. SLAW HAD BEEN OUT FOR LESS THAN 1 HR AND WAS RETURNE.D TV.
COOLER TO CHILL.
First Last
Person in Charge (Print & Sign): RF ecca Whittington
First Last
Regulatory Authority (Print & Sign): Luke Sears
REHS Contact Phone Number ( -
1 0
r'Verification "equire ate:
North Carolina Department of Health& Human Services *Division of Public Health 0 Environmental Health Section 0 Food Protection Program
DHHSis an equal opportunity employer.
7� A&
Page 2 of _ F ood E stab4sh meat In specfion Report, 312013
Comment Addendum to Food Establishment Inspection Report
Estabfislrm-wt 10me: BLACKBURN ELEMENTARY SCHOOL Estabfis'rm-wt ID: 2018110004
Observations and Corrective Actions
Violations cited in this report must be corrected within the time frames below, or as stated in sections 8-40511 of the food code_
NorthCarolina Department of Health Human Services *Division of Public Health • Environmental Health Section • Food Protection Program
DHHSis an equal opportunity employer.
A�
I/
Spell
Page 3 of Food Estab4shment In specfion Report, 312013