SPRING HOUSE AT LITHIA SPRINGS THE

OBSERVED CFSM CERTIFICATE NOT POSTED IN PUBLIC VIEW. PIC STATED THAT THEY ARE CURRENTLY IN THE PROCESS OF SIGNING UP FOR THE COURSE. CA: 1. The original CFSM certificate shall be posted in public view in each food service establishment. An additional copy shall be retained on file at the food service establishment at all times, and shall be made available for inspection by the Health Authority.

2. A CFSM certificate which has expired, been revoked or suspended shall not be posted in the food service establishment.

3. All licenses, certificates, diplomas, or other similar credentials issued or granted to an owner or operator who has successfully completed an approved or accredited food safety certification course and exam shall expire on the expiration date determined by the credentialing organization. Within ninety days of the expiration of the CFSM certificate, the CFSM shall enroll in an approved food safety training course, pass an approved exam and obtain a new certificate.

4. The certification is not transferable between persons.

OBSERVED FOOD EMPLOYEE POUR CONTENTS OF SANI BUCKET INTO HANDWASHING SINK IN THE MAIN KITCHEN. CA: Using a Handwashing Sink.

1. A handwashing sink shall be maintained so that it is accessible at all times for employee use. Pf

2. A handwashing facility may not be used for purposes other than handwashing. Pf

3. An automatic handwashing facility shall be used in accordance with manufacturer’s instructions. Pf

OBSERVED BAG OF UNCOOKED BROCCOLI WITH MOLD LIKE GROWTH IN MAIN KITCHEN REACH IN COOLER. OBSERVED 2 LARGE BAGS OF UNCOOKED CARROTS STORED IN THE BACK OF HOUSE WITH MOLD LIKE GROWTH. CA: Food shall be safe, unadulterated, and honestly presented. COS: FOOD EMPLOYEE TOSSED BROCCOLI AND STATED THAT CARROTS ARE SCHEDULED TO BE PICKED UP THIS WEEK.

OBSERVED PIC NOT PERFORMING DUTIES TO ENSURE FOOD EMPLOYEES ARE PROPERLY SANITIZING FOOD CONTACT AND NON-FOOD CONTACT SURFACES AND SURFACES WITH CHEMICAL SANITIZERS IN BUCKETS, 3 COMP SINK, OR CHEMICAL SANITIZING DISHWASHER. PIC UNABLE TO DEMONSTRATE OR PROVIDE IN A VERIFIABLE MANNER THAT FOOD EMPLOYEES ARE TRAINED ON FOOD ALLERGENS. PIC UNABLE TO DEMONSTRATE OR PROVIDE IN A VERIFIABLE MANNER THAT FOOD EMPLOYEES KNOW THEIR RESPONSIBILITY TO REPORT INFORMATION ABOUT THEIR HEALTH AND ACTIVITIES REALTING TO ILLNESSES AND SYMPTOMS THAT ARE TRANSIMISSIBLE THROUGH FOOD. CA: (k) Proper Sanitizing. Employees are properly sanitizing cleaned multiuse equipment and utensils before they are reused, through routine monitoring of solution temperature and exposure time for hot water sanitizing, and chemical concentration, pH, temperature, and exposure time for chemical sanitizing;Pf (n) Food Safety Training. Employees are properly trained in food safety, including food allergy awareness, as it relates to their assigned duties. Food allergy awareness includes describing foods identified as major food allergens and the symptoms that a major food allergen could cause in a sensitive individual who has an allergic reaction;Pf (o) Reporting Responsibilities. Food employees and conditional employees are informed in a verifiable manner of their responsibility to report in accordance with the Chapter, to the person in charge, information about their health and activities as they relate to diseases that are transmissible through food;Pf COS: FOOD EMPLOYEES SIGNED ALLERGEN AWARENESS AND EMP HEALTH DOC DURING INSPECTION.

OBSERVED CFSM CERTIFICATE NOT POSTED IN PUBLIC VIEW. OBSERVED FRAUDULENT/ALTERED (WITH WHITE OUT) CFSM CERTIFICATE. EHS SEARCHED CERTIFICATION NUMBER ON SERV SAFE WEBSITE TO FIND OUT THAT THE CERTIFICATE IS INVALID AND EXPIRED IN 2020 CA: 1. The original CFSM certificate shall be posted in public view in each food service establishment. An additional copy shall be retained on file at the food service establishment at all times, and shall be made available for inspection by the Health Authority.

