-

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EHE DELRAY5612743192

Fax:

Feb 20 2012 01 :59pm P013/040 TYPE:
• Public School

= = = =

-

ROUTI'IE CONSTRUCT COMPLAINT
QA SURVEY

= CONSULTATION

= CHANGE
OTHER

=

Rf:il\SPfCTJON Of OWNER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
P{]BLICI PRIVATE SCHOOn INSPECTION REPORT

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PREOPEN!NG

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VOC2t;on3!

School

EPrDEMIOLOGY _

Coltege/Universiiy Other _

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RESULTS
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Aspe_riettioIiJ20.695 o/the Florida Statutes (F ..I,t/?is fo,nn will sen'e as a "Notice of Non-Compliance: for any v!o~ations 7UJledItems. mC!rke4 ~wVio{diethe, f'elJUJfpne~tsofChapt~ ME-! 3 and ME-l1a/heFlonda Administrative Code (FAC) and must be. corrected withinthe time period.indicated mo/e"J(ciitlty') , ..•.. .e.c.,.tt.'ollia¥l'e:.G.o~tinr.ied. ope.rationof.. ~lrisfOCil. Y.l!'iihaut making ih.ese corrections is '! violation of CIuip~ ME. 4 3 an ~ . .. ..d..ME-l.l, FAC,. and .. ap ter. -3.,1,E 'S.;. -...•••. .. ·C . .8 .. . .; f Fuzlure1ocon-ect violations mayresult tn an adiinistrative fine or other legal aCflon bemg mllwed or continued. . .. . .. ..<.'-'.; i r.,
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SCHOOL SANITATION
1. School Site

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BUILDINGS 4. Construction

2. Playground Equipment

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8. Natural Vc tila.ion

9. Mechanic!

Veutilation

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1)-.. Handw a.,.", Facilities
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LIQUID/SOLID

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WASTE Disposal

SAFETY
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22. Solid Waste

FOOD
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SANITARY FAC.LIfIES

27. Food Insp. RpL 28 29. _ _

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WATER SUPPLY 11. Clcanline ; & Repair
12. Toilet Fa' till,,·s 13. Separatic 14. Fixture of Sexes _ 18. Installed/Operated/ Maintained 19. Drinking 20_ Approved Fountains Source

CONTROL

_
_6.

5. Maintenance & Repair
Lighting/foot-Candles Ventilation, AJC

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OTHER

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COMMENTS AI'iD INSTRUCTIONS
(continue on attached sheet)

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S£ATE OF FLORIDA

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Copy ofReport Received by:;:;.:~ ,
DR 4104,4/96
(Stock Number: 5744·000-4104-8)

Inspector~ Page 2

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PURPOSE:
CJ REINSPEC'TION CJ ('IIANGE Of OWNER CJ CONSULTATION

IIA ROUTINE
c:J CONSTRUCT.

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
il2I Private School Public School

lilt
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Q2I Charter School Vocational School

c:J COMPLAINT c:J Q\SURVEY

PREOPENING

ADD~~~~~~~~~~~~~~~~
OWNER
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'Aiiwrwllcn Jio.m oftMFJorida SliMes (FS). /his form wTif~6iV"iD..t a 'wotiCiCiiiiio/'-Compl;;;;;Ce:jc;,.-anyvio/Qlion, noted Items marked Mlow vtalate llIe mptirem4tf18 of ChafUTs 64E-13 and 64E-11 of the Florida Admm13tratne Code (FAc) and mus; M corrected within the nm« period indicated in the "Re.ndo1ICl"", above. 9Jntimted operational this facility without l1I1lkzng th&e C.OT1'f'CIIOns 13 a vtolatum of Chapter ME-13 and ME-lJ, FAC, and Chapter 381, Failure 10, eoriect VIOlations may ~~u7t in an administrative fine or odm'legal action bnng tmuated or continued

1

FS

= =

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--, ..,------

I. School Site 2. Playground Equipment
3, Athletic Equipment

c::J c::J

8. Natural Ventilation 9. Mechanical Ventilation
FACILITIES

= = = =

BUILDINGS 4. Construction
5. Maintenance 8 Repair 6. Lighting. Foot-Candles 7. Heating, Ventilation,NC

=

SANITARY CJ

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--

-- ---,-

---uQUIDiSOi.iDWASTE- -SAFETY' --

15, Hand, ash Facilities 16, Shower: Fixtures

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2 I. Sewage Disposal 22. Solid Waste

=
=

---

26, First Aid Kit

FOOD 27. Food Insp. RpL
28. 29. _ _

17. Shower Water Temp, SUPPLY
Maintained 19. Drinking Fountains

VECTORIVERMIN

10. Provided/Accessible II. Cleanliness & Repair
12. Toilet Facilities 13. Separation 14. Fixture of Sexes

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WATER

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18. Installed 'Operated!

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25. Water Collection/Drainage

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Ratio

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(continue

=

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OrnER

20. Approved Source

ITEM
NUMBERS

COMMENTS AND INSTRUCTIONS
on attached sheet)

HEALTH DEPARTMENT lNSPECTOR. ~.c_:rL...L.---4~~L_.!::===_'~:r:2g.,..------,

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----:".- PHONE.

COPY OF REPORT RECEIVED BY: ~':...hR-4:__"£''-''--'''''''''-R~~c.__'''''''£..;t.+..t/!!!!:.:.L-.::.J..
DH 4030, 01/05 (Obsoletes Previous Editions)

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= CH'.NGE

R!:INSPECTION Of OWNER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECfION REPORT

d2I jiri' ate School
_ Public &110,,1

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c22J C,a rt" School
1231 \;'cction.1 School ~, Colle-n; University

CONSULTATION EPIDE~1I0LO(jY

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.rCC.110n above. Continued operanon of rim faciluy wahou« PUlkmg these correcteons n a vsolatton of Chapter ME-13 and 64E·JJ FAC and Chapter 381, FS Failure to CO"U't violauons may tefu}t JI1 an admmlstrauve fine at other leftal ~!IO,! bemg mtuated 01 conlmuu/." ._ .... _. SCHOOL SANITATION LlQUIDISOLID WASTE SAFETY 15. Handwavb Facilities ~ "(,. firsl'id Kit X. Natural \'~nlilat1(ln ~ 21. Sewn!!c Dispo.;»]

tn« Flonda Slluutes fFS}. tht»fotm I' ,Ii lEt'I'C as '."fut,Le oj Non-Comphance fOI am violations notea. Items marked belo ... violate the . requsrements of Chop/en 64E·13 and 64£-11 of th« Flonda Admuvstrativc Cod... (FAC) and must or corrected wtthtn the um« penod tndtcated 1II the "Results"

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OTHER

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12. Toilet Facilities
13. Scpar-nion 14. Fixture _ Ratio

,.rainrained

= 24. Brush, Trash

23. lntcstarion

=

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19. Drinking 20. Approved

Founu.ins Source

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

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DH 4030, 01/OS (ObsOletes Previous :drtr"~:

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STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

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Identification No.lSJ~-~[2]-~~~
Comments and Instructions (Continued from Page 1):

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DH 4104, 4/96 (Stock Number: 5744..()(}()-4104-8)

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PURPOSE:
ROU"'ICiE

--

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I

• REi\!SPECTI()N CONSTRGCT. COMPLAil':T
QA SURVEY

EHE DELRAY 5612143192

Fax:

Feb 20 2012 01:58pm P011/040
TYPE:

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REP

=

c::J ('HANCE OF o\\'~r:R CO'-:SULIATION

lZZJ Charter School

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2. Playground Equipmen:
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ver.rilarion

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=

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c::J

22. Solid Waste

BUILDINGS

c:J

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=
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17. Shower

Water Temp.

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WATER SUPPLY

VECTORIVERMIN CONTROL
24. Brush/Trash

=

FOOD

27. Food Insp. Rpt. _ _

OTHER

1 J . Cteanline:

& Repair

18. Installed/Operated/ Maintained

12. Toilet Fac itie;

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13 _Separatior

:}f >c;xcs

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14. Fixture R; ;0

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23. Infestanon/Control

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28

29.

19. Drinking Fountains Source

25. Water Collection/Drainage

2D. Approved

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

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COUIJT¥ PUBLIC HEALTH Date ~)

DEc?ARTMENT HEAL!!t..J0\ OF
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1_0'

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CONSTiWCT. COMPL\!NT
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R:':l;-,,,SPEcr;ON O!!\NGEOFOWNER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

EHE DELRAY 5612743192

Fax:

Feb 20 2012 01:57pm
TYPE:

P009/040

-

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CO~SULr:\TiON EPtOE?vHOLOGY OTilfR _

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TYPE:
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STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
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Rick Scott Governor

PALM BEACH COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL PUBLIC HEALTH 345 SOUTH CONGRESS AVENUE DELRAY BEACH, FL 33445 TELEPHONE: (561) 274-3187 FAX: (561) 274-3192

DATE

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THIS TRANSMISSION CONSISTS OF PAGES INCLUDING THIS COVER SHEET PLEASE CALL THE NUMBER ABOVE IF YOU DO NOT RECEIVE THE CORRECT NUMBER OF PAGES TO FAX:

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Florida Statutes (FS), this jorm \ If!Ijufrenwnf.'J OjChfJjJfcn 64E-I.3. and64e~ 11o!!he Florida A s elton t100v1!. ConllJtued opertJfl(}1/ oj this facility without ma.: Foil,!:!,!! corr«/ vlolotiorrs!!'_U>'reS~(t in,!,!.~ministrative fine,

MPeTstiiiiiiii7ilT69fWlhe

\ :(';~J .)t.; ""7 i(\Y ...•.. v'
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lime pgriiN/ indicated in tbe "Results" ..,er 6'4Jtc13.aTid_, 64E"Jl, FAC, OM CilDP1U 381. FS.
</ within the

lny v;nldt{o/iS
.'.

note4 Ir~ .'

n,arke.tI btlow ..

. olale iii

--,

.....

SCHOOL SANITATION

= I. SLi1()ul Snc
·t. Athletic

=

LIQUID/SOLID WASTE

SAFETY FOOD

=

EqU1Pl11CI11

SANITARY FACILITIES

BUILDINGS
c:=I C:=J

WATER SUPPLY

c:J 4. Consrrucu.u:

5. Maintenance &

R(p:1ir

c=
c:J

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T\l:k\ )';I~ililiL'\

6. Ligh{ill~iF()()1.-(

';l!ldlc~

;,~,~l'p:lr::! I("!I

~~f S,-'_\r...'s

= = =

VECTORNERMIN CONTROL

=
OTHER

) K,

1I1Slil1

k,i'(

)p(r"1(111

\r1,liliLlinl"d "1. Drinking 21) :\ j'PfU\'l:d loum.un-, Suurce

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

-

co!') OF

IiFPORT

RHTflFD I!l

DH 4030, 01/05

(Obsoletes

Previous Editions)

-

-

-

--18

PURPOSE:
IWI :TINE

= = = =

(ONSTR IICT «)\1 PL.t\ I NT ()/\ SIRVI Y

PRUlPI:NIN(J

= = = = =

RIINSI'IJ'TI()\ CHA'\J(d: 01 O\V,\FR (01\SI TI ArlO" 1:PlllLMlt )IOCY (j1l111Z

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
.. Public School

1221 Charier Schoo!

I23l

Vocarional Schou!

