FOOD ESTABLISHMENT INSPECTION REPORT

Kent County Health Department 700 Fuller Ave. NE Grand Rapids, MI 49503-1996 (616) 632-6900 FOOD ESTABLISHMENT INSPECTION REPORT Based on an evaluation this day, the items marked below are violations of the Michigan Food Law. s cited in this report shall be corrected within the time frames specified below, but within a period not to exceed 10 calendar days for priority or priority foundation items ( 8-405.11) or 90 days for core items ( 8-406.11). Failure to comply with this notice may result in license suspension and/or other legal action. You have the right to appeal any violations listed. XO ASIAN CUISINE SFE 2641 050886 1:30:24 PM MONROE CENTER NW, 58 Last Routine: 10/27/2015 GRAND RAPIDS, MI 49503 Person In Charge (PIC): Kelson Establishment Phone: 616-235-6969 INSPECTION TYPE: Routine Inspection Manager Certified License Posted Antichoking Poster Non-Smoking Area On-site Water/Sewer Category Repeat Description/Remarks/Correction Schedule Correct By Corrected This Facility was inspected by Katherine Sweeney, a representative from Kent County Health Department, on to determine the level of compliance with Michigan Act 92, P.A. 2000. At the time of this inspection, the person in charge of this facility demonstrated acceptable working knowledge of food safety. (s) have been found in the following areas: Protection From Contamination After Receiving, Plumbing System, Destruction of Organisms of Public Health Concern, Limitiation of Growth of Organisms of Public Health Concern Based on the public health significance of deficiencies noted, this facility was found to be in non-compliance. Yes Yes Yes N/A N/A Kitchen 3-304.15 (A) SINGLE-USE gloves shall be used for one task only and discarded when Priority damaged, soiled, or when interruptions occur in the operation. (P) (B) Slash-resistant and cloth gloves shall be used in direct contact only with FOOD that is subsequently cooked. Gloves used with ready-to-eat foods shall be smooth, durable and non-absorbant. Item(s): Single-use glove(s) Location: At the employees Problem(s): Used for multiple purposes Correction(s): Gloves shall only be used for one purpose and then disposed. Single use gloves were used for handling raw shrimp and then were continued to be worn while handling other utensils and equiptment. 3-304.15 (A) SINGLE-USE gloves shall be used for one task only and discarded when Priority damaged, soiled, or when interruptions occur in the operation. (P) (B) Slash-resistant and cloth gloves shall be used in direct contact only with FOOD that is subsequently cooked. Gloves used with ready-to-eat foods shall be smooth, Page 1 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected Kitchen durable and non-absorbant. Item(s): Single-use glove(s) Location: At the employees Problem(s): Used for multiple purposes Correction(s): Gloves shall only be used for one purpose and then disposed. Single use gloves were worn while handling scrubber and cleaning woks. Same gloves were then worn while preparing food. 3-501.16 Repeat Except during preparation, cooking, or cooling, or when time is used as the public Priority health control POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) shall be maintained: (A) 135ºF or above, except that roasts properly cooked and cooled may be held at a temperature of 130ºF; or (P) (B) At 41ºF or less (P) Item(s): Cold food item(s) Location: The Cook line cooler Problem(s): Stored above 41 degrees f Correction(s): Store below 41 degrees F. Cooked breaded pork and cooked chicken were stored in prep coolers above 41F. 58F and 53F respectively. THIS IS A REPEAT VIOLATION. THIS IS THE THIRD CONSECUTIVE REPEAT VIOLATION. 3-305.12 FOOD may not be stored: (A) In locker rooms; (B) In toilet rooms; (C) In dressing rooms; (D) In garbage rooms; (E) In mechanical rooms; (F) Under sewer lines that are not shielded to intercept potential drips; (G) Under leaking water lines, including leaking automatic fire sprinkler heads, or under lines on which water has condensed; (H) Under open stairwells; or (I) Under other sources of contamination. Item(s): Food(s) stored Location: Under the handsink Problem(s): In prohibited area(s) In or under other sources of contamination Correction(s): Store in protected manner. Containers of new grease are being stored under the hand sink and towel dispenser allowing for contamination from hand washing. 