Shipley Donuts
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DEVELOPMENT SERVICES DEPARTMENT
HEALTH DIVISION
1400 SCHERTZ PARKWAY
SCHERTZ, TEXAS 78154-1634
G19-1771
RETAIL FOOD ESTABLISHMENT INSPECTION REPORT i/
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Sao Cent My Day YT tbsp Tie Certi~td CFN Persil Ne. ~~
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Purpose of Inspection: t-Compliance ~ -2=Routirie~ 3-Plaid Investigatipn 4-Visit 5-0ther
Establishment. °~ '"} (~ ~ l fir;';{;i- ; _.__".. Owner:
Physical Address: ~"~, J ~ ~ -r c; -~ U () Zip: Phone: ( )
IJEMERITS
5 Pts Food {PHF Tcmperaturrlli'lme Regalrcaaents
Violations Immediate Corrective Action Remarks COS
i. Pro Caolin for Gooked/P Food
2, Cold Hoid 41 F/45
3. Hot Hoid (140 F)
4. Pr Coakln Temperatures per PHF
S. id Reheatin 165 F in 2 Hrs
Remarks
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llEMERITS
4 Pts PersanactMan 'ng/Source Raluireeaenta
Violations wire Immediate Corrective Action Remarks COS"
6. Personnel with Infections Restriaed/Excluded
7. Proper/Adequate Hand washin
8. Good H gieniC Practices (Eatin Inkin Smaicin Other)
9, ved Source/L,abeling
l0. Sound Condition
1 I . Pro r Handlin ofR •TaEat Foods
12. Cross-Contamination of RawlCooked FoodslOther
~~ 13, ved S tams (HACCP Plansll'ime as Public Health Control) i.--''
14. water Supply - Ap roved SautcelSutllcient CapacitylHal and Cold Under Pressure
bEMERfI'S
3 Pts Facility wed Egripment Rsgeirements
Violations ui~ lmmed'tate Co+-rectivo Action Not to Exceed i0 Da Remarks COS
15. Equi ant A ate To Maintain Product Tem raturc
16, Hand Wash Facilities uate and Accessible
17. Hand Wash Facilities with and Towels
l8. No Evidence of Insect Contamination
! 9. No Evidence of Rodents/Other Animals
20. Toxic Items rl Labeled/StoredlUsed
2l. Manual Ware Washing and Sanitizing at ) tcm Mire
22. Meehanical Ware Washin and Sanidaa ai ) m/tem ure
23. Ap roved SewageJWastewaterDisposal S tam, Pr r Dis al
24. Thermometers Provided/A i Calibrated dr 2
25. Food Contact Surfaces of Equipment and [ltensils CleanedlSanitizedlGood Re air ~ ~~. -.~-~~
26. Postin of Consumer Advisories Heimlich/Raw Shellfish W uR'et Platc
27. Food Establishment Permit -Grade Certificate Posted -Food Handler Training
Other Violations - Violations Require Corrective Actions, Not To Exceed 90 Days Or The Next Inspection,
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Total ~~
Demerits 1 (t ) t I 1 / / ) } / 7 ( g
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Score cl ~l
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Ins ed id t_-~ ,: ~;~; A~ Prirrt: i ° ~ .:r l~ ~
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Follow-Up
Inspection
YES No ;" i ~
Received By ~ `; , i'~
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Print
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Title:
~ ~~, ~5 WHITE -- Custorrter Posting ~ YE LOW -City File
PINK --Consultant File
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