NAME OF SCHOOL ADDRESS
OWNER

RESULTS ..
ZIP
---="-""-+-L--L-----f ------'-=---I---l

=.J

/3000

---,S~:&,-,-~--,-,:t5=-C=L_i,_N_;tJo_-'-IYJ_:_:t.r;;__,_w
..---------..---------_

= Incomplete

Satisfactory

= Unsatisfactory
Correct Violations hv Next Inspection S:(lO AM on:

PERSON IN CHARGE __ --~-----

PHONE

= ,-

CJ

:\JLural Vcmi lauon
1_)

r::::J c=J

2.! S,,-'\\,age

Dj~p\ISi.ll

=

2i,. lirst Aid Kit

= .~
...

c:::J

2. )})a~~l.r(Jl;ild !--quirn;l'I-:: .\Ihkiic hunpmCTll

c:::J

-\icchaIlH,:al

'v':"'ll\iialic~!l

:::2. St11id \\/<1 S1,,'

SANITARY FACILITIES

BUILDINGS

=
[_-:J

c=J

) I). ProvidceV<\cccs:-.ihk· II ! tic:lI1lillcSS &. Rcp:1Ir Toilet lucilitics

WATER SUPPLY

=

VECTORNERMIN CONTROL

=

FOOD
27. Food Insp. Rrl

OTHER

IX. Illstalk(l'(lpcl'alc'd ;"\_;1ainwin(,:d

=
c:::J

2~. Brush.Trash 2). \"/~Itt:r ('olkclion/l)rainagl'

6, r,!~htin~

1'(lt)~-C;.iIH)k"

c:::J

1:1. Scrara1ion oJ'SI...'\c:-, 14. Fi"lmc Ratio

c:.:J

II),

Dr inkinu

I:Ol1l'1;ll1b

c::J -:

H(,_'~HHlg.. \'l'lll.iiution :'\·r c=I

c:=r

20. Appr.»

LollSource

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

~..;2.J :2~
W. st.tn

~h>r

.f.

UiYf-/ Clore.. J-

un',",,,, n r.srrcros ~
11/J 11111)

cor,

01 RU'ORT

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fJ.ITF __ /.:._(

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.
~

DH 4030 01{05 (Obsoletes

Previous Editions)

::

_

--

PURPOSE:

-

= = = = ~

ROLITINE CONSTRUCT. COMPLAINT

Oil SURVEY
PREOPENING

= REINSPITTION = CHANGE OF OWNER = CONSl:LTATION = EPIDEMIOLOGY = OTHER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
tt2J Private School . Public School .. Charter School

I2:3J Vocational School I24r College/University

= Other

_

AQDREsS R

__.~~-"-_!..__'___..!..I1.L.:....:'

L,,_,I'...LZ...L.4,,",/l~Y_-L-=.!.._ CITY
ZIP

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P RSON IN.CHARGE

= 3. Athletic

=

= I. School

Site Equipment

=

2. Playground

= = = =

8. Natural

Ventilation Ventilation

=

9. Mechanical

Equipment

SANITARY FACILITIES
10. Providedl II. Cleanliness Accessible & Repair

=
= = =
(continue

=

15. Handwash
17. Shower

Facilities

16. Showers/Fixtures Water Temp.

= =

21. Sewage

Disposal

=

26. First Aid Kit

22. Solid Waste

FOOD

= = = =

BUILDINGS
4. Construction 5. Maintenance & Repair

WATER SUPPLY
18. Installed/Operated/ Maintained
19.

VECTORNERMIN CONTROL

=

27. Food Insp. RpL

6. Lighting/Fool-Candies 7. Heating, Ventilation, Ale

=

=

12. Toilet Facilities 13. Separation 14. Fixture of Sexes

Drinking

Fountains Source

= = =

OTHER

23. Infestation/Control
24. BrushlTrash 25. Water Collection/Drainage

= n. = 29.

_
_

Ratio

20. Approved

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
on attached sheet)

HEALTHDEP4RTMENTfNSPEC'f, COpy OF REPORTRECEIVEDB,,--7""-"<.J""""'-'-'-"""~~::::'_~--'''_'__--'',"-*'''--

PHON.EP?~ DATE ~

-5'ttJD
'-!..L:;ZOL {

-

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--

PURPOSE:
"(lIIII'E (ONSTRI,(I ( )\WI;\I:\I

-

();\ SIJRVIY PIUOPI'lIN( ,

= = = = =

REII-:Srl.(TI()r-; ('II;\N(;[ OF OWNFR

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
tt2J Private School
Puhlic School

..
I23J
I24i

I22i Charter School
VoC,.lli()OJi

(Ol\SUITA II()N II'IDI:Mi()U)(,Y OIIIIR

School

(:'()Ileg.cil Jnivcrvi t y Other

=

--~-----.----.

NAME OF SCHOOL \ C£.go

RESULTS

ADDRESS
OWNER

\ N. rv\,- \ \'~

Schm I fm_rJ

Palm Bt2ach G:ot\~
(\1 icMe

1ft

_

Satisfaetor~

ZIP PHONE ~~~~~~~~

= Incomplete = Unsatistactorv

~1
I

PERSON IN CHARGE

Mr,
....DATE!
Q_
::O'i

g

SMtih.

Correct Violations h~ ~ :"ext Inspection

I,,

= X;()O A"

[
11;00 [tJOG! lOS

r-o------

~-\

'POSITION#:i
,------

[.~- .:"'-PEiOO-T NUMBER

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,

'scHOOiSANITATI()~'----'
c=:J! Schnol ~itc
:::::J

Ifo:69S o,FiieFitJrlda Statula {FS/this/orm IVquiremfln/s ofCh~.{'11!1'8 64£.13 omJ64E-ll of ihe Florida s~'C!ifm aooJle. ConJ!flul!d opera/ion of thls /llCilifJ! l!'itho"!t FClIiun: toeorrea wa/Qlions IlIQ}I t?5U7,' In all"ot/nUnlslratlve
x ~mllr3) vcmilation

will serve as a "Notice of Non-Compliancei forany vioiatium "OIeil:Jienu ",aifidlieJo)ipl..,iolat~ lbe'J Administrative Code (FA C) and must be corrested within (he linle pen'o(/;"dlcmedjn the "Results making these corrections is '! Vi?0~ion ()ICh(JJ1~JI1' 64E-J.l and 64E-lJ, FAC.QJId .. 'Pter J81, FS. ' ... fine or other legal action being mltwted or contillui!d. ...... . ." . .'
U .Chn, ' ..... '

,

LIQUID/SOLID WASTE-..a
15 lJ:m(iw:J.;;h laciliucc::J

SAFETY -~
c::= "~\. ),':rq
/\1.:)

--I
j

2!

SC\I.:~gc ))isposai

lv.:

SANITARY FACILITIES BUILDINGS
_
....

=

=
c:J

=
I ';

')olid \\/~IStl:

FOOD OTHER

Sho\\'cr

W,lIeT

Temp

'Il. l'rovidecl/ Accessible

WATER SUPPLY
)nsUliILd"())lcr~\l('d'

VECTORNERMIN CONTROL

_ 5. ;vlair;l(,l1,lllcc
(I.

J,

C1e'lillinc"

& Rep');r

_

H\SC~

& Repair

.,
c=J c:::J

12 Tnikt
)3

Facilities
t)r SL'"\t.'c.;

\1aincJillcd ~
c::=J

Li::..:.htin:.l< ]'oo\"C;!ndlc"

Separation

i 9, Dr inkiru: hJllt1wins =:0. Approved Source

c::J

2)

\Valcr (_'olkrtion/Drairwgc

_

7. Healifl~. V<:ntilali~lJl. ·\/C

)4. fi_\.turc Ratio

-----_._----------------

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS

_

II Flf. TJ I (Jr.!: 1R T \H;.\I IllSPH TOR ('OJ') OJ RU'()RT III.CI:JV/:IJ Ii)
OH 4030, 01/05 (Obsoletes Previous

~~:U'd{..M~~~~~~J_75.~~~~:::::::::::::::._P{!4_

Editions)

COUNTY PUBLIC HEALTH UNIT

DEPARTMENT

STA TE OF FLORIDA

OF HEALTH

Identification No. ~
Comments and Instructions (Continued from Page 1):

QJ- ~

OJ- [Q][IJ~[j]~

;Je'J

Exp'red

-Gore

e)fr\o~~P\~:

8-;;>C:CO,) \d.\'2>~ S\SQ'jG':)ffi

( f'M,.~oe.\-no D£-~.

Copy of Report Received bY_~"":""==-'~:\-=~LPage ;,
DH 4104, (stock 4/96 5744·000-4104-8) Number:

lnspector~'~

.~ ~. ..
,

..

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

Date ~\QB\ \ \
Comments and Instructions (Continued from Page 1):

Identification No.§IIQ]-§I[O-rgOJ~OJI?a

\ \) ~ \\ £ \ 2..
ex-\eflor
~~oms..

l S<:u1\1:\'7e a 1 \ £ leO e.~ ) v..xW...c : s
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()eo,...c

Copy of Report Received by

~
Page 2

DH 4104, (Stock

4/96 5744-000-4104-8)

Number:

_

_=

-= -= _ _=
,..

-- -

PURPOSE:
ROUTINE CONSTRUCT COMPLAINT QASURVEY PREOPENING

= = =

= REINSPECTfON = CHANGE OF OWNER
CONSULTATION EPIDEMIOLOGY OTHER _

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
ct:2l Pri vatc Schoo I
_ Public School

I22i Charter School r23I Vocational School i2ltI College/University

=

Othcr

_

= Incomplete = Unsatisfactory
Correct Violations by _, Next Inspection

-

Satisfactory

= 8:00AM

on:

DATE
05
06 07 08 09 10 11 12 13

_

~1201
c6:J125t

- -~ _ c8:Jt3!5J
_ c:9:JdQ

_

d:J13Oi

_

d::tJ15O

= I. School

= =

Site
Equipment

2. Playground 3. Athletic

= = =
_

8. Natural Vcntilauon
9. Mechanical Ventilation

_ _

15. Handwash

Facilities

=
..

Equipment

SANITARY FACILITIES
10. Provided/Accessible II. Cleanliness 12. Toilet & Repair

=

16. Showers/Fixtures 17. Shower Water Temp.

=

21. Sewage

Disposal

...

26. First Aid Kit

22. Solid Waste

=
_

BUILDINGS
4. Construction S. Maintenance & Repair

_

= 7. Heating,

6. Lighting/Foot-Candles Ventilation, Ale

= = =

=
_

WATER SUPPLY
I R. Installed/Operated/

VECTORNERMIN CONTROL

=
...