3-307.11 FOOD shall be protected from contamination that may result from a factor or source not specified under Subparts 3-301 - 3-306. Page 2 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected Kitchen Item(s): Food Location: inside the reach-in cooler Problem(s): Not protected from contamination Correction(s): Store in protected manner. Employee food was located above and with customer food. 6-202.15 Repeat Outer openings of a FOOD ESTABLISHMENT shall be protected against the entry of insects and rodents. Unless otherwise allowed by law. Item(s): Outer opening(s) Door(s) Location: At the door Problem(s): Not provided with Screening that is sixteen mesh to the inch or grea Correction(s): Repair/replace to meet requirements above. Both back doors were open and when closed did not properly seal to prevent pest entry. THIS IS THE THIRD CONSECUTIVE REPEAT OF THESE VIOLATIONS. THE NEXT REPEAT WILL RESULT IN ENFORCEMENT ACTION. Back Area 3-301.11 (A) To prevent food contamination FOOD EMPLOYEES shall properly wash their Priority hands. (B) FOOD EMPLOYEES may not contact exposed, READY-TO-EAT FOOD with their bare hands and shall use suitable UTENSILS such as deli tissue, spatulas, tongs, single-use gloves, or dispensing EQUIPMENT. (P) (C) FOOD EMPLOYEES shall minimize bare hand and arm contact with exposed FOOD that is not in a READY-TO-EAT form. (Pf) Ready to eat foods, cucumbers, were handled with bare hands at the sushi counter. Basement 3-305.12 FOOD may not be stored: (A) In locker rooms; (B) In toilet rooms; (C) In dressing rooms; (D) In garbage rooms; (E) In mechanical rooms; (F) Under sewer lines that are not shielded to intercept potential drips; (G) Under leaking water lines, including leaking automatic fire sprinkler heads, or under lines on which water has condensed; (H) Under open stairwells; or (I) Under other sources of contamination. Item(s): Food(s) stored Problem(s): In prohibited area(s) Under sewer line(s) Correction(s): Relocate to a suitable storage area Page 3 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected Basement Food is being stored under sewer lines in basement. 3-305.12 FOOD may not be stored: (A) In locker rooms; (B) In toilet rooms; (C) In dressing rooms; (D) In garbage rooms; (E) In mechanical rooms; (F) Under sewer lines that are not shielded to intercept potential drips; (G) Under leaking water lines, including leaking automatic fire sprinkler heads, or under lines on which water has condensed; (H) Under open stairwells; or (I) Under other sources of contamination. Item(s): Food(s) stored Location: Through out Problem(s): In prohibited area(s) Under sewer line(s) Correction(s): Relocate to a suitable storage area Foods in the basement are being stored under a leaking ceiling. 4-903.11 Cleaned EQUIPMENT and UTENSILS, laundered LINENS, and SINGLE-SERVICE and SINGLE-USE ARTICLES shall be stored in an approved manner and location. Item(s): Single-service/single-use article(s) Problem(s): Stored on floor or less than 6 inches above floor Correction(s): Store at least 6 inches above the floor. Multiple boxes of single use containers (cups, take-out boxes, straws, napkins) were stored on the floor in the furthest back storage area. Basement dry storage area 3-501.16 Except during preparation, cooking, or cooling, or when time is used as the public Priority health control POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) shall be maintained: (A) 135ºF or above, except that roasts properly cooked and cooled may be held at a temperature of 130ºF; or (P) (B) At 41ºF or less (P) Item(s): Cold food item(s) Problem(s): Stored above 41 degrees f Correction(s): Store below 41 degrees F. An open bottle of lime juice was stored in the dry storage area. 6-202.11 Except as otherwise approved, light bulbs shall be shielded, coated, or otherwise shatter-resistant in areas where there is exposed FOOD; clean EQUIPMENT, Page 4 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected Basement dry storage area UTENSILS, and LINENS; or unwrapped SINGLE-SERVICE and SINGLE-USE ARTICLES. Item(s): Light shielding Problem(s): Not