AMARILLO ENVIRONMENTAL HEALTH DEPARTMENT

808 S. BUCHANAN ST. * PO BOX 1971 * (806) 378-9472 * FAX 378-9353 * TDD 378-4229 * EMAIL: Shaun.May@amarillo.gov

FOOD ESTABLISHMENT INSPECTION FORM

Permit Number: HF49 Food Manager: MIKE GILES Date: 06/23/2017 Risk Assigned
I
Name: CASSIDYS POLO CLUB Purpose of Inspection Follow up Date to TOTAL
PRE-OPENING
required Correct: Demerits
Address: 6019 SW 45TH COMPLIANCE
AMARILLO , TX INVESTIGATION
YES 08/10/2017
ROUTINE X 9
CLOSING
RE-OPENING
OTHER
INSPECTED BY: KARINA HUNT NUMBER OF CORRECTIONS
IN In Compliance
NO Not Observred
OUT Out of compliance
COS Corrected on site
0
RECEIVED BY:
Priority Items (3 Points) violations Require Immediate Corrective Action not to exeed 3 days
Compliance Status IN OUT NO NA COS
01. PROPER COOLING TIME AND TEMPERATURE
X
Time and Temperature 02. PROPER COLD HOLDING TEMPERATURE (41F/45F)
X
for Food Safety
03. PROPER HOT HOLDING TERMPERATURE (135F)
(F = degrees Fahrenheit) X
04. PROPER COOKING TIME AND TEMPERATURE
X
05. PROPER REHEATING PROCEDURE FOR HOT HOLDING
X
(165F IN 2 HOURS)
06. TIME AS A PUBLIC HEALTH CONTROL; PROCEDURES &
X
RECORDS

07. FOOD AND ICE OBTAINED FROM APPROVED SOURCE;

X
Approved Source FOOD IN GOOD CONDITION, SAFE, AND UNADULTERATED;
PARASITE DESTRUCTION
08. FOOD RECEIVED AT PROPER TEMPERATURE
X

09. FOOD SEPARATED AND PROTECTED, PREVENTED DURING X

FOOD PREPARATION, STORAGE, DISPLAY, AND TASTING
Protection From 10. FOOD CONTACT SURFACES AND RETURNABLES; CLEANED X
Contamination AND SANITIZED AT _____ PPM/TEMPERATURE
11. PROPER DISPOSITION OF RETURNED, PREVIOUSLY X
SERVED, RECONDITIONED

12. MANAGEMENT, FOOD EMPLOYEES AND CONDITIONAL X

Employee Health EMPLOYEES; KNOWLEDGE, RESPONSIBILITIES, AND
13. PROPER USE OF RESTRICTION AND EXCLUSION; NO X
DISCHARGE FROM EYES, NOSE, AND MOUTH

Preventing 14. HANDS CLEANED AND PROPERLY WASHED / GLOVES USED X

PROPERLY
Contamination
By Hands 15. NO BARE HAND CONTACT WITH READY TO EAT FOODS OR X
APPROVED ALTERNATE METHOD PROPERLY FOLLOWED

Highly Susceptible 16. PASTEURIZED FOODS USED; PROHIBITED FOOD NOT

X
Populations OFFERED; PASTEURIZED EGGS USED WHEN REQUIRED

17. FOOD ADDITIVES; APPROVED AND PROPERLY STORED;

WASHING FRUITS AND VEGETABLES
X
Chemicals
18. TOXIC SUBSTANCES PROPERLY IDENTIFIED, STORED, AND
USED
X

19. WATER FROM APPROVED SOURCE; PLUMBING INSTALLED;

PROPER BACKFLOW DEVICE
X
Water / Plumbing
20. APPROVED SEWAGE/WASTEWATER DISPOSAL SYSTEM,
PROPER DISPOSAL
X

New_EH116FoodEstInspForm.rpt Page: 1
 AMARILLO ENVIRONMENTAL HEALTH DEPARTMENT
808 S. BUCHANAN ST. * PO BOX 1971 * (806) 378-9472 * FAX 378-9353 * TDD 378-4229 * EMAIL: Shaun.May@amarillo.gov

FOOD ESTABLISHMENT INSPECTION FORM

Permit Number: HF49 Date: 06/23/2017

Priority Foundation Items (2 Points) Violations Require Corrective Action within 10 days
IN OUT NO NA COS
Demonstration of 21. PERSON IN CHARGE PRESENT, DEMONSTRATION OF KNOWLEDGE, X
Knowledge / Personnel AND PERFORM DUTIES / CERTIFIED FOOD MANAGER (CFM)
22. FOOD HANDLER / NO UNAUTHORIZED PERSONS / PERSONNEL X

Safe Water, 23. HOT AND COLD WATER AVAILABLE; ADEQUATE PRESSURE, SAFE X
Record Keeping and
Package Labeling 24. REQUIRED RECORDS AVAILABLE (SHELLSTOCK TAGS; PARASITE X
DESTRUCTION;) PACKAGE FOOD LABELING

Conformance with 25. COMPLIANCE WITH VARIANCE, SPECIALIZED PROCESS, AND HACCP X
Approved Procedures PLAN; VARIANCE OBTAINED FOR SPECIALIZED PROCESSING METHODS;

26. POSTING OF CONSUMER ADVISORIES; RAW OR UNDER COOKED

Consumer Advisory X
FOODS (DISCLOSURE/REMINDER/BUFFER PLATE) / ALLERGEN LABEL

27. PROPER COOLING METHOS USED; EQUIPMENT ADEQUATE TO

Food Temperature
Control / Identification
X
MAINTAIN PRODUCT TEMPERATURE
28. PROPER DATE MARKING AND DISPOSITION
X
29. THERMOMETERS PROVIDED, ACCURATE, AND CALIBRATED;
X
CHEMICAL/THERMAL TEST STRIPS

Permit Requirement 30. FOOD ESTABLISHMENT PERMIT (CURRENT, VALID, AND POSTED)
X
Prerequisite for Operation

31. ADEQUATE HANDWASHING FACILITIES; ACCESSIBLE AND PROPERLY X

SUPPLIED, USED
Utensils, Equipment, 32. FOOD AND NON-FOOD CONTACT SURFACES CLEANABLE, PROPERLY X
And Vending DESIGNED, CONSTRUCTED, AND USED
33. WAREWASHING FACILITIES; INSTALLED, MAINTAINED, USED X
Core Items (1 Point) Violations Require Corrective Action Not To Exceed 90 Days or Next Inspection, Whichever comes first.

34. NO EVIDENCE OF INSECT CONTAMINATION, RODENT/OTHER ANIMALS X

35. PERSONAL CLEANLINESS/ EATING, DRINKING OR TOBACCO USE X
Prevention of
36. WIPING CLOTHS; PROPERLY USED AND STORED X
Food Contamination
37. ENVIRONMENTAL CONTAMINATION X
38. APPROVED THAWING METHOD X
39. UTENSILS, EQUIPMENT, LINENS; PROPERLY USED, STORED, DRIED, X
Proper Use of Utensils AND HANDLED/ IN USE UTENSILS; PROPERLY USED
40. SINGLE-SERVICE AND SINGLE-USE ARTICLES; PROPERLY STORED AND X
USED

Food Identification 41. ORIGINAL CONTAINER LABELING (BULK FOOD)

X

42. NON-FOOD CONTACT SURFACES CLEAN

X
43. ADEQUATE VENTILATION AND LIGHTING; DESIGNATED AREAS USED
X
44. GARBAGE AND REFUSE PROPERLY DISPOSED; FACILITIES
Physical Facilities X
MAINTAINED
45. PHYSICAL FACILITIES INSTALLED, MAINTAINED, AND CLEAN
X
46. SERVICE SINK OR CURB CLEANING FACILITY PROVIDED/ TOILET
X
FACILITIES; PROPERLY CONSTRUCTED, SUPPLIED, AND CLEAN
47. OTHER VIOLATIONS
X

Comments:

EHFN10 - a) Breast implant found inside bar utensil holder b) Liquor bottle nozzles need to be cleaned.
EHFN21 - Certified food manager needed within 45 days. Registesr with city ($40)
EHFN29 - Test strips needed
EHFN42 - Beer cooler racks need to be cleaned
EHFN45 - Floor tiles need to be replaced

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