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FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS
(Mark designated compliance staus (IN, OUT, NA, or NO) for each numbered item. For items marked OUT, mark COS or R for each item as applicable.)
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IN=in compliance
OUT=not in compliance
NO=not observed
NA=not applicable
COS=corrected on-site during inspection
R=repeat violation of the same code provision=2 points
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| Compliance Status |
COS |
R |
| 1 |
IN |
OUT |
NA |
NO |
Supervision |
4 points |
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1-2A. PIC present, demonstrates knowledge, performs duties |
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1-2B. Certified Food Protection Manager |
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| 2 |
IN |
OUT |
NA |
NO |
Employee Health, Good Hygienic Practices, Preventing Contamination by Hands |
9 points |
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2-1A. Proper use of restriction & exclusion |
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2-1B. Hands clean and properly washed |
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2-1C. No bare hand contact with ready-to-eat foods or approved alternate method properly followed |
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4 points |
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2-2A. Management knowledge, responsibilities, reporting |
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2-2B. Proper eating, tasting, drinking, or tobacco use |
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2-2C. No discharge from eyes, nose, and mouth |
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2-2D. Adequate handwashing facilities supplied & accessible |
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2-2E. Response procedures for vomiting & diarrheal events |
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| 3 |
IN |
OUT |
NA |
NO |
Approved Source |
9 points |
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3-1A. Food obtained from approved source |
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3-1B. Food received at proper temperature |
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3-1C. Food in good condition, safe, and unadulterated |
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3-1D. Required records: shellstock tags, parasite destruction |
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| 4 |
IN |
OUT |
NA |
NO |
Protection From Contamination |
9 points |
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4-1A. Food separated and protected |
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4-1B. Proper disposition of returned, previously served, reconditioned, and unsafe food |
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4 points |
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4-2A. Food stored covered |
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4-2B. Food-contact surfaces: cleaned & sanitized |
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| Compliance Status |
COS |
R |
| 5 |
IN |
OUT |
NA |
NO |
Cooking and Reheating of TCS Foods, Consumer Advisory |
9 points |
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5-1A. Proper cooking time and temperatures |
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5-1B. Proper reheating procedures for hot holding |
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4 points |
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5-2. Consumer advisory provided for raw and undercooked foods |
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| 6 |
IN |
OUT |
NA |
NO |
Holding of TCS Foods, Date Marking of TCS Foods |
9 points |
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6-1A. Proper cold holding temperatures |
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6-1B. Proper hot holding temperatures |
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6-1C. Proper cooling time and temperature |
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6-1D. Time as a public health control: procedures and records |
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4 points |
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6-2. Proper date marking and disposition |
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| 7 |
IN |
OUT |
NA |
NO |
Highly Susceptible Populations |
9 points |
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7-1. Pasteurized foods used: Prohibited foods not offered |
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| 8 |
IN |
OUT |
NA |
NO |
Chemicals |
4 points |
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8-2A. Food additives: approved and properly used |
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8-2B. Toxic substances properly identified, stored, used |
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| 9 |
IN |
OUT |
NA |
NO |
Conformance with Approved Procedures |
4 points |
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9-2. Compliance with variance, specialized process and HACCP plan |
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| GOOD RETAIL PRACTICES |
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(Mark the numbered item OUT, if not in compliance. For items marked OUT, mark COS or R for each item as applicable. R = Repeat Violation of the same code provision = 1 point)
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Good Retail Practices are preventive measures to control the introduction of pathogens, chemicals, and physical objects into foods.