provided In storage area Correction(s): Provide adequate light shields and end caps or shatter-proof bulbs. The light in the basement dry storage area was not shielded or shatterproof. Cook Line 3-501.16 Except during preparation, cooking, or cooling, or when time is used as the public Priority health control POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) shall be maintained: (A) 135ºF or above, except that roasts properly cooked and cooled may be held at a temperature of 130ºF; or (P) (B) At 41ºF or less (P) Item(s): Cold food item(s) Location: On the expo line Problem(s): Stored above 41 degrees f Correction(s): Store below 41 degrees F. Panan sauce was stored on stove at 110F. Dry Storage Area 3-202.15 Repeat FOOD packages shall be in good condition and protect the integrity of the contents so Priority Foundationthat the FOOD is not exposed to ADULTERATION or potential contaminants. (Pf) 05/01/16 Item(s): Food package(s) Cans Location: On the shelving Problem(s): Dented, dented on seam or swollen Correction(s): Discard. Severely dented cans were found on the basement can storage rack. THIS IS THE SECOND CONSECUTIVE REPEAT OF THIS VIOLATION. Establishment 3-402.12 If raw, raw-marinated, partially cooked, or marinated-partially cooked FISH are served Priority Foundationor sold in READY-TO-EAT form, the PERSON IN CHARGE shall record the freezing temperature and time to which the FISH are subjected and shall retain the records at the FOOD ESTABLISHMENT for 90 calendar days beyond the time of service or sale of the FISH. (Pf) If the FISH are frozen by a supplier, a written agreement or statement from the supplier stipulating that the FISH supplied are frozen to a temperature and for a time specified by law. 05/01/16 Page 5 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected Establishment Item(s): Frozen fish record(s) Problem(s): Not provided Correction(s): Provide. Parasite destruction records were not provided for the salmon that is being served raw. 6-501.110 (A) Dressing rooms shall be used by EMPLOYEES if the EMPLOYEES regularly change their clothes in the establishment. (B) Lockers or other suitable facilities shall be used for the orderly storage of EMPLOYEE clothing and other possessions. Item(s): Locker(s)/designated storage area(s) for employee belongings storage Problem(s): Not provided Correction(s): Provide. Employee belongings were being stored over utensils and single use items in the waitress area. An employee coat was stored on a container of panko crumbs above a prep table in the kitchen. 6-501.111 The presence of insects, rodents, and other pests shall be controlled to minimize their presence on the PREMISES. by: (A) Routinely inspecting incoming shipments of FOOD and supplies; (B) Routinely inspecting the PREMISES for evidence of pests; (C) Using methods, if pests are found, such as trapping devices or other means of pest control as specified.(pf) (D) Eliminating harborage conditions. There are large amounts of rodent droppings located under the upstairs dry storage racks and under the storage racks that are located next to the back door. 6-501.111 The presence of insects, rodents, and other pests shall be controlled to minimize their presence on the PREMISES. by: (A) Routinely inspecting incoming shipments of FOOD and supplies; (B) Routinely inspecting the PREMISES for evidence of pests; (C) Using methods, if pests are found, such as trapping devices or other means of pest control as specified.(pf) (D) Eliminating harborage conditions. There is a large amount of unused equiptment and boxes in the basement storage area. These are potential harborage conditions. Outside 5-501.113 Receptacles and waste handling units for REFUSE, recyclables, and returnables shall be kept tightly covered, unless they are in continuous use. Item(s): Waste container(s)/container(s) Outside dumpsters Page 6 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected Outside Location: At the dumpster Problem(s): Not covered Correction(s): Keep covered. The dumpster outside was positioned so that the lid was permanently kept open. Storage Area 6-303.11 Light of the proper intensity shall be provided as specified. There is no lighting in the upstairs dry storage area. Sushi Bar 