FOOD
27 Food Insp. Rpt.

OTHER

Facilities or Scxes

Maintained

=

23. Infestation/Control 24. Brush/Trash

=

zs.
29.

HI

sc.
_

13. Separation 14. Fixture

Ratio

=

19. Drinking 20. Approved

Fountains Source

~

25. \\later Collection/Drainage

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

_ -

-

-I
HEALTH DEPARTMENT COPY OF REPORT
DH 4030, 01/05

\

INSPECTOR BY

RECEIVED

~~LJ~~~it1W&fl~~"4~t::Z===-----v:51<. ld e_U ")

(5(P I) 831-5938
DATE.

ct:l-:H/U:)

(Obsoletes

Previous

Editions)

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT Date

91~L{ t 10

Identification No.§J[QJ-~W-[Q]UJ5J[JJ~

Comments and Instructions (Continued from Page 1):

)

~ ~1\3 ? B ... I'd. c9. \~oD 1'5
!

j

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gUOM) Tel](u'5

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No

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-- PURPOSE:

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CONSTRUCT COMPLAINT QASURVEY PREOPENING

= = = = =

REINSPECTION CHANGE OF OWNER CONSULTATION EPIDEMIOLOGY OTHER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
ti2J .. Private School Public School

t22t Charter School
123I.'·lAiCationaI School

I2lI! College/University

AM

= Incomplete = Unsatisfactory
Correct Violations by = Next Inspection = 8:00AM on:

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15. Handwash

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SANITARY FACILITIES _
_ 10. Provided/Accessible I I. Cleanliness & Repair

=
=
_

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= =
_ _

21. Sewage

Disposa I

= =
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26. First Aid Kit

22. Solid Waste

FOOD
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= =

12. Toilet Facilities 13. Separation 14. Fixture of Sexes

=

Ratio

=

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=

=

Iv\\SC
_

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

5

-

PHONE COPY OF REPORT
DH 4030, 01/05

[~~~a~

RECEIVED

BY

----~~(!:'_,~~~:::--:==-~::::::~='----------

DATE:

---7-j7L__--:l_,£~---''-.1.~:__-----

(Obsoletes

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STA TE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

Identification
Comments and Instructions (Continued from Page 1):

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ROUTINE

= = = =

CONSTRUCT. COMPLAINT QA SURVEY PREOPENING

= REINSPECTION = CHANGE OF OWNI'R = CONSULTATION = EPIDE!v110LOGY = OTHER

STATE OF FLORIDA DEPARTMENT OF HEALTh COUNTY HEALTH DEP}\RTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
1!21 Private School
.. ~ Pupllc School Charter School Vocational School

I23J

l2lJJ College/University

= RE
Satisfactory

if

= Incomplete = Unsatisfactory
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BUILDINGS

SCHOOL

SANITATION

= 4. Construction = 5. Maintenance

=

=

& Repair

6. LightinglFoot-Candles 7.lieating, Ventilation,A/C

= = = = =

= = = =

LIQUID/SOLID
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=

WASTE
Disposal

SAFETY

16. Showers/Fixtures 17. Shower Water Temp.

=

21. Sewage

=

26. hr,t

Aid Kit

22. Solid Waste

FOOD

10. Provided/Accessible II. Cleanliness & Repair

WATER SUPPLY
IS. Installed/Operated/ Maintained 19. Drinking 20. Approved Fountains Source

VECTORIVERMIN CONTROL

=

17. Food Insp. Rpt.

12. Toilet Facilities 13. Separation 14. Fixture of Sexes

Ratio

=
COMMENTS

=

= = =

OTHER

23. Infestation/Control 24. Brush/Trash 25. Water Collection/Drainage

= n.

=

_
_

29.

_

ITEM NUMBERS

AND INSTRUCTIONS

(continue on attached sheet)

HEALTH

DEPARTMt"'NT

INSPECTOR.

-~:__:2~b.-E~IL-~~~~--!----------

PHONE·

3?~~O

_

DH 4030, 01/05

(Obsoletes

Previous

Editions)

-= -= -= -= -= -= _ ~
®12SI a::Jl30

-- -

PURPOSE:
ROUTINE CONSTRUCT COMPLAINT QA SURVEY PREOPENIN(,

= REINSPECTION = CHANGE OF OWN[R = CONSULTATION

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
tt2J
Private School Public

e
I23i

School

r22J Charier School
Vocational School

= EPIDEMIOLO(jY
=
OTHER

I24l College/University
_

.

__ _---_,_--___,
...

RE

u ;r

= Incomplete = Unsatisfactory
Correct Violations by = Next Inspection 8:00AM on:

M- Satisfactory

=

-DATE~

05 06 07

08
09 10 c:9:J14O ct01il5I SO 11 12 13

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SCHOOL

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=

_

-

= 2. Playground

= I. School

SANITATION
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= 3. Athletic
BUILDINGS

=

=

8. Narural

Ventilation Ventilation

9. Mechanical

Equipment

= =

SANITARY FACILITIES
10. Provided/Accessible 11. Cleanliness & Repair

= = = = = =

15. Handwash

Facilities

16. Showers/Fixtures 17. Shower Water Temp.

= =

LIQUID/SOLID
21. Sewage

WASTE
Disposal

=
= = =

SAFETY
26. First Aid Kit

22. Solid Waste

FOOD
27. Food Insp. Rpl.

= 5. Maintenance & Repair = = 6. Lighting/Foot-Candles =
7. Heating, Ventilation, A/C

4. Construction

=

WATER SUPPLY
18. lnstalled/Operated/ Maintained 19. Drinking 20. Approved Fountains Source

VECTORNERMIN CONTROL

OTHER
28. 29.

12. Toilet Facilities 13. Separation 14. Fixture of Sexes

= = =

23. Infestation/Control 24. Brush/Trash
25. Water Collection/Drainage

Ratio

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

DH 4030. 01/05

(Obsoletes

Previous

Editions)

-i -I -= -= lOR
ctt:J12.5I
Cl:J13O

_= _= _=

--PURPOSE:
_

_=

~

ROUTINE

CONSTRUCT

COMPLAINT QA SURVEY PREOPENING

=

= = =

=

REINSPECTION CHANGEOFOWNER CONSULTATION EPIDEMIOLOGY OTHER _

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
ct::2I Private School *Ii Public School
I22i Charter School

I23i Vocational School

~~;~FSCHOOL
ADDRE

IltJ 2. (J

LtJ)(,4J1,QTUlff

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CITY

=
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Other

RESULT
I-'-----,---.-j

CZK&eeJ/tJ,lU[e'

f.gc_

..5...8

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~

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fltH,p1lJ)

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PHONE

db I3!'Jl

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BUILDINGS

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=
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8. Natural Ventilation
9. Mechanical Ventilation

_

15. l landwash

Facilities

SANITARY FACILITIES
10. Provided/Accessible II Cleanliness & Repair

= =

=

I (I. Showers/Fixtures 17 Shower Water Temp.

=

21 Sewage

Disposal

=
= = =

26. First Aid Kit

22. Solid Waste

FOOD
27. Food Insp. Rpt.

= 4. Construction
5. Maintenance & Repair 6. Lighting/Foot-Candles Ventilation, AlC

_

=

= 7. Heating,

=

=

12. Toilet

Facilities of Sexes

13. Separation 14. Fixture

Ratio

= =

WATER SUPPLY
I R. Installed/Operated/
Maintained 19. Drinking 20. Approved Fountains Source

= =

VECTORIVERMIN CONTROL
23. Infestation/Control 24. Brush/Trash 25. Water Collection/Drainage

OTHER
28.
29.

__
_

=

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

-

8- cDSawz

DH 4030, Ot lOS (Obsoletes

Previous

Edrtions)

_ ~

--~

PURPOSE:
ROUTINE

= = = =

CONSTRUCT. COMPLAINT QII SURVEY PREOrlNIMi

= = = =

REINSPICTION (1IAMiE 01' OWNJ·Y

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT

TYPE:
tt2I Private
_ Public School School School

t22t Charter

CC):\SUL1AIION FI'II)h'v110LOC;Y _

I23J

Vocal ional School

= OTIILR

=

I24l Collcge/Uuivcrsitv
Other _

ADDRESS~~~~
OVVNER

__ ~~~~~~~~~
Unsatisfactory Correct Violations by = Next Inspection 8:00 A:'1 on: "'.:'1 1 DATE I L.. .4 _j ..

--~~~~~~~~+--=~-r;-----~~
-+--Ll.-~J.l...<J~::':"=::~__:_4.l..A---

PERSON IN CHARGE

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=
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c::::J

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1. Athletic Equipment

\'1L:l'hanical Ventilation FACILITIES
8: Rcpai:

1o, Sbowcrv/Fixturc-, 17. Shower Water Temp.

SANITARY

BUILDINGS

= 4. Construction

= =

5. Maintenance

& Repair

= =

=

= =

=
c:::J

2 I.

SC\.\-HgC

j)i~ro~i:il

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10.l'r()viJcd!Accessihlc II Cleanliness

WATER SUPPLY
IS. Installed/Operated/ Maintained

VECTORNERMIN CONTROL

=

27. rooJ lnsp

RpL

11. Toilet

Facilities

=
CJ

n

lnfcstation.Conrrol

24. nn,,!vTrash 25. Water Collccuon/Draiuagc

6. Liglning/Fovl-Candks 7. Heating. Ventilation. Ale

iiIIt 13. Scparauon

=

or Sexes
Patio

14 Fixture

'" =

I'). Drinking 20. Approved

Fountains Source

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

---

DH 4030. 01/05 (Obsoletes

Previous

Editions)

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

Date

~/C

IdentificationNo.~-~-~JmI0'

~:z; =J1:::~~)
Comments and Instructions (Continued from Page 1):

.If:23 ~ .7JJbsM7Z;)(J
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Copy of Report Received by

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Page 2

DH ~10~. (Stock

4/96 57 ~J,-OOO-J, 10J,-8)

Number:

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STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

Identification

NO.~-~-m~

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Copy ofRcport

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bL2tJ\~, )Lk_Inspecto'_---:, ~~~-..._,..-----,--,,-o
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DH 4104,4/96 (Slock Number: 5744·000·4104·8)

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STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

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Identification Nom-I]fI-I2l~wl::lf

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Page 2
DH 4104, 4/96
(Stock Number:

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-

-= = = =
_

-- -

PURPOSE:
RJ)t:TINE C()NSTRlXT COMPLAINT QA SURVEY PREOPENING

= = = = =

REINSPECTION CHAN(iE OF OWNER CONSULTATION EPIDEMIOLOGY OTHER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
i!2l
_ Private Public Charter School School School

I22i

i23J Vocational School
1241 College/University

=

Other

_

_

Satisfactory

= Incomplete = Unsatisfactory
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05

c6Jl25l

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= =

8. Natural

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_ _

15. Handwash

Facilities

=
..

9. Mechanical

16. Showers/Fixtures 17. Shower Water Temp.

SANITARY FACILITIES

=
_).