2. A CFSM certificate which has expired, been revoked or suspended shall not be posted in the food service establishment.

3. All licenses, certificates, diplomas, or other similar credentials issued or granted to an owner or operator who has successfully completed an approved or accredited food safety certification course and exam shall expire on the expiration date determined by the credentialing organization. Within ninety days of the expiration of the CFSM certificate, the CFSM shall enroll in an approved food safety training course, pass an approved exam and obtain a new certificate.

4. The certification is not transferable between persons.

FACILITY HAS 10 DAYS TO PROVIDE PROOF OF ENROLLMENT IN AN ACCREDITED SERV SAFE COURSE VIA EMAIL.

OBSERVED ICE MACHINE IN FRONT LOBBY AREA WITH AND ACCUMULATION OF DARK DEBRIS. OBSERVED 7 WHITE GLASS CUPS, 1 STAINLESS STEEL PAN, 1 BUTCHER KNIFE, AND 1 STAINLESS STEEL CAKE PAN STORED AS CLEAN WITH FOOD DEBRIS ATTACHED IN THE MAIN KITCHEN NEAR MEAT SINK. CA: Equipment food-contact surfaces and utensils shall be clean to sight and touch. Pf. COS: FOOD EMPLOYEE REMOVED ITEMS FOR CLEANING.

OBSERVED NACHO CHEESE (11/6/25), HALF OF A TURKEY BREAST (11/9/25), AND HAM ROAST (11/4/25) STORED PAST DISCARD DATE. CA: Ready-to-Eat, Time/Temperature Control for Safety Food, Disposition.

1. A food that requires datemarking shall be discarded if it:

(i) Exceeds 7 days, not including the time that the product is frozen; P

(ii) Is in a container or package that does not bear a date or day; P or

(iii) Is inappropriately marked with a date or day that exceeds 7 days . P

2. Refrigerated, ready-to-eat, time / temperature control for safety food prepared in a food service establishment and dispensed through a vending machine with an automatic shutoff control shall be discarded if it exceeds 7 days. P COS: FOOD EMPLOYEE DISCARDED ITEMS.

OBSERVED CUT TOMATO AND CUT LETTUCE PREPPED 11/15/25 WITHOUT PREP OR DISCARD DATE. CA: efrigerated, ready-to-eat, time/temperature control for safety food prepared and held in a food establishment for more than 24 hours shall be clearly marked to indicate the date or day by which the food shall be consumed on the premises, sold, or discarded, when held at a temperature of 41°F (5°C) or below for a maximum of 7 days. The day of preparation shall be counted as Day 1. Pf COS: FOOD EMPLOYEE DISCARDED ITEMS.

OBSERVED CHLORINE SANITIZER IN DISHWASHER ACTIVELY WASHING DISHES BELOW MINIMUM ACCEPTABLE RANGE. FOOD EMPLOYEE PRIMED SANITIZER LINE AND CHECKED FOR KINKS IN LINE AND IT STILL DID NOT MEET ACCEPTABLE REQUIRED RANGE CA: Chemical Sanitizers, Criteria. Chemical sanitizers, including chemical sanitizing solutions generated on-site, and other chemical antimicrobials applied to food-contact surfaces shall:

1. Meet requirements specified in 40 CFR 180.940 Tolerance exemptions for active and inert ingredients for use in antimicrobial formulations (Food-contact surface sanitizing solutions) P, or

2. Meet the requirements as specified in 40 CFR 180.2020 Pesticide Chemicals Not Requiring a Tolerance or Exemption from Tolerance-Non-food determinations. P

OBSERVED 1 DEAD ROACH ON THE BOTTOM OF WHITE GLASS CUP, 2 DEAD ROACHES ON TOP OF ENCLOSED SWEET POTATO BOX, AND 1 DEAD ROACH ON THE TOP OF ENCLOSED SOY SAUCE DISPENSING BOTTLE. CA: Removing Dead or Trapped Birds, Insects, Rodents, and Other Pests. Dead or trapped birds, insects, rodents, and other pests shall be removed from control devices and the premises at a frequency that prevents their accumulation, decomposition, or the attraction of pests.

OBSERVED NO INSPECTION REPORT POSTED IN PUBLIC VIEW. CA: . 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.

OBSERVED 3 COMP SINK IN DISREPAIR (MISSING HOT WATER SPIGOT) IN WAREWASHING AREA OF MAIN KITCHEN. CA: Good Repair. All physical facilities shall be maintained in good repair.

