STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT FOOD SERVICE INSPECTION REPORT

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STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT FOOD SERVICE INSPECTION REPORT 1 of 2 Facility Information Permit Number: 55-48-00011 Name of Facility: CROOKSHANK ELEMENTARY SCHOOL Address: 1455 N WHITNEY Street City, Zip: Saint Augustine 32084 RESULT: Satisfactory Correct By: None Re-Inspection Date: None Type: School (9 months or less) Owner: CROOKSHANK ELEMENTARY SCHOOL Person In Charge: Yasmin Taylor Phone: 904-547-7851 Inspection Information Purpose: Routine Inspection Date: 7/6/2016 Begin Time: 11:00 AM End Time: 11:35 AM Additional Information No Additional Information Available Items marked below violate the requirements of Chapter 64E-11 of the Florida Administrative Code and must be corrected. Continued operation of this facility without making these corrections is a violation of Chapter 64E-11, Florida Administrative Code and Chapters 381 and 386, Florida Statutes. Violations must be corrected by the date and time indicated in the Results section above or an administrative fine or other legal action will be initiated. Violation Markings FOOD SUPPLIES 1. Sources, etc. FOOD PROTECTION 2. Stored temperature 3. No further cooking/rapid cooling 4. Thawing 5. Raw fruits 6. Pork cooking 7. Poultry cooking 8. Other animal cooking 9. Least contact/reheating 10. Food container 11. Buffet requirements 12. Self-service condiments 13. Reservice of food 14. Sneeze guards 15. Transportation of food 16. Poisonous/Toxic materials PERSONNEL 17. Exclusion of personnel 18. Cleanliness 19. Tobacco use 20. Handwashing 21. Handling of dishware EQUIPMENT/UTENSILS 22. Refrigeration facilities/thermometers 23. Sinks 24. Ice storage/counter-protector 25. Ventilation/Storage/Sufficient equipment 26. Dishwashing facilities 27. Design and fabrication 28. Installation and location 29. Cleanliness of equipment 30. Methods of washing SANITARY FACILITIES AND CONTROLS 31. Water supply 32. Ice 33. Sewage 34. Plumbing 35. Toilet facilities 36. Handwashing facilities 37. Garbage disposal 38. Vermin control OTHER FACILITIES AND OPERATIONS 39. Other facilities and operations TEMPORARY FOOD SERVICE EVENTS 40. Temporary food service events VENDING MACHINES 41. Vending machines MANAGER CERTIFICATION 42. Manager certification CERTIFICATES AND FEES 43. Certificates and fees INSPECTION/ENFORCEMENT 44. Inspection/Enforcement General Comments No violations found at time of inspection. Email Address(es): yasmin.taylor@stjohns.k12.fl.us; danielle.raley@stjohns.k12.fl.us Inspector Signature: Client Signature: Form Number: DH 4023 01/05 55-48-00011 CROOKSHANK ELEMENTARY SCHOOL

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT FOOD SERVICE INSPECTION REPORT 2 of 2 Violations Comments No Violation Comments Available Inspection Conducted By: Brittnee Williams (955211) Work: (904) 209-3250 ex. Date: 7/6/2016 Inspector Signature: Client Signature: Form Number: DH 4023 01/05 55-48-00011 CROOKSHANK ELEMENTARY SCHOOL

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT FOOD SERVICE INSPECTION REPORT 1 of 2 Facility Information Permit Number: 55-48-00233 Name of Facility: HICKORY CREEK ELEMENTARY SCHOOL Address: 235 Hickory Creek Trail City, Zip: Fruit Cove 32259 RESULT: Satisfactory Correct By: None Re-Inspection Date: None Type: School (9 months or less) Owner: HICKORY CREEK ELEMENTARY Person In Charge: Christopher Parker Phone: 904-547-4277 Inspection Information Purpose: Routine Inspection Date: 1/12/2017 Begin Time: 12:25 PM End Time: 01:00 PM Additional Information No Additional Information Available Items marked below violate the requirements of Chapter 64E-11 of the Florida Administrative Code and must be corrected. Continued operation of this facility without making these corrections is a violation of Chapter 64E-11, Florida Administrative Code and Chapters 381 and 386, Florida Statutes. Violations must be corrected by the date and time indicated in the Results section above or an administrative fine or other legal action will be initiated. Violation Markings FOOD SUPPLIES 1. Sources, etc. FOOD PROTECTION 2. Stored temperature 3. No further cooking/rapid cooling 4. Thawing 5. Raw fruits 6. Pork cooking 7. Poultry cooking 8. Other animal cooking 9. Least contact/reheating 10. Food container 11. Buffet requirements 12. Self-service condiments 13. Reservice of food 14. Sneeze guards 15. Transportation of food 16. Poisonous/Toxic materials PERSONNEL 17. Exclusion of personnel 18. Cleanliness 19. Tobacco use 20. Handwashing 21. Handling of dishware EQUIPMENT/UTENSILS 22. Refrigeration facilities/thermometers 23. Sinks 24. Ice storage/counter-protector 25. Ventilation/Storage/Sufficient equipment 26. Dishwashing facilities 27. Design and fabrication 28. Installation and location 29. Cleanliness of equipment 30. Methods of washing SANITARY FACILITIES AND CONTROLS 31. Water supply 32. Ice 33. Sewage 34. Plumbing 35. Toilet facilities 36. Handwashing facilities 37. Garbage disposal 38. Vermin control OTHER FACILITIES AND OPERATIONS 39. Other facilities and operations TEMPORARY FOOD SERVICE EVENTS 40. Temporary food service events VENDING MACHINES 41. Vending machines MANAGER CERTIFICATION 42. Manager certification CERTIFICATES AND FEES 43. Certificates and fees INSPECTION/ENFORCEMENT 44. Inspection/Enforcement General Comments No apparent violations found at time of inspection. Email Address(es): Christopher.Parker@stjohns.k12.fl.us Inspector Signature: Client Signature: Form Number: DH 4023 01/05 55-48-00233 HICKORY CREEK ELEMENTARY SCHOOL

STATE OF FLORIDA DEPARTMENT OF HEALTH COUNTY HEALTH DEPARTMENT FOOD SERVICE INSPECTION REPORT 2 of 2 Violations Comments No Violation Comments Available Inspection Conducted By: Brittnee Williams (955211) Inspector Contact Number: Work: (904) 209-3250 ex. Print Client Name: Date: 1/13/2017 Inspector Signature: Client Signature: Form Number: DH 4023 01/05 55-48-00233 HICKORY CREEK ELEMENTARY SCHOOL