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| Compliance Status |
COS |
R |
| 10 |
OUT |
Safe Food and Water, Food Identification |
3 points |
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10A. Pasteurized eggs used where required |
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10B. Water and ice from approved source |
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10C. Variance obtained for specialized processing methods |
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10D. Food properly labeled; original container |
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| 11 |
OUT |
Food Temperature Control |
3 points |
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11A. Proper cooling methods used: adequate equipment for temperature control |
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11B. Plant food properly cooked for hot holding |
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11C. Approved thawing methods used |
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11D. Thermometers provided and accurate |
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| 12 |
OUT |
Prevention of Food Contamination |
3 points |
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12A. Contamination prevented during food preparation, storage, display |
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12B. Personal cleanliness |
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12C. Wiping cloths: properly used and stored |
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12D. Washing fruits and vegetables |
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| 13 |
OUT |
Postings and Compliance with Clean Air Act |
1 point |
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13A. Posted: Permit/Inspection/Choking Poster/Handwashing |
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13B. Compliance with Georgia Smoke Free Air Act |
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| Compliance Status |
COS |
R |
| 14 |
OUT |
Proper Use of Utensils |
1 point |
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14A. In-use utensils: properly stored |
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14B. Utensils, equipment and linens: properly stored, dried, handled |
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14C. Single-use/single-service articles: properly stored, used |
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14D. Gloves used properly |
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| 15 |
OUT |
Utensils, Equipment and Vending |
1 point |
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15A. Food and nonfood-contact surfaces cleanable, properly designed, constructed, and used |
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15B. Warewashing facilities: installed, maintained, used; test strips |
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15C. Nonfood-contact surfaces clean |
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| 16 |
OUT |
Water, Plumbing and Waste |
2 points |
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16A. Hot and cold water available; adequate pressure |
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16B. Plumbing installed; proper backflow devices |
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16C. Sewage and waste water properly disposed |
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| 17 |
OUT |
Physical Facilities |
1 point |
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17A. Toilet facilities: properly constructed, supplied, cleaned |
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17B. Garbage/refuse properly disposed; facilities maintained |
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17C. Physical facilities installed, maintained, and clean |
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17D. Adequate ventilation and lighting; designated areas used |
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| 18 |
OUT |
Pest and Animal Control |
3 points |
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18. Insects, rodents, and animals not present |
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| Food Establishment Inspection Report Addendum |
| Violations cited in this report must be corrected within the time frames specified below, or as stated in the Georgia Department of Public Health Rules and Regulations Food Service Chapter 511-6-1, Rule .10 subsections (2)(h) and (i). |
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Establishment
Xi An Gourmet House |
Permit #
FSP-060-010274 |
Date
02/16/2024 |
Address
955 SPRING ST NW
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City/State
ATLANTA GA |
Zipcode
30309 |
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TEMPERATURE OBSERVATIONS
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| Item/Location |
Temp |
Item/Location |
Temp |
Item/Location |
Temp |
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Cold Holding, Main Kitchen, Cooler, , Beef
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34.0 ° F
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Hot Holding, Main Kitchen, Steam Table, , Beef
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152.0 ° F
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Hot Holding, Main Kitchen, Steam Table, , Beef strip soup
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141.0 ° F
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Hot Holding, Main Kitchen, Steam Table, , Tomato soup
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135.0 ° F
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Cold Holding, Main Kitchen, Prep Top Cooler, , Tofu
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40.0 ° F
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Cold Holding, Main Kitchen, Prep Top Cooler, , Tofu
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38.0 ° F
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Cold Holding, Main Kitchen, Prep Top Cooler, , Shredded cucumbers
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41.0 ° F
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Cold Holding, Main Kitchen, Prep Top Cooler, , Sprouts
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38.0 ° F
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Item
Number |
OBSERVATIONS AND CORRECTIVE ACTIONS |
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1-2A
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Violation of Code: [511-6-1.03(1)(a)-(c)1,4,5,6-14,15, 16]
Facility failed to comply and maintain no priority items. Demonstration of Knowledge. Based on the risk of foodborne illness inherent to the food service operation, during inspections and upon request, the person in charge shall demonstrate to the Health Authority knowledge of foodborne disease prevention, application of the Hazard Analysis Critical Control Point principles, and the requirements of this Chapter. The person in charge shall demonstrate this knowledge in one of the following ways:
(a) Compliance with Chapter. Complying with this Chapter by having no violations of Priority Items during the current inspection; Pf
(b) Certified Food Service Manager. Being a certified food service manager who has shown proficiency of required information through passing a test that is part of an accredited program; Pf or
(c) Correct Answers to Food Safety Questions. Responding correctly to the inspector's questions as they relate to the specific food operation. New Violation.
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2-2D
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Violation of Code: [511-6-1.06(2)(o)]
During routine inspection observed hand washing sink with metal pan and trash can blocking sink. Hand washing sinks shall be accessible at all times. Advised management to ensure employees are not using hand washing sink other than washing hands. COS manger removed metal pan and trash can. New Violation.
