Inspector: TERRI RAINEY, SANITATION AND SAFETY SPECIALIST
Risk-Based Violations
Demonstration of knowledge not in compliance as evidenced by unavailable certified food
protection manager certificate, priority violations observed, and person in charge not answering relevant
food safety questions correctly.
o
Backroom- interior of ice bin has build up of black matter. Retail- nozzles of frozen beverage
have build up of black matter. Issued stop use.
Retail- fried chicken, fried fish, grits and smoked sausages displayed in hot holding unit have
internal temperatures of 124-128 degrees F when taken with an accurate thermometer. Issued stop sale
and release.
Y
x
Unable to verify that food employees are aware of their responsibility to report diagnosis and
symptoms related to foodborne illnesses. Reporting Agreement provided.
Person in charge did not answer questions related to foodborne illnesses and symptoms.
Employee health guide provided.
o
Backroom- milk, hot dogs, smoked sausages stored in walk in cooler have internal
temperatures of 46-48 degrees F when taken with an accurate thermometer. Issued stop sale and release
All items voluntarily discarded during visit.
x
Backroom- raw shell eggs stored in walk in cooler have an ambient temperature of 46
degrees F when taken with an accurate thermometer. Issued stop sale and release. Eggs voluntarily
discarded during visit.
x
Establishment does not have written procedures for the clean-up of vomit and diarrhea.
Retail Area: Age restriction signage for hemp extract products intended for inhalation not
present.
Retail Area: Hemp extract products including pre-rolls found without ingredients,
manufacturer's information and/or net weight identified on product packaging. Issued stop sale
o
Retail Area: Hemp extract products including flower and pre rolls found without a scannable
barcode/quick response code, a batch number, an expiration date, an internet address, and/or the number
of milligrams of each marketed cannabinoid on product packaging. Issued stop sale
o
Retail Area: Hemp extract products including vape cartridges, pre rolls and flower found
without the statement "Not Intended For Ingestion - Do Not Eat" on product packaging. Issued stop sale
o
Retail Area: Hemp extract products including flower, pre rolls and cartridges found without
serving size identified on product packaging. Issued stop sale
o
Print Date: 4/17/2025
Page 1 of 7
77
o
Citation Description: Hemp extract distributed or sold in the state does not have a certificate of analysis
prepared by an independent testing laboratory that states: a. The hemp extract is the product of a batch
tested by the independent testing laboratory; b. The batch contained a total delta-9 tetrahydrocannabinol
concentration that did not exceed 0.3 percent pursuant to the testing of a random sample of the batch; c.
The batch does not contain contaminants unsafe for human consumption and d. The batch was processed
in a facility that holds a current and valid permit issued by human health or food safety regulatory authority,
and that meets sanitation requirements documented on a report from the regulatory agency. s. 581.217(7)
(a)1, F.S.
Observation: Retail Area: Hemp extract products including vape cartridges do not have a corresponding
certificate of analysis by an independent testing laboratory. Issued stop sale
Backroom- no soap or hand drying device/paper towels at hand wash sink in employee toilet
room. Kitchen- no paper towels/handdrying device at hand wash sink.
Backroom-No hand wash sink in room with ice machine. Issued stop use.
Retail- no label on packaged crackers displayed for retail sale. COS- crackers moved from
consumer reach during visit.
Establishment does not have certified food protection manager.
Good Retail Practice Violations
Establishment does not have ice test results.
INSPECTION: KRATOM
Violation No.
Retail- store packaged ice not labeled. Issued stop sale and release. Ice voluntarily
discarded during visit.
Print Date: 4/17/2025
Page 3 of 7
x
43
Citation Description: Single-service or single-use articles handled, displayed or dispensed without
protection from contamination of food- and lip-contact surfaces; single-service or single-use knives, forks or
spoons not presented so that only the handles are touched by employees or consumers; or single-service
or single-use articles that are intended for food- or lip-contact not furnished for consumer self-service with
the original individual wrapper intact or from an approved dispenser. 4-904.11
Observation: Retail-coffee stirs not individually wrapped displayed by coffee maker. COS- stirs moved
from consumer reach during visit.
Retail - soiled cardboard using to display chips
Backroom- walk in cooler not maintaining temperature to keep temperature control for safety
foods at 41 degrees F or less. Ambient temperature is 46 degrees F when taken with an accurate
thermometer. Issue stop use.
Establishment does not have chlorine sanitizer test kit
Kitchen- wash and rinse solution not maintained clean.
Backroom- unisex employee toilet room does not have self closing door.
Backroom- unisex employee toilet room opens directly into area where ice machine is
located. Issued stop use.
o
Backroom- unisex employee toilet room door left open during visit.