BUILDINGS

=

= =

=

21. Sewage 22. Solid

Disposal Waste

= = =

26. First Aid Kit

FOOD
27. Food Insp. Rpt.

10. Provided/Accessible II. Cleanliness 12. Toilet & Repair

WATER SUPPLY
IX. Installed/Operated/ Maintained

VECTORNERMIN CONTROL

_

= 7. Heating,

6. Lighting/Foot-Candles Ventilation, A/e:

= =

_

Facilities of Sexes Ratio

13. Separation 14. Fixture

=

=

19. Drinking 20. Approved

Fountains Source

= =

23. Infestation/Control 24. Brush/Trash 25. Water Collection/Drainage

OTHER • 2S. 29.

o\:).';:erv.,h
_

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

COPY OF REPORT RECEfVED BY L~~W)"_"~.a.M.'~llil!:!::'DH 4030. 01/05 (Obsoletes Previous Editions)

DATE- _

__,S~_~ ..... -J/,__ 9-<-.>3c",,-_;/'
~ \~?..

_

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

IdentificationNo.I5JQJ-~ITJ
Conunents and Instructions (Continued from Page 1):

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-:ll=83Wcr::5?

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rrnfe.

%e

oais

f'eo~

Due -bJ.od ±.c;'o\Q On-3\dg e..qs-\-'2>icW ~

Copy of Report Received by

~

'11YM ~
Page 2

DH ~IO~.
[Sto ck

~3

1,/96 57 ~~-OOO-~ 1O~-8J

Number:

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

Date~~,OO\1
Comments and Instructions (Continued from Page 1):

Identification o.~a-51[]-lOOla@H]. N

~ ~\fed..

Othor COnrorOS/OtsecyPflsons.
oro.e
MOe

fke etb0er''S'oa.C On rEd) B)oo\{oA, ~

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0

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'beeches

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tridga..

~

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orea. ;wfu;=\i(.J.Q.cf

Sdv\~\Y£..cl-el.Qe..
S't-o\)\clt\cNe.

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Eq2,pme()-t- -I-toto. Co-mpckr- lebs, \cc:.ct\ec:l, \f) :=-;,d,Q. c..\c.:££0QXv)
'CO 1"\(e.
et---\)0CC;l2',Sher

'Po<&\ou-£ek·UWe-~.

k\re. e,zb~isheCs.

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bQ\\w~. ~ ?s"'-n310 ex:~-\-~

ocb"x:R_K. to u)q)ls <?i;-\-~. C\~\ooxns
.

Copy of Report Received by

L tf'M ~trnlV1
pagea~3

Inspector

DH 41 04. {Slock

~/96
57 H-OOO-~ 10~-8J

Number:

- c2J_ -= -= -= -= _ O::l IQOJ

---

-...
= = = =

PURPOSE:
CONSTRUCI COMPLAINT

.a.t RUUTINF

Q/\ SURVEY PREOPENI"lG

= = = = =

Rl'lNSrECTION CHAN(;~ Or OWNER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
ct:2J Private School
_ Public School

I22J Charier School

CONSULfATION EPIDEMIOLOGY OTHER

I23J

Vocational School

i2l:Il College/University

= Other

_

NAME OF SCHOOL ADDRESS
OWNER

::c:> \

5

!

So ~ct \\0

CITY ZIP

~""""""'--'--'=::u.L!""'__"~

f--'----"'-'--=I

t6\ro ~

C6.J'o~ So\xxP\ Dsk:CT

= Incomplete = Unsatisfactory
Correct Violations by .m Next Inspection

-

Satisfactory

PERSON IN CHARGE

PHONE

= 8:00 A\1 on: DArE

Q:l 00

c2J i05I_
2M]

c:3::1 ttl)! iI"MJ [3:J ctO c:ztJct"5' Lltltt5l cSJ_
d)J125J

05 06
07 I~!
W.JfL-..J

C5:.112O

08 09

c:6:J t25i cXJl3:OJ

c:1:Jl30 E:8:Jl35J c9:J
r4t)J

Lltl Lltl c4.J ...

'*

10
11

c:SJ13S

i:SJ cSJ t:SJ CSJ t:SJ
d)J d)J d)J C6:J d)J

...

140

dOl !llSl d:!JiSOJ
d:2l155! -~~

_iiISI
ct:1J r50i rt21155J

.!ei:lion 12Q;69J 0 the Flo • 'IlSiQiutu (FS)( thiJ/o_rm wU/ ~uve.· ··~a .. "Notice olNon~co;np7jQnce: v!QI~lltm.r flO/ed. Tt.etrl$. below violat£! 111£ ntquuvmmt5i QjChoplf:1'6 611E-13,and 64E-J J oilllt F_IOTu/.rI Jftinlllljjfr{lflloeCadi!, (FAr;; QJld must ~ currr&JeJ MTrllrll1lhtlllm~ pttrlmf IndJcoteti III 1M "RI!SIIJIs" secao» Qbo~'t'. ConttflUe(j apera/IOfl of tha fm:l7lf)' withau: making these correettonsiso v/(JiDtion (J/ Chapter 64£-.1 J mu:J 6<#$-1/, FAe. tmd Chaptl!l' 381, FS. FaillLfll II) cflmra.violafiollS mDJ' rtlull in afl otJmrniJtratlveji"" or ()lh~1;/~gDI actionbeiflg~""iQleJ '!_r_;;COfI_;_t_jfl_ui!d._.;.._ ~ ~~ __ ~ __,

!orany

SCHOOL SANITATION
I. School Site Equipment

=
_

LIQUID/SOLID WASTE
S. Natural Ventilation Ventilation

2. Playground

9. Mechanical

3. Athletic

Equipment

SANITARY FACILITIES

BUILDINGS

= 4. Construction
5. Maintenance & Repair 6. Lighting/Foot-Candles venulauon, A/C 7. Heating,

=
_

=

=

_

15. Handwash

Facilities

16. Showers/tixtures
17. Shower Water Temp. IX. Insiallcd/Operated/
Maintained 19 Drinking 20. Approved

=
_

=

SAFETY

21. Sewage

Disposal

=

26. First Aid Kit

22. Solid Waste

FOOD

10. Provided/Accessible I I. Cleanliness & Repair

WATER SUPPLY

_

_

=

= =

12. Toilet Facilities 13. Separation 14. Fixture of Sexes

=

VECTORIVERMIN CONTROL

=

27. Food Insp. RpL

OTHER
.. 28. ~~~~iLl 29. L,f:ul=.L!LI-=..ff'-e:h

Ratio

=

Fountains
Source

=

=

23. Infestation/Control 24. Brush/Trash 25. Water Collection/Drainage

ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

-

-+-=:D!..U..s........A.....~~~~
RECEIVED
Previous

PHONE.

§tol

907-59Lf 3
~/,--,O",,_

COPY OF REPORT

BY

_=-

-3o<~__L

__

--I;__--I"""'~---------

DATE

--",o""--,'-I,__·--=O,--,,,(r;,__,

DH 4030, 01/05

(Obsoletes

Editions)

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

Date

L\ Iv 1#0\0
, I

Identification o.(5](g-~[]-~IQ]~~@ N

Comments and Instructions (Continued from Page 1):

~ «'9 f'O isce\\goeOtJS
flC)\-

9:l.feji~
'10

CDnCQ£ a

==-t

bu'\\o\,oO
bc;s

L} .£Ioor [!)A"!t

sec.lA?JXJl;
SCC~

\:e.G&;
~

\I,)c;\\(."''''(1-

bcl...eol'D b\d& \...c ;

0..

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e\ec1'flul

co"\ -p\ecse
CDlcro
'\f\

p)C!~o...J.)C1Qn;~ t
1Cx)

Jspe.

un;; I\

repa;ceo\. j
aoeL;:O~

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cJcy;Q., -to S\o'fS(U)C;+e rJ

EqUIPffi:?o+

w<¥.ed..

;:e\lecc,\ f;Glen Q Q__

\,,'0$ bu'\ \d; o~ L\-.

Copy of Report Received by

-'~===.I'--=-_~fL+:s_8_:_;_'-==-Page 2

Inspector

--~~CM~·="'9..qu...bac@fl:.!....ll!!::~""""_ __

-

DH .10., "/96 [Stock Number:

57....·000· ..10.·8)

-

-

_ -

-

-

--=
=

PURPOSE:

= C(}N~TRUtT. = ClIANGE OF o\\·NtR
CO~.iPL\INT QA.SURVI:Y PREOi ENING

R()UTl~:f

~

Rl:INSPECTION

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL

TYPE:
ct2l rrh .ite School
_ ~
~..i'

PuL:ic School Charter School
Vocational

=
c::::J

=
=

INSPECTION REPORT[j)

= EPIDEI,;IOLOGY
OTHER

CONSU!.TAI'ION _

School

=

c:!l College/University
Other _

1=
...

r- ~. ~-.-~a,,:;.·c~~.-: F 1~:l.'':_J·,1.i~t·~1-:
c::J "";';" : 1-:1 ~;.

RESULTS

Qjr:j8'!,;:;i~~~rr~, r_(,~ r _~~'~~-~2tilr 'b<" b:.
:: 1:-,.'":

,._

....
-~:.

.

./~

,is JI4ff secuo» 120.695 oflhe Honda SttJIU~ (Fs), flus form will ~erve as a "]1[0'11.'" of Non-Complumce. for anv violations noted Items marked below vtolate the lW/uuemenJs of Chapters 64E-13 and 64E-l I of the Florida Admmntranve Code (F.4C) and must be corrected within the time period tndicated in Ihe "Results" section above. Continued operatum of this facility WIthout mailing th~,,! corrections i, a violation of Chapter 64E-H and 64E-1 I, FAC and Chapter 3111,FS Failure to correct Viola/IOns moy resutt In an admtmstrauve fine or other legal action being imnaied or continued SCHOOL
I. $,h",l

= 2. rIa, ·:fOundEq' :P'"

=

SANITATION
Site
'II

=
_

8. Natural
Q.

\.ntilation

=

Mcch.rucul \ cntilation

=

=

15. Handv.ash

Facilities

=
..

LIQUID/SOLID

WASTE

1. AthL ti . Equipmcrt

SANITARY FACILITIES

BUILDINGS

= ~. = =
_

=

=

16. Shower Fixtures
17. Shov cr .. .ucr Temp.

=

21. Sc-vagc Disposal

= =

SAFETY
26. FlU Aid Kit

22. ~oliu Wa·:t~

FOOD

VECTORIVERMIN CONTROL
23.lnk'Statlon/('olltrol

= 27. Food In n. RpL
OTHER
_2K~~ 2'> _

10. Pro. idedi Accessible
II. Clcanliucss 12. Toilet & Repair Facilities
OfSCXL

WATER SUPPLY

Construction & Repair . .:-C ..ndlc,

~

5. ~,.,inLoan<o

6. LiJhtin;'·Fc

=

=

=
~

I~. Instailcu/Op<.,"tcdl Maintained I'.. Drinking Foum.iir.

