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The bolded items reflect ticketable offenses with the Chicago Department of Public Health (CDPH) # of
Fail(s) Grade
1. Employee Facilities Score: Serious
1.1 Clean and organize all offices, remove outdated posters/memos
L/R Mgr, Engineers, Teachers, Main Office
Fail - Office has dust
Fail - Clutter must be removed
Fail - Office needs to be organized
1.2 Employee lockers clean in/out (no food storage-designated areas only)
Fail - dust & debris in locker
Fail - clutter needs to be removed/organized
1.3 Tops/bottom of lockers clean & free of all materials
Fail - remove all materials from top of lockers
Fail - dust/dirt observed
2. ***Food Temperatures Score: Critical ($500) A
***IF CHECKED A REINSPECTION MUST BE CONDUCTED, AUTOMATIC "F"*** x $500
2.1 Fail - Cold food are not held at 40°F or below
Fail - Hot foods are not held at 140°F or above
Fail - Frozen foods are not held at 0°F or below
3. Food Storage & Handling Score: Critical ($500) A
3.1 There are no bulging or leaking canned goods or expired products in x $500
storage
Fail - bulging, dented or leaking canned goods
Fail - expired products in storage
3.2 Fail - canned foods stored in remarked containers, not in original container
3.3 Fail - small equipment and utensils are not being sanitized between uses
Fail - small equipment is not air dried
4. Dry Storage Score: Serious ($250)
4.1 Food is protected from contamination x $250
Fail - food is not covered/labeled/dated
Fail - dirt/dust observed under and behind racks
4.2 Racks are clean and free of rust and/or painted shelves in good condition
Fail - racks dirty to sight and touch
Fail - rust on racks
Fail - exposed wood on painted shelves
4.3 Light shields and fixtures are in good condition and clean
Fail - light shields dirty and/or cracked.
Fail - light shields missing
4.4 Storage areas are kept clean
Fail - area dusty/dirty
Fail - not organized/remove all clutter
4.5 Chemicals are stored away from food and other supplies
Fail - chemicals stored with food are not separated
Fail - food and supplies are not 6"from floor and wall and 18" from the ceiling
Fail - food stored in non-designated food service areas
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10. Manager Sanitation Certificate & CDPH Report Score: Critical ($500) A
10.1 Current Sanitation and Food handlers Certificate x $500
Fail - certified manager is not on the premises
Fail - expired manager sanitation certificate
Fail - staff does not have food handlers certificate
Fail - original sanitation license is not on the premises
Fail - CDPH Summary Report is not displayed and visible to all customers
Fail - previous CDPH violations not corrected by due dates
11. All Rooms, Closets, Offices, Gym, Auditorium, Other Score: Critical ($500)
11.1 All areas are clean, organized and free of clutter x $500
Fail - missing lights
Fail - above areas are not clean/organized
Fail - clutter found, must be removed
Fail - food items are being stored in the classrooms/student desk
Fail - classrooms used for feeding are dirty/not maintained
Fail - lockers are not clean/food present
Fail - areas found to be dusty/dirty
Fail - waste cans/pencil sharpeners are not dumped
Fail - chalk rails/boards are not clean
Fail - dirty/stinky mops, buckets, custodial carts in use.
Fail - custodial closets dirty/dusty or in poor condition
Fail - water leaking/stains
Fail - First floor windows open no more than 6". Second floor and up windows closed.
12. ***Pest Control Score: Critical ($500) A
***IF CHECKED A REINSPECTION MUST BE CONDUCTED, AUTOMATIC "F"*** x $500
12.1 Pest infestation signs were observed in the following areas:
Fail - Food Prep Area
Fail - Food Storage
Fail -Teachers Lounge
Fail - Student Lunchroom
Fail - Under/Inside/Behind Food Equipment & Serving Lines
Fail - Any classroom, office, closet, gym, auditorium, other
Fail - rodent droppings found around the loading dock/dumpster area
Fail - evidence of rodent dropping found in the custodial closets
Fail - rodent droppings found in heating units
Fail - evidence of rodent activity in the basement areas
13. ***Pest Control Score: Critical ($500) A
***IF CHECKED A REINSPECTION MUST BE CONDUCTED, AUTOMATIC "F"*** x $500
13.1 Fail - burrows found around exterior of the building
Fail - doors need to be rodent proof (light observed) or propped open
Fail damaged windowscreens
Fail - dock area has debris, clutter, not clean
Fail - Dock/dumpster area has leaking liquid waste
Fail - pest evidence found in heating units, drains, exit doors, other
Fail - cracks and holes need to be sealed to prevent rodent entry
Fail - holes and cracks observed around the foundation
Fail - no pest control and or log book on premises
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Details/Findings Page
Instructions: Fill in details from inspection/walk through in each appropriate category below
1. Employee Facilities Score: Serious
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Details/Findings Page
Instructions: Fill in details from inspection/walk through in each appropriate category below
6. Utensils and Equipment Score: Serious A
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Details/Findings Page
Instructions: Fill in details from inspection/walk through in each appropriate category below
11. All Rooms, Closets, Offices, Gym, Auditorium, Other Score: Critical
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Details/Findings Page
Instructions: Fill in details from inspection/walk through in each appropriate category below
15. Ceilings & Walls Score: Critical
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SCORING PAGE
Check here if failures were marked in sections 2, 12, 13 and 18. A re-inspection must be completed
1) Assign a score for each grade under Serious and Critical on the Scoring Page as follows:
A=4
B=3
C=2
D=1
*Average scores for Serious and Critical colums will auto calculate
2) Assign a total letter grade using the chart below based on the total score:
A=4
B = 3-3.9
C = 2-2.9
D = 1-1.9
F = 0-0.99
**If you grade an F in sections 2, 12, 13 and 18, final grade must be an F regardless of average
** Total score will auto calculate
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NSS Inspector
Facilities Inspector
Lunchroom Manager
Engineer
Other
Other
Additional Comments:
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