Food Establishment Inspection Report meta _7 [VIRGINIA DEPARTMENT OF HEALTH 'No. of Risk Factor/intervention Violations [pate (ODS Ie: (central Virginia Health District No. of Repeat Risk Factor/intervention Violations ‘Time in [As Governod by 12 VAC 5-421 Time Ou | pee Telephone Me Eide el SIGE shot A ik Category. Permit Holder DBORNE ILLNESS RISK FACTO} UBLIC HEALTH I Cire desigraies comptance sate (N, OUT, NO, A) foreach rumberad tem ask % in apprepdte box or COS nor Insincomplance —OUT=ratincomplanee NOsnolobsened Niro apolicabe coS-conected once dung napacion _ Revoest vin ‘Compliance Status ‘oF ‘Demonstration of Knowtadpe 2® ° No Propo etn. cing. hy zx fvour a) mre ate wet oro NO No dacharge from eves, nose, and veut Lederooted ods | {2 |OUTNA 2D Fond resid at rover errata [Progr coking time & tomeratures I Prom aetna recs torre lea et cooing ine & lemaratures i rope at hotang temperenres coi holsngteeratutes Proper sate makin & isostion | Hie 0 a pubic eal contr posed & reco Consumer Advisory erton in energe present, cemensrates knows, Management awareness: pobey present Prover use ofreorting, restretion & excsion | [Procecues for responding to voriing end dlarteal events. | “Good Hyglenie Pract Proventing Contamination by Hands Highly Suscopsibte Populations: JT NO [Hands eesn & jrover) washed TE] [amy ourwn — eteuand ods sd probes ood not |] rr WA wio Ne bate hand ntact wth RTE foods or approved | lonree ee a ‘Ghomicat > stornte matod ropety flows ~ iste Ranashing ects supiod Bases ||| 7 OUTED). Feed semen aroma & por uned ‘oproved Source | Tur oneiexs pop Ka ere, cust | Food olaed Form epcroved ste co | ontermance wh Approved Procedures cc 18 fa(ijouT Fens in goo conston. ea, unasulrtod c vehcour fay Recured ocors veils setvock a, —= OP” corse dsivcton | Tank actors re oper acon or owas eile ste ns protectin rom Conlaminaion drevat contin corse ingens Pb Hen four ood Real Pectces are prevenstve measures to contol he adeton of pathepens, chemical, 2 pysial objet ini ood. (Gnplarce wih aane, eceaed pOOR, Igrcce pan " | OUT NIA Foad seperate & proiece T 1 | imarventons ars cone measues to prev: foosbore less oy UT NA Proper slsposion of returmad,proviusly e6rved, | reconditioned, & unsate food | ‘GOOD RETAIL PRACTICES Nai" in eopoprite borYor COS ander R—_COSscorecad onshe dying secon Revepea vein inspec [Nor >in box numtoee tom snot eomplance —= | | Pye Food and Water =i Proper Use of Viena 7 | [Posteurzed egg uted wnor roqurec— i “BE |[ine wens propery stored a= pots eee THE) Ot sees or peor dis ences |] 22 Noten obtener specilied rocessingmotheds 1] | 48.|_sigevsed snge-seves aries rover stored 8 used ||| oS Foo Temerature Contr 6) IGoves used propery im =| earner earworm) | i Tiers Pipi an Voraing — 4 temperature cont | a) Fd & nenood cone suraces deanabie, ] | 34 anttood proped, cooked forhet holding -| [proce designed, constructed 8 used | (as aggroved inawing methods utes [ [| a) areas ots ints maitaned.& used nas | 32-11 —htmoecirs povided a posure im | | —TRorstood cebiocsuss dan | - Food identneation t PhyatcalFeiiles 37_[ Feed propery Steles gna container TT) “St cai tor avetabe, adequate jressure | — Prevention of Food Contamination | “St ) Pumping instal, pope bockfow devices | SB Toate niall prset | 5] —Tsenage watever oper spoed | 3 | | Comtamnaton crevents: dug eos preperation, storage & dey 53 Tofet feces: pros constaetee supa. & clesned ° Sh [Garbapo & reluse prover dose: feces maintsined | || 55 [Physical faites installed, maintained, & clean Personal ceaniness - C \wiving cline: opel used & stored | washing tras & veyotablos 55 | [Adequate venation & Ighlng: descnated areas used __ sae: |ODEL ZO70 | or (Signgite) 710112016~ Food Establishment Inspection Report — r»-s!