Backroom- utility sink has build up of black matter.
Backroom- no covered trash can in unisex employee toilet room.
Backroom- debris on floor in storage room, debris on floor in walk in cooler
Backroom- inoperable AC condenser in hallway next to employee toilet room.
Backroom- hammer stored on top of ice machine.
Backroom- no mechanical ventilation or window in employee toilet room.
Backroom- missing light bulb in area where ice machine is located.
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.
Establishment sells product containing hemp and kratom intended for human consumption.
Changed food establishment type to include the sale of product containing hemp and kratom intended for
human consumption.
o
Hemp Extract products observed to be over the 0.3% total delta 9 THC concentration
according to product package labeling.¿ Issued stop sale
A Supplemental Report was also issued during the visit which includes important information for management.
Establishment open and operating with an expired food permit.
o
INSPECTION: VENDED WATER/VENDED ICE
Violation No.
Stop-Sale Orders & Supplemental Actions
STOP USE ORDER
Reason: FS 500; FAC 5K-4 Violation of Florida Food Law.* Food Temperature Control: Thermometers provided and
accurate.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
Disposition: Equipment was obtained, repaired or replaced, checked, and released.
STOP SALE ORDER
Reason: 500.10(1)(a), 581.217(3)(e), F.S., 893.03(1)(c)190.a., F.S.* Controlled Substance
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: 500.10(1)(a), 581.217(3)(e), F.S., 893.03(1)(c)190.a., F.S.* Controlled Substance
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Print Date: 4/17/2025
Page 2 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
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 SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Distribution and Retail Sale
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: 4/17/2025
Page 3 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Print Date: 4/17/2025
Page 4 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Print Date: 4/17/2025
Page 5 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Print Date: 4/17/2025
Page 6 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Print Date: 4/17/2025
Page 7 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Print Date: 4/17/2025
Page 8 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Print Date: 4/17/2025
Page 9 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
Comments: The product contains a control substance prohibited pursuant to Chapter 893, Florida Statutes, and may not be sold or distributed. To
request a Food Safety Inspector visit to obtain a written release of the Stop-Sale Order for purposes of removing and destroying the product,
contact the Business Center at (850) 245-5520 or
[email protected]. Release of the product for destruction may require a court order.
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
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: 4/17/2025
Page 10 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
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 SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
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: 4/17/2025
Page 11 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
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 SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
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: 4/17/2025
Page 12 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
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 SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
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: 4/17/2025
Page 13 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP SALE ORDER
Reason: FS 500.04; FS 500.11 Misbranded.* Labeling
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 SALE ORDER AND RELEASE
Reason: FS 500.04; FS 500.10 Adulterated.* Time/Temperature Control for Safety Food: Proper cold holding temperatures.
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 500.10 Adulterated.* Time/Temperature Control for Safety Food: Proper cold holding temperatures.
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 500.10 Adulterated.* Time/Temperature Control for Safety Food: Proper hot holding temperatures.
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.* Food Identification: Food properly labeled; original container.
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: To request a Food Safety Inspector visit for written release when corrections have been made for request release of equipment,
contact the Business Center at (850) 245-5520 or
[email protected].
Print Date: 4/17/2025
Page 16 of 19
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: To request a Food Safety Inspector visit for written release when corrections have been made for request release of equipment,
contact 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.* Utensils, Equipment and Vending: Food and nonfood-contact
surfaces cleanable, properly designed, constructed, and used.
Comments: To request a Food Safety Inspector visit for written release when corrections have been made for request release of equipment,
contact the Business Center at (850) 245-5520 or
[email protected].
Print Date: 4/17/2025
Page 17 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight:
STOP USE ORDER
Reason: FS 500; FAC 5K-4 Violation of Florida Food Law.* Preventing Contamination By Hands: Handwashing sinks properly
supplied and accessible.
Comments: To request a Food Safety Inspector visit for written release when corrections have been made for request release of equipment,
contact 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.* Physical Facilities: Toilet facilities: properly constructed, supplied,
and cleaned.
Comments: To request a Food Safety Inspector visit for written release when corrections have been made for request release of equipment,
contact the Business Center at (850) 245-5520 or
[email protected].
Print Date: 4/17/2025
Page 18 of 19
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) 14, 15, 16 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
I, _____________________________________________________ the person in charge of KWIK STOP AUSTRALIAN AVE 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)
(Signature of Representative)
TERRI RAINEY, SANITATION AND SAFETY SPECIALIST
MD RAHMAN, PERSON IN CHARGE
Print Name and Title
FDACS-14325 Rev. 07/13
Print Date: 4/17/2025
Page 19 of 19
Lot: Number of Packages:
Quantity: Size of Packages: · Total Weight: