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June 2025 June 2025 Charles Harris, MD-Health Officer Retail Food Establishment Plan Review Packet Please answer the following questions completely for a timely review. This document must be submitted with the application and all other required materials as per page 2 of the Retail Food Establishment Permit Application at least 30 days prior to facility opening or change of ownership. If you have any questions, please call our office at [PHONE REDACTED] or email [EMAIL REDACTED] . Retail Food Establishment Name: Contact Name/Manager: Date: A. FOOD PREPERATION Check categories of Time/Temperature Control for Safety foods (TCS foods) to be handled, prepared, and served. ☐ Thin meats (poultry, fish, eggs, hamburger, sliced meats, fillets etc.) ☐ Thick meats (whole poultry, roast beef, chickens, hams etc.) ☐ Cold processed foods (salads, sandwiches, vegetables etc.) ☐ Hot processed foods (soups, stews, chowders, casseroles etc.) ☐ Bakery goods (pies, custards, creams etc.) ☐ Other (please list): B. MENU ITEMS A menu for your facility is to be submitted with your application. Please ensure the submitted menu includes any allergen warnings as applicable. Please briefly describe your menu items below: C. FOOD SUPPLIES 1. Are all food supplies inspected and approved sources? ☐ YES ☐ NO 2. When receiving food shipments, are temperatures checked? ☐ YES ☐ NO 3. Are containers inspected for damage? ☐ YES ☐ NO 4. What happens to food shipments that are found to be unsatisfactory? ---PAGE BREAK--- Lbl 2 2 D. COLD STORAGE 1. Is there adequate refrigeration to store refrigerated foods at 41°F or below? ☐ YES ☐ NO 2. How many refrigeration units are available? 3. Is there adequate freezer availability to store frozen foods at 0°F or below? ☐ YES ☐ NO 4. Does each refrigeration and freezer unit have a functioning thermometer? ☐ YES ☐ NO 5. Are light shields or shatter resistant bulbs provided in each refrigeration or freezer unit? ☐ YES ☐ NO 6. Will raw meats, poultry and seafood be stored in the same refrigeration units with cooked/ready-to-eat foods? ☐ YES ☐ NO 7. If yes, in what order will items be stored vertically from top to bottom, to prevent cross contamination? 8. Is there a bulk ice machine available? ☐ YES ☐ NO 9. If yes, what is the cleaning and sanitizing schedule for the ice machine? E. THAWING Please indicate how TCS foods will be thawed in each category by checking the box next to it. Thick Meats Thin Meats Cold Foods Hot Foods Baked Goods Other Refrigeration ☐ ☐ ☐ ☐ ☐ ☐ Running Water <70°F ☐ ☐ ☐ ☐ ☐ ☐ Microwave ☐ ☐ ☐ ☐ ☐ ☐ Cooked Frozen ☐ ☐ ☐ ☐ ☐ ☐ Other (describe) F. COOKING 1. How will food product thermometers be used to measure final cooking/reheating temperatures of TCS foods? ---PAGE BREAK--- 3 3 2. Please describe each method of calibrating food product thermometers: a. Cold Water: b. Boiling Water: 3. Please list all types of cooking equipment (ovens, stoves, microwaves, grills etc.) : G. HOT/COLD HOLDING 1. Describe how hot TCS foods will be maintained at 135°F or above during holding for service: a. Indicate type of hot holding units: b. Indicate number of hot holding units: 2. Describe how TCS foods will be reheated to 165°F or above for hot holding: 3. Describe how cold TCS foods will be maintained at 41°F or below for cold holding: a. Indicate type of cold holding units: b. Indicate number of cold holding units: ---PAGE BREAK--- 4 4 H. COOLING 1. Please indicate how TCS foods will be cooled from 135° to 70° within two hours and from 135°F to 41°F within a total of six hours checking the appropriate boxes. Thick Meats Thin Meats Cold Foods Hot Foods Other Shallow Pans ☐ ☐ ☐ ☐ ☐ Ice Bath ☐ ☐ ☐ ☐ ☐ Reduce Volume ☐ ☐ ☐ ☐ ☐ Rapid Chill ☐ ☐ ☐ ☐ ☐ Other ☐ ☐ ☐ ☐ ☐ Other (describe): 2. Please indicate the location where cooling will take place and the method used: I. FOOD PREPARATION 1. Please list all categories of food that will be prepared more than 12 hours in advance of service (soups, sauces, dressings, etc.): 2. Will Reduced Oxygen Packaging (ROP), Vacuum Sealing or Sous-vide be utilized in any part of the food preparation process? ☐ YES ☐ NO a. If yes, please describe the process: 3. Please list how employees will be trained in good food sanitation practices: ---PAGE BREAK--- 5 5 a. Please