Inspector: 393053
Risk-Based Violations
Lounge Area: Black substance found on interior of bin and on metal grids of table-top ice
machine. Stop Use Order issued. See supplements.
Lounge Area: Food contact equipment and utensils not sanitized before use. Stop Use
Orders issued. See supplements and comments.
o
Person in charge did not respond correctly to question related to foodborne illnesses and
their symptoms. Employee Health Guide provided.
Repeat
COS
o
8
Citation Description: Sign or poster notifying food employees to wash their hands not provided at all
handwashing sinks used by food employees, or handwashing signage not clearly visible to food employees.
6-301.14
Observation: Lounge Area: Hand was sign not provided at hand wash sink behind bar. Hand was sign
provided by inspector.
Written procedures for the cleanup of vomit and diarrhea events not available at time of visit.
Guidance document was provided.
Retail Area: Gummies containing hemp extract found without the number of milligrams of
each marketed cannabinoid on product packaging. COS: Items were voluntary discarded during visit. Stop
Sale Order and Release issued. See supplements.
x
Retail Area: Packages of gummies containing hemp extract displayed behind counter found
without serving size identified on product packaging. COS: Gummies were voluntarily discarded during visit.
Stop Sale Order and Release issued. See supplements.
x
Backroom Area: Hand soap and paper towels provided at mop sink.
Lounge Area: Packages of Skittles labeled in a foreign language do not have an English
language version as part of the labeling. COS: Packages were voluntarily discarded during visit. Stop Sale
Order and Release issued. See supplements.
Certified food protection manager certificate not available at time of visit. Guidance
information was provided.
Good Retail Practice Violations
Lounge Area: Thin probe thermometer not available at time of inspection.
Lounge Area: Three compartment sink not provided for cleaning food contact surfaces. Stop
Use Order issued. See supplements.
Lounge Area: Drainboard not provided.
Backroom Area: Employee restroom doors not self-closing.
Outdoor Area: Dumpster not covered with lid at time of visit.
Retail Area: Sign stating "THE SALE OF KRATOM TO PERSONS UNDER THE AGE OF 21
IS PROHIBITED, PROOF OF AGE IS REQUIRED FOR PURCHASE" not posted at point of sale or
adjacent to the display of kratom products. COS: Signs were posted during visit.
Retail Area: Kratom products including cans of Full Boar and Mitra kratom seltzers in a
self-service display with open access to consumers without proof of age verification. COS: Display case
was locked during visit.
Establishment was found to be operating beyond the scope of their existing food permit by
processing open food items without being permitted to do so. See comments.
o
INSPECTION: KRATOM
Violation No.
Citation Description and Observation
Repeat
COS
Stop-Sale Orders & Supplemental Actions
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Approved Source: Food obtained from approved source.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Product was voluntarily destroyed by food establishment management and witnessed by inspector.
STOP USE ORDER
Reason: FS 500.04; FS 500.172 Unsanitary Equipment.* Protection From Contamination: Food-contact surfaces: cleaned
and sanitized.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP USE ORDER
Reason: FS 500.04; FS 500.172 Unsanitary Equipment.* Protection From Contamination: Food-contact surfaces: cleaned
and sanitized.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 9/5/2024
Page 10 of 13
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP USE ORDER
Reason: FS 500.04; FS 500.172 Unsanitary Equipment.* Protection From Contamination: Food-contact surfaces: cleaned
and sanitized.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP USE ORDER
Reason: FS 500.04; FS 500.172 Unsanitary Equipment.* Protection From Contamination: Food-contact surfaces: cleaned
and sanitized.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 9/5/2024
Page 11 of 13
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP USE ORDER
Reason: FS 500.04; FS 500.172 Unsanitary Equipment.* Protection From Contamination: Food-contact surfaces: cleaned
and sanitized.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP USE ORDER
Reason: FS 500; FAC 5K-4 Violation of Florida Food Law.* Utensils, Equipment and Vending: Warewashing facilities:
installed, maintained, and used; test strips.
Comments: When corrections have been made, request a Food Safety Inspector visit for written release of product by contacting the Business
Center at (850) 245-5520 or
[email protected].
Print Date: 9/5/2024
Page 12 of 13
When the department or its duly authorized agent finds, or has probable cause to believe, that any food or food-processing equipment is in
violation of this chapter or any rule adopted under this chapter so as to be dangerous, unwholesome, fraudulent, or insanitary within the meaning
of this chapter, an agent of the department may issue and enforce a stop-sale, stop-use, removal, or hold order, which order gives notice that
such article or processing equipment is, or is suspected of being, in violation and has been detained or embargoed and which order warns all
persons not to remove, use, or dispose of such article or processing equipment by sale or otherwise until permission for removal, use, or disposal
is given by the department or the court. It is unlawful for any person to remove, use, or dispose of such detained or embargoed article or
processing equipment by sale or otherwise without such permission in accordance with 500.172 (1) Florida Statutes.
Release - Other
The Food Establishment voluntarily agrees to release the products listed in the stop-sale order(s) on page(s) 1, 2, 3, 4, 5, 6, 7, 8, 9 for
destruction. The Food Establishment will not hold the Department liable for any lost revenue or income as a result of the destruction.
___________________________________
Signature of Food Establishment Representative
AN ADMINISTRATIVE HEARING IS AVAILABLE FOR ALL ORDERS, NOTICES, AND REPORTS IN THIS
SUPPLEMENTAL REPORT
If you wish to contest the Department's action, you have the right to request an administrative hearing to be conducted in accordance with
Sections 120.569 and 120.57, Florida Statutes and to be represented by counsel or other qualified representative. Your request for hearing must
contain:
1. Your name, address, and telephone number, and facsimile number (if any).
2. The name, address, and telephone number, and facsimile number of your attorney or qualified representative (if any) upon whom service of
pleadings and other papers shall be made.
3. A statement that you are requesting an administrative hearing and dispute the material facts alleged by the department, in which case you must
identify the material facts that are in dispute (formal hearing), or that you request an administrative hearing and that you do not dispute the facts
alleged by the department (informal hearing).
4. A statement of when (date) you received the Notice and the file number of this Notice.
Your request for a hearing must be received at the address shown on this Notice within twenty-one (21) days of receipt of this
Notice. If you fail to obtain a Release from this Notice or fail to request an administrative hearing within the twenty-one (21) day
deadline you waive your right to a hearing and the Department may enter a Final Order imposing up to the maximum penalties as authorized by
Florida Law.
HEARING WAIVER AND WAIVER OF RIGHTS
Jose Barrios
I, _____________________________________________________
the person in charge of University Vape hereby waive a notice and a hearing
as provided in Chapter 120, Florida Statutes and waive all rights as provided on the last page of this report.
____________________________________________
(Signature)
ACKNOWLEDGEMENT
I acknowledge receipt of a copy of this document.
(Signature of FDACS Representative)
KAITLYN FORD, SANITATION AND SAFETY SUPERVISOR - SES
(Signature of Representative)
Jose Barrios, Manager
Print Name and Title
FDACS-14325 Rev. 07/13
Print Date: 9/5/2024
Page 13 of 13
_____________________________________
Scott House, Sanitation and Safety Specialist
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight: