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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 3 D
1.1 Clean and organize all offices, remove outdated posters/memos
L/R Mgr, Engineers, Teachers, Main Office
X Fail - Office has dust
X Fail - Clutter must be removed
X 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) 2 B
4.1 Food is protected from contamination x $250
Fail - food is not covered/labeled/dated $500
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
X 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
X 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) 1 B
10.1 Current Sanitation and Food handlers Certificate x $500
Fail - certified manager is not on the premises $500
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
X Fail - previous CDPH violations not corrected by due dates
11. All Rooms, Closets, Offices, Gym, Auditorium, Other Score: Critical ($500) 1 B
11.1 All areas are clean, organized and free of clutter x $500
Fail - missing lights $500
Fail - above areas are not clean/organized
X 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) o 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 3 D
All offices needs to be dusted around the school. The school has multiple offices in the building. All offices, must have clutter removed, all items must be 6 inches from
the floor. All microwaves, coffee makers and refrigerators must be removed from school. Please use teachers lounge for for microwave, coffee maker, refrigerator use.
All wood shelving must be removed and replaced with metal, or stainless steel racks. This was noted on the health inspectors report, from previous year. Paper supplies
stored on crates, must be removed and stored 6 inches from the floor, and 18 inches from the ceiling. Paper supplies and racks blocking egress doors, must find area for
storage of equipments not being used, out of the way of the doors.
Work order must be placed on walk in cooler. It has and old condensor unit, needs to be cleaned and free of mold. The unit needs to be replaced, it's a tripping harzard
for staff. It has a step up from the outside, coming into the cooler. Persons carrying items can't see where they are going, if they are carrying large items. The floor needs
to be cleaned, this was noted on the health inspection, especially under the racks.
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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
Flooring and wood shelving was noted on the previous health inspectors report. The SDM must follow up with work orders and communicate to engineer and Principal.
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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 1 B
All classrooms and closets must remove items stored on the floor, items must be 6 inches form the floor and 18 inches form ceiling. All refrigerators, coffee
makers, and microwaves must be removed from each classroom. The school must remove all items that are in front of radiator, nothing should block these
areas. All cords must be removed that are running across classrooms floors. Extension cords, computer cords, etc., or use a cord gurad for safety. (tripping
harzard for students and staff).
Bait boxes are needed around the outside of the school. The engineer needs to contact the Pest Management company, to have bait boxes placed outside around the
school.
Annex building, noted that was a gas smell, found that a floor drain was missing a cover, between classroom 301 and 304. In the annex all classrooms must remove all
refrigerator, and microwaves from each area, where they are housed. All clutter must be removed off the floor, all items must be 6 inches from the floor, and 18 inches
from the ceiling. Tape must be removed from locking mechanisms. that ajoins claassrooms, in the annex building. The engineer must check, hot water and water pressure
in the annex. Pressure was low in most classrooms.
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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 2 C
Classroom 121 ceiling pipes needs to be stuffed and caluked. Ceiling tiles missing around the building, needs to be replaced, walked with engineer, noted with
him.computer lab, between exit door 1 & 2. Noted that there is a major stress fracture in claroom 301 on south wall, needs to e repaired.
Pool area used as a storage area, must remove, all old desk, chairs, custodial equipments, and other misc. items. Leaking water noted in the shower area of the gym.
Concerns that floor paint is peeling in shower area of pool area, and needs to be corrected. Room 104 and 105 has holes in frome of doors, that need to be repaired.
Gym, aduitorium, has big gaps between floor and wall that need to be repaired asap. Mail room has tile missing and broken that need to be repaired or seald with floor
wax and finish. Gym, please remove all excess items from electrical closet, and other areas in the gym. Weather strip needed on doors leading to outside on annex south
door, and other exterior doors in the school. Suggest, that sound sensor be placed on doors leading to court yard. unable to return in after leaving from the class.
Engineer must check all auto faucets, tho ensure they are staying on form 30 seconds or more.
Low water pressure notice in restrooms in the annex building. Also no hot water, check the hot water tank, reading 100 degrees. Engineer must turn up the temperature.
Basement has multiple items stored on floor. The school must remove all old desk, chairs and broken equipment in tunnel areas, also in the area above the gym,
auditorium and mechanical rooms. Place all old records on shelving and remove all items not in use. Engineer must remove all broken snow removal equipment, not in
use, repair broken doors, and repair leaking ceiling above light in storage area, shows rust on rebarr. remove all old and wet area rugs. Remove all old paints and stains.
Please clean all classrooms, and MDF rooms from clutter. Check all egress doors and remove all clutter around and near all doors for safe exit of students and
staff. Check all emergency lighting, to ensure it's properly working, repair them as needed. Removed all extention cords from classrooms, and work areas
where students come. Must have guards to prevent trip harzards for staff.
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SCORING PAGE
X 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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Other
Other
Additional Comments:
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