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2-2E
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Violation of Code: [511-6-1.03(6)]
Facility failed to provided proper documentation or kit in an event of vomiting or diarrhea. Responding To Contamination Events. A food establishment shall have procedures for employees to follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the food service establishment. The procedures shall address the specific actions employees must take to minimize the spread of contamination and the exposure of employees, consumers, food, and surfaces to vomitus or fecal matter. Pf New Violation.
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4-1A
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Violation of Code: [511-6-1.04(4)(c)1(i)(ii)(iii)(v)(vi)(vii)(viii)]
Observed raw shell eggs stored over cooked beef. Food shall be protected from cross contamination by:
(i) Except as specified in paragraph (i)(III) of this subsection, separating raw animal foods during storage, preparation, holding, and display from:
(I) Raw ready-to-eat food including other raw animal food such as fish for sushi or molluscan shellfish, or other raw ready-to-eat food such as fruits and vegetables, P and
(II) Cooked ready-to-eat food; and P
(III) Frozen, commercially processed and packaged raw animal food may be stored or displayed with or above frozen, commercially processed and packaged, ready-to-eat food.
(ii) Except when combined as ingredients, separating types of raw animal foods from each other such as beef, fish, lamb, pork, and poultry during storage, preparation, holding, and display by:
(I) Using separate equipment for each type, P or
(II) Arranging each type of food in equipment so that cross contamination of one type with another is prevented, P and
(III) Preparing each type of food at different times or in separate areas; P
(iii) Cleaning and sanitizing equipment and utensils; New Violation.
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8-2B
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Violation of Code: [511-6-1.07(6)(c)]
During routine inspection observed chemical glue stored on prep table above food. Storage, Separation. Poisonous or toxic materials shall be stored so they cannot contaminate food, equipment, utensils, linens, and single-service and single-use articles by: Separating the poisonous or toxic materials by spacing or partitioning. Advised manager to arrange facility to store chemicals below and away. Cos manager removed glue. Corrected On-Site. New Violation.
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| Food Establishment Inspection Report Addendum |
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Violations cited in this report must be corrected within the time frames specified below, or as stated in the Georgia Department of Public Health Rules and Regulations Food Service Chapter 511-6-1, Rule .10 subsections (2)(h) and (i).
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Establishment
Xi An Gourmet House |
Permit #
FSP-060-010274 |
Date
02/16/2024 |
Address
955 SPRING ST NW |
City/State
ATLANTA GA |
Zipcode
30309 |
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Item
Number |
OBSERVATIONS AND CORRECTIVE ACTIONS |
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10D
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Violation of Code: [511-6-1.04(4)(d)] Observed containers of sauces and spray bottles not properly labeled to identify food product. Food Storage Containers, Identified with Common Name of Food. Except for containers holding food that can be readily and unmistakably recognized, such as dry pasta, working containers holding food or food ingredients that are removed from their original packages for use in the food establishment, such as cooking oils, flour, herbs, potato flakes, salt, spices, and sugar shall be clearly and legibly identified, in English, with the common name of the food. Advised manager to ensure all food items are properly labeled. New Violation.
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11A
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Violation of Code: [511-6-1.04(6)(e)] During routine inspection observed several metal pans of beef stored on shelving improperly cooling. Cooling shall be accomplished in accordance with the time and temperature criteria specified under DPH Rule 511-6-1-.04(6)(d) by using one or more of the following methods depending on the type of food being cooled: Using rapid cooling equipment. New Violation.
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12A
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Violation of Code: [511-6-1.04(4)(r)] During routine inspection observed raw beef being actively prepped onto of trash container. Advised manager to use prep-table. COS: manager place raw beef in meat sink. Corrected On-Site. Repeat Violation.
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13A
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Violation of Code: [511-6-1.02(1)(d)] Observed incorrect inspection posted in public view. The most current inspection report shall be prominently displayed in public view at all times, within fifteen feet of the front or primary public door and between five feet and seven feet from the floor and in an area where it can be read at a distance of one foot away. New Violation.
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15C
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Violation of Code: [511-6-1.05(7)(a)2,3] During routine inspection observed equipment heavily soiled with old food debris and encrusted grease. The food-contact surfaces of cooking equipment and pans shall be kept free of encrusted grease deposits and other soil accumulations. Repeat Violation.
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Remarks
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Followup 
Initial