7. Heating, \';Iltilat: )11.1\/('

=

13. Separation

= 24. Brusb 'Trash = 2~..... .ter Collectio:

Dr.uru.ge

14. Fixture Ratio

ITEM
NUMBERS

-s .,n-tct \ ces lli~\tt S~hcoI
l,l

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNI

(p.

V

.1..

immf =.""'. . ... IlEAL.
C1I!.. .

Date

5)5/10

Identification o.I§B-fB!iJ-~ID~~Hl N

Copy of Report Received by

fltrt;J

tM-J

f't1qi /,J

./0 d~pecoor

~

Page 2
DH 4104, 4/96 (Stock Number: 5744-000-4104-8)

CHD

III!'

- ~.!:~:J - .... -I = = ._ _ ~~~~~IN BEGIN

-

-

---PURPOSE:

= = CONSTRUCT. = COMPI. \INT
ROUTINE

REINSIECTION CHANGE OF OWNER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTIf DEPARTMENT
PUBLICI PRJV~TE SCHOOL lNSPECIlON REPORT

TYPE:

c::J c::J

= =

CONSULTATION EPIDEMIOLOGY

<J)

I22J Charter School
I23l ',Ocatiooal School

...
ct2I

Pri- ,Ie School Public School

Q.'" SURVEY

c::J

I2l'J ColJ..J<' 'University

PREOPENlNG

= OTHER

= Other
RESULTS

i ADDRESS

,

"'="-Q--¥-J"!!ic,--L..o;L4'"~~LJJ..---"""""~'---

i OWNE~F'_"""..o(b,..f-----.,..--:::=-------,:::---I
~~-t~_
I

= Il'comrkt~
c::J

_

Satisfactory Unsati factor::

END

Correct ..,'ielarlons b~ .. Ne': ~ In' jJedion c:J t?:OO }.l': ~ c 11!

r " - - --'---'
I ~.
I

DATE

--

I;, ~:d':~Tl,.; r
1 ..

I
I

"

1

i
i

.~.<:. ;_"l~~

:.,,]..

'"~.t;

:

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L~ '.

,-:_t. ~

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dOl

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".1

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10
11

",'.

tt.;·",,:"

"1:;,,-,:,.,

I~-"> Lt:."' ~ ---~--

"",n,..

I

'of the "Florida Statuies (FS): thu fmm li iij $flw -U_, IJ '",ioi,(:"-ofNoll-Compill.11fct!, for am viotations noted Items mariU:dbelov. vtolate the requirements of Chapters 64E-] 3 and 64E-l1 of.the Florida Admsnistrauve Code IF1C) and lIIUJl be corrected wuhtn the /'11Ie period indicated iJI the "Results" section above. Continued operation oj this facilit» without making these correcuons /3 a violation 'of Chapter 64E-13 IlIId 64E-II, FAC, and Chapter 381, FS. _!allure i!' carrec~'!.~kztIo_1J5.7IU) ",,'!.ult In ~"admimftTa/n~efine_or ot!'a legal'!~t!on b~mg ,!"tzote_d f!r l.onrinued 0 _ SCHOOL SANITATION LlQUlDlSOLlD WASTE SAFETY I. School Sit c::J 8. Natural Ventilation c::J 15. H.:.:nd",u;h faeililU:l; 21. Sew~".' Disj-osal

'-, AsPer se,ctiOIf 120.695 =
c::J

~\ioJ

: MALES

."1
L

'::1I

c<7;

'2 •

:~,

'3'}_::..l,'

14

OUT OF 'm"I;-:[SS

=

=
c=J

2, Playground E~uipmcnt

9. Mechanical

'-':nlilation

3. ,\thlctic Equipment

SANITARYFACILITlES

BUILDINGS _

= 4. Construction

=
_

=
c::J c::J

16. Shower,

'Fixtures

22. Solid WcSle

FOOD

17. Shower \II _<terTemp.

10. Prollded/J\ccc"ibk I L Cleanlines . & Repair 12. Toilet Facilities
13. Sep .. ration of Sc,CS

WATER SUPPLY
18.lnstalled'Operated! ! ;..tintaincd 19, Drrnking Fountains 20, vpproved Source

VECTORIVERMIN CONTROL

= 27, Food
28.
2<).

10' p. Rpt.

OTHER -

= 6. Li,'htin&'Foot-Candles

5. Maintenance & Repair

=

'c::J

7, Healin~. \cntilation,IIiC

=

=
c::J

= =
c::J

::3, lnfestation/Control
:4. Brush/Trash

=

;(,oca.'t1_

25. W~ter Cotlcrion/Drc.na-re

14. Fixture Ratio

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

-

-

DH

4030,

01105

,')bsoIetes

Previous

Editi<>n:o)

Comments and Instructions (Continued from Page 1):

~~:~:~:r:e~cp~\'S
'ruACldC~
LoQrn

(ids

locK'tcCoo~

t

6<'2-)

i fi.ls-\- Ctfl\\'c
\OL~r

'004

mQin ball £o-k¥UlA~S
(oO{()

(2) Md
.

VeIl+de,{;'Of) '5yskms &"fawfQ/OJacA

@W m tc.b &0 ~ca.l
f"'f\M.b} CCmolJL
I .

(100 Of)

I~'-t15

Ul>.e . .l

--G c S-Iw'ay_ @mp-'-kcs),
.

Copy of Report Received by

JI ~~ X rYlll.lILd.A"d., fAx'l J -h e..liltd: i'flfl ,JO Inspecto
Page 2

DH 4104, 4/96

(Stock Number: 5744-000-4104-8)

CHD

.. -. . .. .. .. .. .. .. .. .... . ...

-. .-. ..-.

.-. .-. .-.

-. . .. ..

.... -.. . . -

..

.. .. = .. = .. = .. = ..
--

PURPOSE:

= ROUTINE
CONSTRUCT . COMPLAINT
QASURVEY

_

PREOPENING

= = =

= CHANGE Of OV.~ER
CONSULTATION EPIDEMIOLOGY OTHER _

REINSPECTION

COUNTY

DEPARTMENT

STATE OF FLORIDA

HEALTH DEPARTMENT

OF HEALTH

TYPE:
~ _ Private School Charter School VlCatianal School Other _

PUBLICI PRIVATE SCHOOL INSPECTION REPO~

lt3I Public School

123

.~---------~~~--.---

=

I2#.l College ·University

Sfltisfhctoa; .
InCCillp!ete

Unsatisfaetory

= = 4. Construction = _ 5. Maintenance & Repair = = 6. Lighting/Foot-Candles = = 7. Heating. Ventilation, AIC =
ITEM
NUMBERS

3. Athletic Equipment BUILDINGS

=

=

2. Playground Equipment

= 9. ~!echanical

Ventilation

SANITARY FACILITIES 10. Provided/Accessible 11. Clc mliness & Repair 12. Toilet Facilities 13. Separation of Sexes 14. Fixture Ratio

=

=

16. Showers/Fixtures 17. Shower Wner Ternp.

=
_

22. Solid Waste

FOOD

=
=

WATER SUPPLY
18. Jnstalled/Operated/

VECfORNERMIN CONTROL

=

27. Food Insp. Rpt.

Maintained
19. Drinking Fountains

=

=

=

23. lnfe-aauon/Control 24. Brush, Trash 25. Water Collection/Drainage

=

OTHER 28.

=

_ _

29.

20. Approved Source

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

Date

\0 1:1-1

/lO

DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH I

STATE OF FLORIDA ~

Identification o.!3~-~ N

r=-r.-.,,.....,.nI::!Iof-~

Comments and Instructions (Continued from Page 1):

DH 41 04. ~/9d.
(Stock Number: 57H-(){)D-4104-8j

_

-

-

-

:=

-

-= =

PURPOSE:
ROUTINE CONSTRUCT _

-

= COMPLAINT
c:::l QA SURVEY

=

=

= CH \NGE OF O\\"NER
CONSULTATION EPIDEMIOLOGY
__ --'::::--

RElNSPECnON

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
d2J Private School It3I Public School
_ ~ Charter School vocanona! School Other _

pREOPENING

= :O:.:.T~H=ER~====-

~h

=

1241 College Uniyersit~

r----------- -I RES~~
SatisfactfJry

Incomplete Un"at1~ractory

BUILDINGS

= = =

2_ Playground Equipment

=

9_ Mechanical

ventilation

=
= =

3_ Athletic Equipment

SANITARY FACILITIES

= 4. Construction

= 7. Heating, Ventilation, NC =
ITEM
NUMBERS

=

5. Maintenance & Repair 6. Lighting Foot-Candles

= = =

= =

16. Showers/Fixtures 17. Shower V, ater Temp.

=

22. Solid Waste

10. Provided'Accessible II. Cleanliness & Repair

WATER SUPPLY
18. lnstalledOperated/ Msintained
19. Drinking Fountains 20. Approved Source

=

VECTORIVERMIN CONTROL

=

12. Toilet Facilities 13. Separation of Sexes

=

23.lnlestatioll·Control 24. Brush. Trash

= 25. \\ ~ter Collection/Drainage

= = =

FOOD
27. Food Insp. Rpt. 28. 29. _ _

OTHER

14. Fixture Ratio

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

:Ls) •
_

-- c:::J

PURPOSE:
R'~'I""'" ........ '- III,'
CONSTRUCT

EHE DELRAY 5612743192 Fax: STATE OF FLORIDA DEPARTMENT OF HEALTH :OUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL Ll\ISPECTION REPORT

Feb 20 2012 01:54pm P002
TYPE:
C!:l
• Private Sch\.~,-)~ Pd_)!ic Scheel

· . fJ~'D::Ef".;.J ~':"--' [COt'S tux "';"-;:

~i~r~l:'ti::; ili1!;.

\C.;;:jt~.i%
r®·:~::;;!
C.il ~':'''':

.S[D£i!
l

:.1

jeL.
~i:i,

!,~,~).>,
.~ .':'_:j..r

FEMALES

lLfn~::;'~~,rSe,;ji',
10:.'!~~(.:t;;

•.

!_:~.'

~'ti.~ ,-~~:C,i)

f >:;!:%:' ~~\:i jd..-:tSS-:'

j:ki!:~.f':~,;

,

ro;,~:~>t'

£3_-._-~ :;~'I I t!t,.7J
~£~: :~?;;,:il
i .:

~?_~.D·7 CD I..;i

b'~~":'!lr;

120.69 50! the-Florida Starures(FS) fhii/orm willsen'e ;"'5 'Notice of Non-Compliance: for any violations noted mwkediJelow ike.'1 requirements of Chapters 64E-! 3 and 64£-11 of tl Florida Administrative Code (FA C) and must be corrected within the time period indicated in the i'Results'<>! section above. Continued operation of this facility without making these corrections is a violation of Chapter t$4Ecl J and 64E-Il. FAC,and Chapter 381. PS .'i L~!,!':.il~e_IO_ co_rrecl_dolations"':rJ'.':"!t<l~~nt}'!_a_<1__"!~ fine or other legal action being initiated or continued. . istrative .. .. --- -.-----.-_. .... .... ......" -- UQuID/SOLID\l;'ASTE--SAFETY- .------, . . .! SCHOOL SANITATION FOOD SANITARY FACII TIES BUILDINGS
.5.
L-1

1- As-pe~section

a

I'-~,:~ · ~~,~~
·

iMALES;

i~

t ,,·
ji-erm violGte

VECfORlVERM.IN

=::J

27. Fond Insp. RPL 2~. 29. _ _

WATER SUPPLY
i ~~. inst;]lk.j_iOptn~led/

CONTROL
I:::J c=J

?·toi!"h'';~:in~c Repair & 6. Llghdng/f~(.'·~-Candlcs

c=
~

:2.