_«__ ‘RGA DEPARTWENT OF HEALTH ‘Central Virginia Health District ate IO DEt.Zo20 [fst is apie gH Fw Roe Beye 'Sio 4% Sleds mibburn, VA = a ke jon = aes it Hemviecaton Temp ay Lj 1%" ——— — ped GN Z = Comp. Sto. _\ogpap a_i a 1 — eitcmsaid, sh. mera + Beco Suetal Person in Charge Signatur Inepector ‘Signature, vom _— "AND CORRI [Motors ced inthis report must be a Viewte Food Regulators tntsitwewsvdnvgna.govremvronmentath JE ACTIONS within the tne frames below, or as stated in sections § 12 VAC 5.2030 of Re gulationsindex him ‘rma tS. py emperors “oa _walk in lobes of FI aie tanta sehen CA. iin A eae Learnt be achteweale Cons = —Food Estab: hment Inspection Report Pago fot _O /RGINIA DEPARTMENT OF HEALTH « No.of Risk Factortervetion Vilaions —} Violations tral Virginia Health District, = ‘of Repeat Risk Factorinervention Vioistione tn (Governed by 12 VAC 5.421 Time out lishment: ip Code Telephone Mask in appropriate box for GOS andoe R nen conptance 0 on — cosscorecsensie dingépecien —_ Rereges Von ‘Complance Status ces n | | Compliance Status pose ‘Demonstration of Knowledge cies Foes rime fonweesture Fi | hor on fn ehage preter deroneees ones, j [OUT WA 3, Propr cooking ne &temeranres land perfor dues. | a NOUTWA NP roger enaing paced orf Rang [our ——‘Cerited Food Proteciton Manaer [[-} [20 [OUT NANO Proper cootingtime & temperatures | Einployee Health “, EAINOUTIWA —Propernottekingtempertues 3 HOUT Menacerent awareness; potey resent [1] eivourwa pro (OUT Progor uso of regring resticion & exclusion [-) 2aQitporwawo = JMOUT Procedure ‘er oarendiigto vomitn and derbaaievents. 24 NOUTETNO ‘Good Hyglante Pracveas = [OUT NO Peder esting tasting criking or fobocco wee T TROUT NO Nodechanp tom oye, nose 3 mash Z a Preventing Contamination by H Ss Highly Soecopible Poptatons ice a eae J WO tones ean yous 7 ‘spiourja Poteauaceos wd portend | lobar ha oF peo na 8 G0 ne elena gop od | | ee i ginour ‘Adequate nanewashing facies supjod & accossibio |_| | 27 INOUT BB Food addlives: aprroved & woreriyused E Approved Source | Z[WOuT “Trou ewstnces opty Kent, ses, used | fi iouT cod cbiaines tom apsoved source | |_| | Conformance with Approved Procedures hz JN OUT NARI Food redBlved at 10 ;er tomearature Lh ao ourwa ',_ Pompe wih vriangp, specialize process, | sour footing oni soe feat ———| COnM + ansce son ure recor aves sheetock tas, i alate q i [:hontrefeemermeeermen | Nels oa ea lai Protection trom Contamination role conirteg ltrs cteossoma uns or hry Pub Hoth HSINOUTWA Foce separated & potacied [1 ) tntervonsions ae contol measure o prevent oabome aness inn | He IMOUTNA — Fooe-contact suriaces: cleaned & sanitized 7 yur Prove aepostion of tne, prevousy ved, | . becondtioned. & unsafe food ‘GOOD RETAIL PRACTICES [eosRata races premniate essa cnob saaion apogee, nya ds nfs. Xn box ¥ numbered item is net in compliance __ Mark x" in 2p\s0pTate boxfor COS andioe R__COSscerectod one during apacton _Roreyeat vision [a Se = P| ‘Safe Food and Water | : Proper Use of Utensils [peacoat neem | i, eae Fp pam ete Le eet eS nia Se ee [pees acer eens one mie li Food Temperature Control 46 | Gloves used property T [= | Peoaen teu toes owenee Sara stanuar wT poe w {- nt 00d sro erly cooked for hot hoiing | openly designed. construcid. 6 used {patie ee elec ——— a eae = heen peepee Ste a Food kkentification | = Physical Facilities ee Ch a Soe en Fae ee fe ee Conterrinalion prevented during food jregaration, storace & disslay = | __TToilet facilities: croverly constructed, supplied. & cleaned || as ae a ee SS Heh pees aes serene | 2 | Weaninghuts veges TICE I Tas nite verttin & ing cen ated sees uaad 1] lj a Porson in Cher, of Yo due fay Kos Bate: 6S Nec 2019 Jnapector — owp:* YES (AQ (Chelon) FolowapDate Tiow20%6{ Food Establi RGINIA DEPARTHENT OF HEALTH tral Virginia Health Ditriet = Governed by 12 VAC 5-424 ister ‘CigiState: “time: Hime Owe fee = ; | | ‘OBSERVATIONS AND CORRECTIVE ACTIONS” | on Molina ied inthis reports bn gore wth he terres Below ore tated In aectons§12VAC 53900 of ltt, tne Feed Reguasone, iow te Food Roguatons | lumber ntip:/iwmw.vah.virginie.goviEnvironmentalHealth’Food/Regulations/index.htm | | arson in Charge Signature) 22) Anayector Signatur) __Food E Establishment Inspection Report — |RGINIA DEPARTMENT OF HEALTH No. of Risk Factorfintervention Violator ‘Virginia Hoalth District bs ‘of Repeat Risk Factor/interventicn Violations | Time in ime Out “rats: icitistate: cade Telephone 1 i Permit Holder Tiepection Tye: uta Rsk Factor TlnnjRlek Category o k. low Ob PeOoeing complet CAT 1 234 Cole desbrated compilanco stat (N, OUT, NO, Ni} foreach numbered item ar" in epropit bx foe COS anor R INeincomplance OUT=netincomptancaNiO=ootcbserved _NAenct applable cos-coreciosonsiadumng mepecten _Rerepes oistion coon Compliance Status OR ‘Compliance Status——_ Freon core prow, eons, ‘BO NAW Piper cong te em ee 1 Nour und performs cuts, [Zour ——Cerifed Food Preteion Manarer ——|-| sioornnwe Peer cming tis &tampsotes ee a ae GNOUTWA prover hot hong temoeratres |S 1NOUr Management awareness ole sosent 1) E]NOUTNA roger coldhadng temparaies GROUT Proper ue of repering ration & excision Za|NOUTNAN® Prosar dale marking dszoston | 5 (Nour Procedures for responding {0 vomfing and diartheal events. | Seed Hygiene Precise — a: 7 fe Nour er cling taut diring, orebacsous0 || |aslyyouraa Consumer adviony proved or | 7 our Ciocharoe from ee, 286 nd auth NOUN pdercooked fonds i | Preventing Contamination by Hands Hah Susceptible Populations _ z a (ROUT “Wands sean & proce wathes “| Feclwourna” Pastas ooo vse: ponies oods ret | Fence wanue|Ne bo far cei wih TE ale =P Cod LL "erate metho propery olones eres on oINOUT __Adequato handusshing faite uppod & Foot adives egroved & gogeihused I Approved Source a “Toxic supsiances propery tented ‘Rused I 1 INOUT [Food obtained from approved source: “I ‘Conformance with Approved Procedures _ 2 "2 IN OUT NANG [Food received at proger temperature rT (Complance wih variance, specialized process, | | SNOUT Food eedeonton ew, brostraad || [MOOT + lancer tn i oe ouvada wo fRetated ecodeevelbl natok eo ¥ toga tas 1 our No este dexucton | itt tine pace ees doe ae wee) i PSEA RR CORSET || pen cn cert nore er ea. Hat SSINOUTWA Food separsed &proaces T rete ae cot eaauic over dbo hess rn. [ie NOUT NA Food:contateuface: eared & sanitized t trout Mepe" Gepodion af relumed, revousy Sone, reconditones,& uate 058 = = ‘GOOD RETAIL PRACTICES loood Rete Practice re reverse mosie fo cotol hesitant pabegers chemicals, ela oblis nooo. | [irn-X'inton frmterd tom notin conptone MERC narra bot't COS snd R_COSsconeied ons dung berecton _ Revepestvoton L es | Se 7 | Safe Foos'ana Water I oper Uae of Uwe [Pesiurd ose used wnererequtes Inuse viens rover toced chances |Wator& oe trom anroved source Utensis, equemen & nore: so jee) sore, od I \Veriance cbtsned fr specialized prococsing methods ShJe-use 8 srale-seneeaniles: groper ered & wot || Food Tem corature Contr 5 used properly | "Proper cooling methods used; equate equipment for “Utensil, Equipment and Vending _temsorature conto! (rojerycesicred, constructe “wareweshing felts itll, 'Nop-cod contact surfaces clean ant food propery cooked for hat haldeng ‘A pexoved trawin, method used “Thermometers proved & securaie | | Feed propery Bbeied ona con o| sossu T I Prevention of Food Contamination S| «| SY) Planting rtd; proper baciow deviess : 52_|__Sewayo & waste water openly cispated ‘= | 291 Comeminston zeveried dung fos reparation, rage’ display | | $3 | Totetacites: properly canstucied, supyied, 8 cleaned Persona Soaniness - “75 5t Garbage 8 ttuse propel posed aces meinat 41 Wiping cots: propery used &scred ~ 55) Physeal eis nstbee, marvainea & clean WZ iWeshing fits a vocpadios 5 | “Adequate vetition 8 hing: dei pated ares used Person in Charge (Signature Inspector (Signature) I 7101/2016,Food Establishment Inspection Report «| ecunemen L feat cc | Te Out: ‘OBSERVATIONS AND CORRECTIVE: vm. Wleions cited nhs reportmustbe coveted witin he ne ramesosow, Oras sated n secton § 2 VAC 280 of itt, the Food Regulations. View he Food Reguations at: cad ania govenvrenmontalMeathFooaRegulaonsindex him _ se epector Signature) 7) .