list the name(s) of certified training courses: 4. Does the facility have at least one Certified Food Manager at this location? ☐ YES ☐ NO a. Please list the name(s) of certified training courses: 5. Please describe how the facility will minimize the handling of ready-to-eat foods (gloves, tongs, food grade paper etc.): 6. Please describe your date marking system and/or food rotation for prepared foods: 7. Will all produce be washed prior to use? ☐ YES ☐ NO a. Where is the approved location for washing produce? b. Will test kits be available for produce wash? ☐ YES ☐ NO c. Describe the process: *The Hamilton County Health Department recommends that all new and remodeled facilities have a separate prep sink in addition to dishwashing sinks (3-compartment). A separate prep sink for raw meat is strongly recommended but not required.* 8. Describe the process used to minimize the amount of time TCS foods will be kept in the temperature danger zone (41°F to 135°F) during preparation: J. EMPLOYEE HEALTH 1. What is the established policy to exclude or restrict food workers who are ill or have infected cuts or lesions? Please submit a copy of your Employee Health Policy as required. 2. What is the established policy for the clean-up of a vomiting or diarrheal event? Please submit a copy of your policy as required. 3. Will employees be instructed to wear effective hair and beard restraints and to wear clean aprons? ☐ YES ☐ NO ---PAGE BREAK--- YES YES 6 6 K. INSECT AND RODENT HARBORAGE 1. Will all outside doors be self-closing and be rodent and insect proof? ☐ YES ☐ NO 2. Will garage doors or windows in dining areas be open to outdoors when the seasons allow? ☐ YES ☐ NO a. If yes, air curtains or screens will be required to prevent insect and rodent entry and must be provided on the floor plans. Please describe the method: 3. Will screen doors or air curtains be provided at all entrances that will be open to the outside? (back kitchen, doors delivery doors etc.) ☐ YES ☐ NO a. If yes, please describe location and type: 4. Will all pipes and electrical conduit chases be sealed; ventilation systems, exhaust and intake protected? ☐ YES ☐ NO 5. Is the area around the building clear of unnecessary litter, brush, boxes, or any other harborage? ☐ YES ☐ NO 6. Please describe the pest control schedule: a. Pest control frequency: b. Pest control company name: L. GARBAGE AND REFUSE Inside Facility: 1. Will garbage containers have lids when not in use? ☐ YES ☐ NO a. If yes, describe how hand contamination will be prevented: 2. Will refuse be stored inside? ☐ YES ☐ NO a. If yes, where? 3. Where is the designated area for garbage can and floor mat cleaning? ---PAGE BREAK--- 7 7 Outside Facility: 1. Will dumpsters be used? ☐ YES ☐ NO Number: Size: a. Frequency of pick-up: b. Are the lids tight-fitting and in good repair? ☐ YES ☐ NO 2. Describe the outdoor location and surface where garbage cans/dumpsters will be stored: 3. Describe the surface and location of the grease storage receptacle: 4. Is there an area to store recycled containers? ☐ YES ☐ NO a. If yes, describe location: M. PLUMBING Please check the correct backflow and/or back siphon prevention method for the following fixtures: Air Break Air Gap Vacuum Breaker Other (describe) Dishwasher ☐ ☐ ☐ ☐ Mop Sink ☐ ☐ ☐ ☐ Ice Machine ☐ ☐ ☐ ☐ Soda Fountain ☐ ☐ ☐ ☐ 3-compartment Sink ☐ ☐ ☐ ☐ Prep Sink ☐ ☐ ☐ ☐ Ice Bin ☐ ☐ ☐ ☐ Dipper Well ☐ ☐ ☐ ☐ Refrigeration/Condensation ☐ ☐ ☐ ☐ 1. Are floor drains provided and easily cleanable? ☐ YES ☐ NO a. If yes, indicate locations: 2. Is a separate mop sink provided? ☐ YES ☐ NO ---PAGE BREAK--- 8 8 N. WATER SUPPLY 1. Indicate water supply source: ☐ Public ☐ Private Water Well a. If private water well, has the source been approved by IDEM? ☐ YES ☐ NO ☐ Pending b. If approved what is the PWSID number? 2. Indicate source for ice: ☐ Made on premise ☐ Purchased O. SEWAGE DISPOSAL 1. Is the building connected to the municipal sewer? ☐ YES ☐ NO a. If no, has the private onsite system been approved by IDOH? ☐ YES ☐ NO ☐ Pending 2. Are grease traps provided? ☐ YES ☐ NO a. If yes, where are they located? b. Has the utility/municipality approved of the size? ☐ YES ☐ NO P. EMPLOYEE AREAS/DRESSING ROOMS 1. Are separate dressing rooms/lockers provided for employees? ☐ YES ☐ NO a. If no, describe storage facilities for employees’ personal belongings: Q. GENERAL 1. Will insecticides/rodenticides be stored separately from cleaning and sanitizing agents? ☐ YES ☐ NO a. Please indicate location: 2. Will all toxic agents used on the premise (including personal medications) and for retail sale be stored away from food preparation and storage areas? ☐ YES ☐ NO 3. Will all containers of toxic agents, including sanitizer spray bottles, be clearly labeled? ☐ YES ☐ NO 4. Will laundry facilities be located on the premise? ☐ YES ☐ NO a. If yes, indicate what will be laundered: b. Please indicate location of clean linen storage: c. Please indicate location of soiled linen storage: 5. Will food grade containers and/or bags be used for storing bulk food products? ☐ YES ☐ NO 6. Will all containers be labeled with contents? ☐ YES ☐ NO 7. Please indicate all areas where exhaust vents will be located: a. Has state and/or local Fire Marshal been notified for inspection? ☐ YES ☐ NO 8. Will sneeze guards be provided at all self-serve food units? ☐ YES ☐ NO ☐N/A ---PAGE BREAK--- 9 9 9. Will the facility have any outside storage or refrigeration units? ☐ YES ☐ NO a. If yes, indicate location: R. DISHWASHING/SANITIZING 1. Will a 3-compartment sink be utilized for dishwashing? ☐ YES ☐ NO a. Will the largest pot/pan fit into each compartment? ☐ YES ☐ NO b. Will drainboards be provided on both ends of the 3-compartment sink? ☐ YES ☐ NO c. What type of sanitizer will be used at the 3-compartment sink? ☐ Chlorine ☐ Iodine ☐ Quaternary Ammonia ☐ Other: 2. Will a commercial dish machine be utilized for dishwashing? ☐ YES ☐ NO a. What type of sanitization will be used for the dish machine? ☐ Hot Water ☐ Chemical b. Provide water temperature: OR chemical type: c. Will ventilation be provided for high temperature dish machines? ☐ YES ☐ NO d. Will all dish machines have templates with operating instructions? ☐ YES ☐NO e. Will all dish machines have accurate working temperature/pressure gauges as required? ☐ YES ☐ NO 3. Is the hot water generator sufficient for all the water needs of the facility? ☐ YES ☐ NO 4. What type of sanitizer(s) will be used in the facility for buckets, spray bottles or clean in place equipment? ☐ Chlorine ☐ Iodine ☐ Quaternary Ammonia ☐ Other: 5. Will test kits be available for all sanitizers? ☐ YES ☐ NO 6. Will sanitizer spray bottles be used in the facility? ☐ YES ☐ NO 7. Will sanitizer buckets be used in the facility? ☐ YES ☐ NO 8. How will equipment such as cutting boards, cooking equipment, counter tops and other food contact surfaces that cannot be placed in a dishwasher or 3-compartment sink be cleaned and sanitized? S. HAND WASHING/TOILET FACILITIES 1. Will hand sinks be available in each food preparation and dishwashing area? ☐ YES ☐ NO 2. If utilized, will self-closing metering faucets provide a flow of hot water for at least 15 seconds without the need to reactivate? ☐ YES ☐ NO 3. Will soap dispensers be available at all hand washing sinks? ☐ YES ☐ NO ---PAGE BREAK--- 10 10 4. Will hand drying facilities (paper towels or hand dryers) be available at all hand washing sinks? ☐ YES ☐ NO 5. Will hot and cold running water under pressure be available at all hand washing sinks? ☐ YES ☐ NO 6. Will hand washing signs be posted in each employee restroom? ☐ YES ☐ NO 7. Will hand washing signs be posted at all employee used hand sinks? ☐ YES ☐ NO 8. Will all toilet room doors have self-closing devices? ☐ YES ☐ NO 9. Will all toilet rooms be equipped with adequate ventilation? ☐ YES ☐ NO 10. Will covered waste receptacles be available in each restroom? ☐ YES ☐ NO T. DRY GOODS STORAGE 1. What is the projected frequency of food deliveries? 2. Will adequate storage space be provided for dry goods based upon the menu, meals, and frequency of deliveries? ☐ YES ☐ NO 3. Will all dry goods be stored at least 6 inches off the floor? ☐ YES ☐ NO U. FINISH SCHEDULE Please indicate which materials will be used for the following areas. Example: plastic coving, quarry tile, FRP, stainless steel, paint, etc. Ceiling tiles in food preparation areas, bar areas, storage rooms, dishwashing rooms and restrooms must be smooth, easily cleanable, and non-absorbent. Floor Coving Walls Ceiling Kitchen Bar Food Storage Other Storage Toilet Rooms Dressing Rooms Garbage/Refuse Mop Basin Area Dishwashing