Toiiel Fae:!.

c:;' . Sc.'\c~

:Y1aii1i.:iir;,;J

24. Srush/Trash

=

=

OTHER

13. Scpar~t~()n,

25. \.v~ter ColkCLion/Dn~ir:;~g(:

c= 20. Approved Source

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

V

_

ifF1LTH DEI~i1(/Aff'\Tl.\SPECTOII·~~~~~ti

OH

4-030. 01/05 {Obsole19S F'relJlous Editions}

...

EHE DELRAY 5612743192 Fax:

Feb 20 2012 01:55pm P003

STATE OF FLORIDA DE >ARTMENT OF HEALTH COU1~;UBLIC B~ra~, J 'AU l C\ Y" ~)') e t:"" !{'yY)~_c;J.. Date

~)

O~.... %~/D

IdentificationNo.m-~[l-r~~HQ]~W

~sVtJO~~(~vJQt~
/" to 13 ~
~lh

Comments and Instructions (Contimu.I from Page 1):

e~haYlAc,\'\~<;
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PURPOSE:

ROUTil';l

Ri;i!',Sf'ECTIOi'i

DEPARTMENT OF HEALTH ;OUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:

~

Private School

Public Schoo!

_ = QASURVEY - = PREOPENING
NAMEOFS

-

= COMPLAINT

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Chaprers64E-13 and Florida Administrative Code (FAC) indicatedinthe, R<!$Ultt I reqUIrements ofContinued operation of64E-II of th. vitbout making these corrections is aand must beofcorrected 64E~13the time periodFAC.aiulChdpter38t;.F'_s,i secMn above. this facility violation Chapter riild64E,J1,· 1 Failure to correct violations result an admu strative fine or other legal action being initiated or continued. .. .. .. .,j t SCHOOLSAl'iTIATIO~",-----'---·-----------.------LIQUID/SOLID WASTE-~~ SAFETY '1
within ".j may in

i.. As.-pe.- .. r. .. -

:&e ...

crwn.l i7i69f..of the FlOrida- Statu/is (FS).. ~irf.·.i.orm ill serve as a "Notice of Non-Compliance: for O--;'Y. ~iO/atiO,;s.!oled7rem.~. ;;;;;;.W w , ....

lreJ.· .

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BUILDINGS

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SANITARYFACIL rres 10. Provided/A, ess.ble
l;. Cleanliness
<

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WATER SUPPLY
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VECfORIVERMIN-' CONTROL
24. Brush/Trash

OTHER

I'

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Repair

i 8. installed/Operated/ Maintained

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& Repa~r

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Fountains

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COMMENTS AND INSTRUCfIONS

HEALTH DEPARTMENT INSPECTOR: H-1~IP"'1f-'~P

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PHONE: -'-'~:....t.--;'-___.!-l---_'__-----

DH 4G3C. 01/05 (Obsoletes Previous Editions)

C§-1lD/HEAOQQJARTERS

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~tATJ!, PURPOSE:
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Uj; j;'LURlDA

fax:

Feb 20 2012 02:08pm
TYPE:

P039/040

DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

~

Colicgc.Uuivcrsny

i

1

.RESULTS·]
bac&mpnete

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IE. !n~i<~!Icd/OptnHcd/

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EHE DELRAY5612743192 Fax:
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Feb 20 2012 02:09pm P040/040 ~ ! I {,

;TATE OF FLORIDA DEIARTMENT OF HEALTH COUN TY PUBLIC HEALTH UNIT

Date

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Identification No.[3I[~-~[l]-~l]grj[E@
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RFI"<SPLCTION ('II.ANGEOF()WNI'.R Ul:\SLLlAliON f-PI[)[MI()LO(d UIHEI< _

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

ITPE:
Et2l
..
PriY<Ill;

Sehoul

Pubhc School Charier School
Vocnuonal

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r.23J

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NAME OF SCHOOL

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;'i pe;- tiCifoo/20.69j-o!ihcFloridaSl'ti/:"'te.!' (FS), this form serve as a "Notice of Non-Compliance: jor any violations noted/terns marked belOw l'iiilole the requirement o/Olopters 64£-13 and 64~JJolthe Florida Administrative Code (FAC) and must be correctedwithinthetime [1Qiodindicmt!dinlh "Results" ec(ioJl abov CI)nJ!1IJItd o_perDlJo'!o/t!t jacllif): with0l!f making these correcliO_ns is Cf vi?lq~ion ojCluipwr, 64E~13(;md64E-JI,FAC.,and Chapll!r 3 '1, FS'__/.
Failun: to COi7f!d Vlolatfar» mUJ're$l!IIIn,Qn administrative fine or other legal action being Initiated or contl71ui!4,

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WATER SUPPLY
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ITEM NUMBERS

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

IIH/_T/IIJFI}IIiT·\/FVTIVSl'fTTO

DH 4030. 01/05

(Obsoletes

Previous Editions)
I

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

Date

,q~/I

Identification o.I3Jk2J-[]rn-[J~I2J~caN

Comments and Instructions (Continued from Page 1):

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Identification No.[5]~-m-~~[ZJ[gm--

Comments and Instructions (Continued from Page 1):

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PREOPFNINC

= = = = =

RFINSPECTION CH;\l\(jl OF OWJsiER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
1121 Private School _ ~ Public School Charter School School

CONSULTATION FPIDEMIOLO(iY OTHER

123! Vocational
~

College/University

NAME OF SCHOOL -=11Et:::;:_:..:.1HZ.---=-~=__:_..L_____::__J=~:__

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As Piir-sec-I-;o")"iii@Jof-'-he-F,-'o-n-td.-a-siiiiiiii(FS}-:tilitformw. I.'ll $erve as a "Notice of NOn~CO"!pIit:inCe:for-QlI-)';!(jlfiw.-ns~o-te-d-Ii-~ems--IIJQ,ft(l&ii;;';~lo-. l-(JJ-e-'he-. rt!qUll"f!I1l([1ll.f o/CJrapt(93 64E-13 and 64&1 J of the FI()rldoAdmml$tr<Itlve Code (FAC) and m.wtt be C(}rrecJed li.'lthm the lunpuioJ ",dicel din Ihe Resulb' sea/1m above: ConJ1mLeJi operation o{,hlsfaclllly wilhouJmaking these-corrections is a violation a/Chopts64£-13 and ME·II. FAC and Chapler 381. FS. .FoiJrdC 10 QO"!".E ~/QIQIi!!!l.f m . !:£:fult in (VI OlIminlsirativejine or other legal action being initia/f'.d or_CilnlI1JI!_ed. ....._.__ ... , . . ...

SCHOOL SANITATION

=I
c:::J

ScI",nl

Site
Equipment

=
c:::J

LIQUID/SOLID WASTE
X, Natur'll
').

Ventilation Vcruilatio»

= 3. Athletic

2. P!<lyground lquiprnent

Mechanical

SANITARY FACILITIES

BUILDINGS
c:J 4. Consuuciion '.\lainten3nce & Repair ~

= 7. Heating,
ITEM NUMBERS

_

6, Lighung/Foot-Candlcs Ventilation, AlC

=

= =

=

=

= =

=

SAFETY

21. Sewage

=

26. First Aid Kit
27. f:onel Insp. Rpt.

16, Showers/Fixtures 17. Show", Water Temp.

c:::J

22. Solid \Vastc

FOOD

1(1, Provided/Accessible II. Cleanliness & Repair

WATER SUPPLY

=

VECTORIVERMIN CONTROL

=

I~. lnstallcd/Opcratcd?

12. Toilet Fae iliucs

Maintained

13, Separation 14. Fixture

or Sexes

=

=
=

OTHER

2~. Infestation/Control 24, Brush/Trash 25. Water Collection/Drainage

= =

2~, 2'1,

_ _

Ratio

=

IiiIIi

1'1. Drinking 20. Approved

Fountains Source

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

DH 4030, 01/05

(Obsoletes

Previous

Editions)

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT

Identification o.~[Q]-~0-~~[]~~ N
Comments and Instructions (Continued from Page 1):

I~ ~LlfLlIV)/ft
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Page 2
DH 4104. 4/96 [Sfo c k Number: 574.·000-.10.-8)

-. -PURPOSE:

= = = =

ROUTINE

CONSTRUCT

COMPLAINT

QASURVEY PREOPENING

= = = = =
"HOOL

REINSPECTION CHANGE OF OWNER CONSULTATION EPIDEMIOLOGY OTHER

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

1

YPE:
Public School

ct:2J Private School
..

t22J Charter School t23I Vocational School I2ltJ College/University

=
~
.;_;_~--+

Other

_

AME 0

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IiIII

ADDREis05
OWNElt
0

5hent:.rJ,oa.b P./3. C. G. B .

8lvd.

PE

IN CHARGE

.An-fby W hCir+

= Incomplete = Unsatisfactory
Correct Violations by __ Next Inspection

Satisfactory

= 8:00AM

on:

05 ~t-L,
LL-'I'-~ 06

07
08

_

c7:J13O
c1Di3!3I

09
10 11 12 13

_

_

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~

As pu I«tion 120.695 of 1M Florida SUi.1idt:s (FS). Ihi4 jo,.". .... ll en.-;;:ro "Heiice 'ojNtJn-&mpUa;-.;e-:for any liOI4lIolU:n:ot~«I....-cI;;"lems-··' ~m:o.tkd=':::;bj:=':/OW=~::;iolD:;::t~:t:;:h~::; i ~ ofCluJpten 64£.1 a1Ul64£-1l of W FIQrldu AdmiJristrative Code (FilC). and musr be co~/ed K';lhin th I.me puiod intiitilltill" Ih~ "RtlSNILt" ucliOn Ilbore. CDnJlflued opuafion QfllW foci!ity 'IIdlhaul molcing /he! COrreai()ff.f is Q violalirm ofChapler ME-IS ltlId 64E-1J. FAC (ltfd C/lapter J 1. FS Faibut- w ~ .iolatio", 'rcnill ilIA administrative fin., or o(hc:_I~ or:lrOfI being inj'iD.I~ or CCJntinllBfi. ..._ ...... "--!

=I

= 3. Athletic
.-

= 2. Playground

SCHOOL SANITATION School Site Equipment Equipment

=

=

k. Natural Ventilation 9. Mechanical

_

Ventilation

BUILDINGS _ 4. Construction
5. Maintenance & Repair

= 7. Heating.
ITEM NUMBERS

_

6. Lighting-Foot-Candles Ventilation. Ale

= =

=

= =

SANITARY FACILITIES 10. Provided/Accessible
II Cleanliness & Repair 12. Toilet Facilities

= = =

15. Handwash Facilities
16. Showers/Fixtures

= =

LIQUID/SOLID WASTE 2 I Sewage Disposal
22. Solid Waste

= =

SAFETY 26. First Aid Kit
27. Food Insp. Rpt.

FOOD

17. Shower WaterTemp. I R. installed/Operated/ Maintained 19. Drinking Fountains 20. Approved Source

WATER SUPPLY

VECTORNERMIN CONTROL _ 23. Infestation/Control

13. Separation of Sexes 14. Fixture Ratio

_

=

= =

24. Brush/Trash

= =

OTHER 2H. 29

_

25. Water Collection/Drainage

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY PUBLIC HEALTH UNIT
Date

s/zrl , ..

U'/o

Identification No. ~

@]- ~DJ- jg!elI2J [g~

Comments and Instructions (Continued from Page 1):

#5-dginkDM\'~ I Bf.j'4i ..:q)4W~ ~~WO{k at/u f &,-.iT";
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:

Page 2
DH .. 10 .. , 4/96 (Slock Number: 57 ... ·000-.10.-8)

-

--= -= -= -= L3J

--

PURPOSE:
ROUIINL CONSTRllCI CO\1PLAII"I QA SURVEY PRJ-OPENIN(;

-

= = CHAN(iF OF OWNER = CONSt'lTATION = EPIDEMIOlO(;Y = OTHER
RJlNSPITIIO"

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:
d2l Private School Public School 122 Charter School r23J Vocational School

~

Collcge.L'nivcrsiry

=

Other

NAME OF SCHOOL

f-~SUL'fS--J
!iii!

ADDRESS

1)'0£ rh~n

OWNER

fI3 C (t_

tiOIJ l, 814·

= Incomplete = lInsatisfactory
Correct Violations by Next 1nspection = 8:00/\,\1 on:. I

Satisfactory

PERSON IN CHARGE

-+A~t)'_"~-'--'-"Q~r-;'-"3"-'t_14-.l..oC.~'b...._n.u..C\<-Ld-,--

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IH SINESS

Ai- JJe. -,.--sl'!C.fimlo/Chnplvs(j4&'/ j (md MJ3.J J oj Ihe Florida....·Administrative a 1iO-:@50IdIeFIOridaSt.tnNtU(F.'S),th.isfl ..o rm .W.il.l. ... serve. as. requfreml!Tll$.

'.'Notice. a/NO. n- m!fl. 1I.·ane fa. ;'-imy.·'-",.loifitiom nDted fit-m l niiirkiMfbila ... ..co.... .. .' .. c ..:. ... wvla. lUI."Ih~. Code (FAC) .and must.be oor:mr:led within t~ rime period /.ndiooled /11 lhe "'&:nlfl_'se.t:tIQnobolllf'. CoMinued apsrtrfi(J1I oflhts /r;u;il.i/)' wilhuu.' making these corrections is a violation ojCJlopfer 64E-13 and 64'£-11, FJlC,wul ChOfJIt!T 381, FS. .. Pailure to mm:1ll riolmio/lS m . remIt ill' an oominutroljve fine or other legal action being initiated or eonn"'IIJ.ed..

I

-SCHOOLSANITATI~

=,
c:::J).

= I. School Site = = 2. PIayuround Equipment =
Athlcti«

----

.. ---.. X. Natural Ventilation
'i. Mechanical I!I!III

LIQUID/SOLIDWASTE -----sAFETY-----~--1
Vc'ntilatllll1

=
c:::J

I". l lanclwash lacilnics
16. Slw\\'ersili,tures 17 Shower Water Temp.

= =
_

21. Sc\\a"e

Disposal

2A Iirs: !\id Kit
27. iooci

22. Solid Waste

FOOD

Equipment

SANITARYFACILITIES

BUILDINGS

= 4. Construction
Maintenance & Repair
~

= =
c::::J c::::J

10. I'rovidcd/Acccssihk-

WATER SUPPLY

I I. Cleanliness
13. Separation

& Repair

=

VECTORIVERMIN CONTROL

=

Insp. Rpt.

OTHER
~2X.~ ~29.~

IP ln-aallcd/Opcratcd. Maintained
19. Drinking Fountains

11. Toilet Facilities

=
=

13. Infestation/Control
24. BrushfTrash 2~. Water Coflecuon.Drainauc

=

6. Lighting/Foot~Candlcs

7. Hcaung, Ventilation.

Ale

=

or S('v:-s

14. ICixtlire Ratio
I

=
!WW)

C:7"-

20. Approved Source

ITEM NUMBERS

) - 6T

(.

50, '1 Ii

COMMENTS AND NSTRUCTIONS
(continue on attached sheet) _

lb;

0~

Y:to.IFC
...

-

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PI/ONE'

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_

-

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cttJrSOl ~

-

-

-- PURPOSE:

~

ROUTINE

= = = =

CONSTRUCT. COMPLAINT QASIIPV"Y PRLOPLNIMi

= = = = =

R[]~SPLCTION CHANG[ 01 OWNER CONSUI.T,\TION EPIDLMIOLOCiY

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

-

TYPE:
Public School

It2i Private School I22J Charter School 1231 Vocational Schoo] I2Zli (. ollege/U ui vorsi't),

NAME OF SCHOOL
. ADDRESS

5t
CITY ~~¥--~'-"'l ZIP _...._.~---t--~-4
i1&iil I--""-=-::;__..--j

3<.-..f11~C'--...L-5~h-=lb-'-'h"",aJQ..'" fl'..tflJ-l'u,--h-'---J6~AL'="V.(IJ..J~.

-+(+(;--4,(,-<-< -4'1/;>":'-r-------

= Incomplete = Lnsatisfactory
Correct Violations by _ Next Inspection

Satisfactory

ID"~
~,~::t:lC~~06 c4Jct5J LS:l12Ol r:5J125i c:!JOO d3:Jr35J r.:9:J@ r:tOilllSJ

= 8:00AM

on:

05

""""~"'~.-,Ir..., 07
08 09 10 ·12
13

®125J

LZ:J13l)!

®f35i

_!5SJ =
=

14

1. School Site 2. Playground Equipment

=
=
= = =

H. Natural

Ventilation Ventilation

=
=

9. Mechanical

= 3. Athletic Equiprncnt
BUILDINGS

SANITARY

FACILITIES
& Repair

= =

15. Handwash
17. Shower

Facilities

=

16. Showers/Fixtures Water Temp.

=

2 I Sewage

Disposal

=
= =

26. First Aid Kit

22. Solid Waste

FOOD
27. Food Insp. Rpl.

= 4. Construction
5. Maintenance & Repair

10. Provided/Accessible
11. Cleanliness 12. Toilet Facihtics

WATER SUPPLY
18. Installed/Operated/ Maintained

VECTOR/VERMIN CONTROL
_

OTHER
r;e ~8

_6.

Lighting/Fcot-Candlcs

=

13. Separation

of Sexes

iiiI!ji!

=

19. Drinking 20. Approved

Fountains Source

= =

23. Infestation/Control 24. Brush/Trash 25. Water Collection/Drainage

~9. __

S~.c

-'- __

I b, II

COMMENTS

AND INSTRUCTIONS

(continue on attached sheet)

f b :'-11 b,;

>

S},

rf.c

-

-

--= =
= =
DWNER
cZJ ~ c3:J~

PURPOSE:
KOUTINF CONSTR (r(,T

C()\1PLAleiT

QA SURVEY PREOPF'iI"i(;

= = = = =

KFINSI'I'CTION CHAMii. mOWN! k

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:


IZ2
r23l

ct2J

Private School Pulll,c School Charter School Vocal ional School

COl\SIJl.1 AIIO~
rPIIlEMIOI.()C Y

r2Zli ( '1.)IIc-gc-lUniversily

OlliFf{

=
!
CITY
____.4.o£_r.__:::__-:-----,-'-j

Other

NAME OF SCHOOL

ADDRESS

::?.rus:- S/.) [ IV IJ IV 'DC/A Ii eLyD. P e~.~ S
~_f.Ti_1J-"-(

r--11lDl---I
am

~

= Incomplete

Satisfactory

= Unsatisfactory
Coned Violations by Next Inspection = 8:00AM on:
,__--,.---.-

PERSON IN CHARGE

C_'!v_~_~_~__· __ l<.I_g~:_4_~.€7
c._"

-----'-l

::

DATE

.._j

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05

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As per eclion 110.69JQjiiie

FloridiJ$JoMei(FS).lh:tsiOnhwil/serv£:(JS a"NQticeofNon~Q:JmplitJm;e.1or any l,jO.IQliohs;;ot~d /u'nISlIWmq bi/o;'lliolllll1 the rcqufremCRU af_Chllplcrt 64E-/3 lind 64E-II 0/ the Florid/) Administrative Code (FAC) and I1JJJSI be corncled within the lime puiod iTldicaldl in the ..Rulllts" s clion abuuc.. Colllinuod operon n of 1111 /aCJ1i1)' WiJ/0U! flli/king these corrections isa violotio« ()fChDplU 64E--l Jond 64~1 1. FAC. tmd C/!OpltH' 381. F. FaIlure '.0 cornel "wlarlrms__!n !!'SI!!~.il!. QnadminisJrdtioieline or other legal actiqn beingmilllJltd orC()nli"ued . .~ _

SCHOOL SANITATION
c::J

=
c::::J

LIQUID/SOLID WASTE
I). I landwash 17 Shower F""ililies
c.::::J c::=J 21. Sl.'",l,.agc ni~po:-.al

SAFETY

=

26. FIN

Aid Kit

3. Athletic Equipment BUILDINGS

=

2. Playground

Equipmeru

i)

.\h:chanical

vcntil.uion

c:J

SANITARY FACILITIES

=
c::::J

=
_

=

16. Showcrv/Fivturc«

~2. S()I id \V,tSk

FOOD

Water Temp.

4. Conxrruction 5. Maintenance & Repair

=
c:J

10. I'ro\'idcd/Acol'ssihlc
II

WATER SUPPLY

('k3nlincss

& Repair

= =

VECTORIVERMIN CONTROL
_ 23. lnfcst.nionControl

=

27. Fnod Insp. Rpt. 2~. 2'). _ _

OTHER
c::::J

IS. Installed/Operated: Maintained

...

12. Toilet

lucilitic-, ()rSl'~~e:-.

=

=

o. Lighling/FClot~Cantlle~

7. Healing, Ventilation. Ale

=

13. Separation

_

19. Drinking Fountains
20. Approved Source

c::::J

2~ water Collcction.Drainagc

I·+' Fixture Ratio

ITEM

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

NUMBERS

19

/2.!J-

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s:

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LY1£DIA

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DH 4030, 01 (05 (Obsoletes Previous

//7 107

\cdlt ons)

-

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_

_= _=
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-- -

-

PURPOSE:
ROl;n"E _ CONSTRlJCT COf\-iP!_/\iNT _ QA su~nrt:Y

DEPARTMENT OF HEALTH

EHE DELRAY 5612743192 Fax: STATE OF FLORIDA

Feb 20 2012 02:06pm P033/040
TVPE:
Li2J Privmt Schoo:
_ ~
~

= CHANCF
cz; c:J

REiNSPECT,ON DF OWNER

.:OUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPOR:i:\

Public SChool, Charter Scboo!
Voc2tiof'!2.1 Scnocl

CO~SULTATlON
EPjDL:tv1iOLOGY

_

= PREOPENfNG

c:::J

= OTHER

_

-V

Correct 'Vi,)hHiO!lS by l'ien nl1)Specti&1l _ g:OOAf~i Oil:

=

. As pe:seclion 120.693 of theFTo;ida Statutes (FS),ms,form will serve as a "Notice oj Non-Compliance.for (11)'viokmoflS1!0Ied. ltems~;"l!rked UJJoW.~(>f4Jlthe ··FeqUlremenlS. of Chapters 64E-13 and 64 E-II.oflh 'Florida Administrative Code (FA C) and must be.corrected within the time penodmazcatedm;thf;RestillS"j secfiondbiJve.f:onfinueaoperatlOnofthisfacili1} 'oiihout making these corrections is a violation of Chapter MEc 13 ana ME-H, FA Cl1fldC/iap(er}81::J"0<j Failuh!toc6i:jectviolatwns may result ~_~ ~i,'slfath!efine or other legal actio" being initiated or c6>itillw:d ..,'. _ _:::-'"--'-...:..__.~-.<' ";. ':')
SCHOOL SANHATION School Site 2. Playground Equipment 3. Athletic Equipment

.. j

= :_ = =
Lt.

= =
= =

8. Natural Ve~L "ie1 9. Mechanical \ ntiiation

=

LIQUID/SOLID
15. Handwash Facilities 16. Showers/Fixtures 17. Shower Water Temp.

SANlTARY FACIITIES

= =

= =

\VASTE

SAFETY

21. Sewage Disposal 22. Solid Waste

=

26. First Aid Kit

II
_

FOOD

BUILDINGS
Construction
c::J

=

=

10. Provided/A.

.essib!e , R.opair es

WATER SUPPLY

l l . Cleanliness
12. Toilet Faclli

= 6. Lighting/Foot-Candles
c::::J

5. Maintenance & Repair

=
=
=

VECfORIVERMIN CONTROl.

i 8. Installed/Operated/ Maintained 19. Drinking 20. Approved Fountains Source

=

=

_

23. lnfcstation/Control 24. Brush/Trash 25. Water Collection/Drainage

OTHER 28

=

=

27. Food Insp RpL

13. Separation { Sexes 14. Fixture Rati

=

=

29

II
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7. Heating, Ventilation, j;)C

!=:

ITEM

COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

NUMBERS

- , S=;"'=,;:::::,~ - [= = -I= = - ,I ~: ~::~::::~;::t~C~;':~:~ :: _ r:=J: QA SURVEY PREOPENING

_= _=

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EHE DELRAY 5612743192 Fax: :SIAI.l!; HIt' ~'LORlDA
ROUT!""

Feb 20 2012 02:07pm P034/040
TYPE:
_ Public School

PURPOSE:

_ = CONSTRuCT
COMPLAiNT

=
.. CJ

REINSPIOCTIOo;

DEPARTMENT OF HEALTH ~OUNTYHEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

CfP.NGlOFOWNl:iZ
CONSULTATJON

=

c: EPiDE~·i:OLOG'(
OTHER _

r . section
r=J

[- .•.••.As.-.-

·.per.~.- - ·.-sep.tw n..'.12'0'..6 95. OJ. '.heF.l.o. rik. &;. Mes .(FS. ~,~~f<or;;;Will serve di-a'7.NOtiCe ofNon-Comp".·ance:for ..•... .' •.. any...V!.ol.~io.ns.,!.ote.d.'.lte. ms.'.m -.Wke. d belo w v,.·i;J. ..•. fCfe· i~.·..•..•..•.•..•... •j. . !1?fJtm'ements0f_Chapters 64E-1 J and 64E-11 of th. Florida Administrative Code (FAC) and must be correctedwtthtn-thetime periodindicatedin the ..Restil1,r; a50 Vee. Co n.tinue opera/i.on of this factlity witho ut making these corrections is a vU?wtiIJnof ChapterME-Hand/>4. .., i .. , E.~11,:FAC;l11!'i~.ler 3. ./;. 'E.; 8 .'Y result inan "'1>""",!"'~ flu "".,.1"",1 action being initiated

=

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=

21 Sewage Disposal 22. Solid Waste

F=OOD26.FirslAidKit

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= 3. Athletic

2. Playground Equipment

c=J

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Equipment

SANITARY

FACIL

rrss
Repair .,

=

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27. Food Insp. Rpt

BUILDINGS

-

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4. Construction

=

10. Provided/At ess.ble i I. Cleanliness, ;:~:;:i:C~i~ 14. Fixture Rati,

WATER SUPPLY

=

CONTROL

18. Instal led/Operated/

. = 7. Heating, Ventilation,
ITEM !';"UMBERS

Ale

=

=

=

19.~ir~;:7,::e:ounwins
20. Approved Source on attached sheet)

=

OTHER

: ~:: ::~~:~:CtiOniDrainag~ 29.

23. Infestation/Control

=

28.

I

I

II

COMMEl'<TS k'iD INSTRUCTIONS
(continue

---

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EHE DELRAY 5612743192 Fax:

S'lATJ!; 01< j<'LORlUA

Feb 20 2012 02:05pm
TYPE:
t:t2J Private School

PURPOSE:

=
t:::J

= CONSTKUCL
COMPLAlNT QA S~RVEY

ROUTfNE

DEPARTMENT OF HEALTH 'OUNTY HEALTH DEPARTMENT
PUBLIC! PRIVATE SCHO~ tN"SPECTJON REPORT

= =
c:::J

= CONSULTATiON
OTHER

CHA"UE

OF OV"""Nl':R

\.0

= PREOPENING

EPIDEMIOLOGY

= 2. Playground Equipment = 9. Mechanicai \. = 3. AthleticEquipment SANITARY FACII.
BUILDINGS

CJ 1. School Site

c=J

8, Natural

Venti

tio" rtilation

=
=

=

15. Handwash

Facilities

=

16. Showers/Fixtures J 7. Shower Water Temp.

=

21. Sewage Disposal 22. Solid Waste

=

26. First Aid Kit

FOOD
2/, Food Insp. Rpl. 28. 29 _ _

=
..

=

TIES
Repair es

VECTORIVERMIN

4. Construction 5, Maintenance & Repair

=

10. Provided/At ess.ble
II. Cleanliness 12. Toilet Facili 13. Separation 14. Fixture

WATERSUPPLY

=

CONTROL
_

=

18,Installed/Operaled! )vla;ntained

= 6. Lighting/Foot-Candles =
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_

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23. Infestation/Control 24. Brush/Trash

= =

OTHER

c Seves

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]9, Drinking Fountains 20. Approved Source

c:::: 25. Water Collection/Drainage

ITEM
NUMBERS
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COMMENTS AND INSTRUCTIONS
(continue on attached sheet)

CO$ec

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INSPECTO

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COPY OF REPORT RECEIVED BY:

... ~idltA-.l..."JC=-.p.-""","-------;-

OH 4030, 01/05 (Obsoletes Previous Editions)

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EHE DELRAY 5612743192

Fax:

\

Feb 20 2012 02:05pm P030/040

~rATE OF FLORIDA DEPlRTMENT OF HEALTH {;;\ COUN>Y PUBLIC HEALTH UNIT~

Date

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EHE DELRAY 5612743192

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Feb 20 2012 02:06pm

P031/040

COUN'Y PUBLIC HEALTH UNIT \...;]_)

!TA TE OF FLORIDA DEP\RTMENTOFHEALTH

~

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Fax:

Feb 20 2012 02:06pm

P032/040

~TA TE OF FLORIDA DEP.iRTMENTOFBEALTH COUNTY PUBLIC HEALTH UNI.l01J

.Jhi\

Identification No~QJ~-[Q[]DJ[3~

OH .104.419(,

!Stock Nllmber: 57.~·OOO-~lO"1I1

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PURPOSE:
ROLTINE
CONSTRUCT.

DEPARTMENT OF HEALTH
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TYPE:

=

R[INSPECTION
CHA!-:GE OF OWNER

r:OUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

rz:::a
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PriV3:C" Sclw·t)l Public School Cbcrtcr Scheel

t23r Vocational Schor"

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2. Playground Equipment

= 9_ Mechanical
SANITARY
i 1.

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!6. Showers/Fixture,

= 22. Solid

Waste

FOOD

3. Athletic Equipment

FACll

17. Shower Water Temp.

VECTORNERMIN

27. Food Insp. RpL _

BUILDINGS

10. Provided/A'
Cleanliness

WATER SUPPLY
Maintained

CONTROL

OTHER
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20. Approved

COMMENTS AND INSTRUCTIONS

COPY OF REPORT R£C£fVED

B Y- --Jy~__:_-..j<::.-F-+-"'-

DH 4030, 01 ;05 {Obsoletes Previous Editions}

CHDIHEAOOUARTERS

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EHE DELRAY 5612743192 Fax:
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J<.,

Uk' I'LUtUVA

PURPOSE:
ROLTiCiE CO~STRucr _ ~ Rh"i,PECTICiN C}i.ANGE OF O\.VNER
C.=i

DEPARTMENT OF HEALTH , :OUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

TYPE:

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.f.l!ilure_~c'!_rre'3_~~olatio_f!S m'!!..!!!!!!t}__n:m-'!cll1Jir'!.'!Et::.':
SCHOOL SA.NlTATION c::::J l. School Site
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ITEM NUMBERS

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CopyofReport Received by-tJ.;...~J~lnspecto~~

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PURPOSE:
ROUT:NE __ ~EjNSrECIJnN CHAxG£ OF OWNER

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STATE OF FLORIDA DEPARTMENT OF HEALTH :OUNTY HEALTH DEPARTMENT
PUBLICI PRIVATE SCHOOL INSPECTION REPORT

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TYPE:
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Private Scn001 Put-die Schoo! Charter Scheel Vocational School College/University Other _

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ITEM NUMBERS
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WATER SUPPLY

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12. Toiler Facili
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14. Fixture Rati.

=

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=

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OTHER
28.
29

_
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EHE DELRAY 5612743192 Fax:

\

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-~=y 1')00

Feb 20 2012 02:03pm P025/040

\

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;,TATE OF FLORIDA DEFARTMENT OF COUN:'Y PUBLIC HEALTH _~.~~

HEAL1~. .
Identification

Date

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No.B::Q-§[]-[QI]Jm[]~
Cfyotr'lS

Comments and Instroctions (Continued from Page 1):

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