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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 AdInspection EIRe-Inspection
City: NEWTON State: NC Date: I I / 1 5 / ;Z 0 1 3 Status Code: A
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Zip: 28658 18 Catawba Time In: 1 1 : 5 6 o Pm Time Out: 1 a : 0 5
County: m
CATAWBA COUNTY SCHOOLS TotalTime: 9mMutes
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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Proper use of reporting. restriction & exclusion
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Proper eating . tasting. drinking. or tobacco use
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No discharge from eyes. nose or mouth
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Food obtained from approved source
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Food received at proper temperature
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Personal cleanliness El
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Food in good condition . safe & unadulterated
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Wiping cloths � properly used & stored H
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Required records available � shellstock tags.
parasite destruction
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Washing fruits & vegetables HFEI.0�0�0
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Food separated & protected
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In -use utensils: properly stored »
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Food contact surfaces- cleaned & sanitized
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Utensils. equipment & linens: properly stored .
dried & handled
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Proper disposition of returned, previously served.
�reconditioned . & unsafe food
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Single use & single -service articles: properly
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Proper cooking time & temperatures
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Gloves used properly
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approved. cleanable, properly designed,
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Proper hot holding temperatures
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Warewashing facilities- installed, maintained, &
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Proper cold holding temperatures ET
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Non contact surfaces clean
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Proper date marking & disposition s
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records
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Hot & cold water available adequate pressure
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Plumbing installed. proper backflow devices
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Consumer advisory provided for raw or 01H11111
undercooked foods
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Sewage & waste water properly disposed
T o ile t facilitie s � properly constructed . supplied
& cleaned7110H
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Pasteurized foods used. prohibited foods not
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Garbage & refuse properly disposed. facilities
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Food additives: approved & properly used �E
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Physical facilities installed, maintained & clean
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TGxicsubstances properly identifed stored, & used 0
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Meets ventilation & lighting requirements:
�designated areas used
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Appiloyed"PIT04 e#ures .2643, 2644, 2S54 . ..............................
Total Deductions:
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Compliance with variance. specialized process.
educed oxygen packing criteria or HACCP plan 40FETIETIETIE]
North Carolina Departmentof Health & Human Services * Division of Public Health 0 Environmental Health Section * Food Protection Program
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 [9 On -Site System
Water Supply: [E Municipal!C o mm unity F-1 On -Site System
Permittee: CATAWBA COUNTY SCHOOLS
Minspection [—]fie-Inspection Date: 11115/2013
Comment Addendum Attached? El Status Code:
Category #: IV
Email 1:
Email 2:
Telephone: Email 3:
1 Temperature Observations
Item Location Temp Item Location Temp Item Location Temp
CORN HOT WELL 176
CARROTS HOT WELL 158
CHICKEN HOT WELL 125
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 -
CHICKEN BITES WERE OUT OF HOT HOLDING TEMPERATURE. THEY HAD BEEN OUT FOR LESS THAN AN HOUR AND
WERE REHEATED.
Person in Charge (Print & Sign):
Regulatory Authority (Print & Sign): Luc as
First
First
sears
REHS Contact Phone Number ( -
Last
Last
V
'Verification�e-
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 Fd Estab4shment 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