OBSERVED SEVERAL CUCUMBERS IN MAIN KITCHEN REACH IN COOLER WITH MOLD LIKE GROWTH. CA: CA: Food shall be safe, unadulterated, and honestly presented. COS: PIC DISCARDED CUCUMBERS.

OBSERVED ICE CREAM SCOOPS, CAN OPENER BLADE, MEASURING SPOONS, AND FRENCH FRY CUTTER STORED AS CLEAN WITH AN ACCUMULATION OF FOOD DEBRIS. CA: Equipment food-contact surfaces and utensils shall be clean to sight and touch. Pf. COS: PIC REMOVED ITEMS TO BE CLEANED.

OBSERVED NUMEROUS LIVE AND DEAD ROACHES IN THE COOLER DRAWERS, PREP TOP COOLER, AND CABINETS OF DINING AREA. CA: Controlling Pests. The presence of insects, rodents, and other pests shall be controlled to minimize their presence on the premises by: 1. Routinely inspecting incoming shipments of food and supplies; 2. Routinely inspecting the premises for evidence of pests; 3. Using methods, if pests are found, such as trapping devices or other means of pest control as specified under subsections (6)(e), (6)(m), and (6)(n) of this Rule; Pf and 4. Eliminating harborage conditions. COS: FOOD EMPLOYEE REMOVED PESTS.

OBSERVED CUPS BEING USED AS SCOOPS IN SUGAR AND COFFEE IN THE MAIN KITCHEN. CA: Storage of In-Use Utensils. During pauses in food preparation or dispensing, food preparation and dispensing utensils shall be stored: 1.Except as specified under paragraph 2 of this subsection, in the food with their handles above the top of the food and the container; 2.In food that is not time/temperature control for safety food with their handles above the top of the food within containers or equipment that can be closed, such as bins of sugar, flour, or cinnamon;3.On a clean portion of the food preparation table or cooking equipment only if the in-use utensil and the food-contact surface of the food preparation table or cooking equipment are cleaned and sanitized at a frequency specified under DPH Rule 511-6-1-.05(7)(b) and (8)(a); .In running water of sufficient velocity to flush particulates to the drain, if used with moist food such as ice cream or mashed potatoes; 5. In a clean, protected location if the utensils, such as ice scoops, are used only with a food that is not time/temperature control for safety food; or 6. In a container of water if the water is maintained at a temperature of at least 135°F (57°C) and the container is cleaned at a frequency specified under DPH Rule 511-6-1-.05(7)(b)3(vi). COS: FOOD EMPLOYEE REMOVED CUPS.

OBSERVED NUMEROUS STAINLESS STEEL AND FOOD GRADE PLASTIC CONTAINERS STACKED WET IN THE MAIN KITCHEN AND IN THE WAREWASHING AREA. CA: Equipment and Utensils, Air-Drying Required. After cleaning and sanitizing, equipment and utensils: 1. Shall be air-dried or used after adequate draining before contact with food; and 2. May not be cloth dried except that utensils that have been air-dried may be polished with cloths that are maintained clean and dry. COS: FOOD EMPLOYEE STACKED CONTAINERS TO PROPERLY AIR DRY.

OBSERVED SWEET POTATOES IN MAIN KITCHEN WITH MOLD LIKE GROWTH. CA: Food shall be safe, unadulterated, and honestly presented. COS: PIC DISCARDED SWEET POTATOES.

OBSERVED 3 COMP SINK AND HAND SINK IN DISREPAIR IN MAIN KITCHEN (BACK OF HOUSE). CA: System Maintained in Good Repair. A plumbing system shall be repaired according to law; P and maintained in good repair.

MUST BE CORRECTED WITHIN 72 HOURS

Observed the PIC is not aware of the 5 reportable symptoms and 6 reportable illnesses as related to food safety. CA: The person in charge, food employees, and conditional employees shall comply with reporting responsibilities and exclusion or restriction of food employees.

-WHILE ONSITE EHS EMAILED GA DPH EMP HEALTH QUICK DECISION GUIDE.

OBSERVED FOOD CONTACT SURFACES NOT CLEAN TO SIGHT AND TOUCH IN KITCHEN; FOOD DEBRIS PRESENT ICE CREAM SCOOPS, CAN OPENER, FOOD DICER, AND OTHER STORE UTENSILS IN THE DRY STORAGE AREA. CA: Equipment food-contact surfaces and utensils shall be clean to sight and touch.