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HOSPICE OF WICHITA FALLS, INC.November 14, 2013 Public Health Pre vcu[. Promolc. Pro�c et. Wichita Falls - Wichita County Public Health District 1700 Third Street Wichita Falls, TX 76301 940 - 761 -7800 Inspection Checklist 558 -16F -1 HOSPICE OF WICHITA FALLS, INC. 4909 JOHNSON RD WICHITA FALLS TX 76310 Process 2 Inspection- Regular Page 1 of 1 In Out N/O N/A Pts Violation Description ftE X 5 1 Proper Cooling of Cooked/Prepared Foods X 5 2 Cold Hold 41/45 degrees F X 5 3 Hot Hold 135 °F X 5 4 Proper Cooking Temperatures per PHF X 5 5 Rapid Reheating for Hot Holding X 4 6 Personnel with Infections Restricted /Excluded X 4 7 Proper/Adequate Handwashin X 4 8 Good Hygienic Practices Eatin /Drinkin /Smokin /Other X 4 9 Approved Source/Labeling X 4 10 Sound Condition X 4 11 Proper Handling of Read -To -Eat Foods X 4 1 12 Cross - Contamination of Raw /Cooked Foods /Other X 4 1 13 Approved Systems Time as Public Hlth Control /HACCP Plan X 4 14 Water Supply - Approved/Adequate/Hot & Cold Under Pressure X 3 15 Equipment Ade uate to Maintain Product Temperature X 3 16 Handwash Facilities Adequate & Access X 3 17 Handwash Facilities with Soap & Towels X 3 18 No Evidence of Insect Contamination X 3 19 No Evidence of Rodents /Other Animals X 3 20 Toxic Items Properly Labeled /Stored /Used X 3 21 Manual /Mechanical Warewashing & Sanitizing m/Tem p. X 1 3 22 Manager Demonstration of knowledge/Food Handlers Certificate X 3 23 Approved sewage X 3 24 Thermometers Provided/Accurate/Properly Calibrated +/- 2 F X 3 25 Food Contact Surfaces - Cleaned /Sanitized /Good Repair/Storage X 3 26 Posting Consumer Advisories- Heimlich /Raw Shellfish /Buffet X 3 27 Food Establishment Permit S`Cff 100 Robbie O'Neal, Public Health Officer OWNER / MANAGER SIGNATURE Control# 84823 HOSPICE OF WICHITA FALLS, INC.; 4909 JOHNSON RD; WICHITA FALLS Site 558 Inventory 1 Printed 11/18/1308:20