3-304.15 (A) SINGLE-USE gloves shall be used for one task only and discarded when Priority damaged, soiled, or when interruptions occur in the operation. (P) (B) Slash-resistant and cloth gloves shall be used in direct contact only with FOOD that is subsequently cooked. Gloves used with ready-to-eat foods shall be smooth, durable and non-absorbant. Item(s): Single-use glove(s) Location: At the employees Problem(s): Soiled Correction(s): Replace soiled glove. Single use gloves were removed from employee's hands and then put back on after completing task. Gloves may only be used once. 3-501.14 (A) Cooked POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL Priority FOR SAFETY FOOD) shall be cooled: (1) Within 2 hours, from 135ºF to 70ºF; and (P) (2) Within 4 hours, from 70ºF to 41ºF or less (P) (B) POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) prepared from ingredients at ambient temperature shall be cooled within 4 hours to 41F or less. (P) (C) POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) received in compliance with LAWS allowing a temperature above 41ºF during shipment from the supplier shall be cooled within 4 hours to 41ºF or less. (P) Item(s): Cooked food(s) cooled Location: At the beverage station Problem(s): From 70 degrees f to 41 degrees f for more than 4 hours Correction(s): Utilize shallow pans, ice baths, agitation, or quick chilling to cool food items. Rice at the sushi bar, made yesterday (4-20), was measured at 51F. Page 7 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected Sushi Bar 3-501.17 (A) READY-TO-EAT, POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE Priority FoundationCONTROL FOR SAFETY FOOD) prepared and held refrigerated for more than 24 hours in a FOOD ESTABLISHMENT shall be clearly marked at the time of preparation to indicate the date or day by which the FOOD shall be consumed. (Pf) (B) A container of refrigerated, commercially prepared READY-TO-EAT POTENTIALLY HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD) shall be clearly marked, at the time the original container is opened in a FOOD ESTABLISHMENT, to indicate the date or day by which the FOOD shall be consumed. (Pf) 05/01/16 A date marking system that does not exceed 7 days, including date of preparation, or opening is to be used. (Pf) Item(s): In house prepared ready-to-eat potentially hazardous food(s) Location: At the Cooler Problem(s): Without date of consumption marking Correction(s): Provide proper date marks as stated above. Spicy tuna, wasabi mayonnaise, and crab mix were without a date of consumption marking. Foods were made yesterday, 4-20. 5-205.11 Repeat (A) A HANDWASHING SINK shall be maintained so that it is accessible at all times for Priority FoundationEMPLOYEE use and used for no other purpose. (Pf) (B) An automatic handwashing facility shall be used in accordance with manufacturer's instructions. (Pf) 05/01/16 Item(s): Handwashing sink(s) Problem(s): Not accessible Correction(s): Handwashing sinks are to be accessible for use at all times Sanitizer buckets were being stored in the sushi bar hand sink. THIS IS THE THIRD CONSECUTIVE VIOLATION. 3-304.14 (A) Cloths that are in use for wiping FOOD spills on TABLEWARE shall be maintained dry and used for no other purpose. (B) Cloths in-use for wiping counters and equipment shall be held between uses in a chemical sanitizer solution, and laundered daily. (C) Cloths in-use for wiping surfaces in contact with raw animal FOODS shall be kept separate from cloths used for other purposes. (D) Dry wiping cloths and the chemical sanitizing solutions shall be free of FOOD debris or visible soil. (E) Containers of chemical sanitizing solutions shall be stored off the floor and used in a manner that prevents contamination of FOOD, EQUIPMENT, UTENSILS, LINENS, SINGLE-SERVICE, or SINGLE-USE ARTICLES. (E) SINGLE-USE disposable sanitizer wipes shall be used in accordance lable instructions. Item(s): Problem(s): Wiping cloth(s) wet Stored in Less than 50-100 ppm chlorine 50-100 ppm chlorine Page 8 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected Sushi Bar Correction(s): Store wiping cloths in 50-100 ppm chlorine. Wiping cloths at the sushi bar were stored in less than 50ppm chlorine. Walk in Cooler 3-501.15 (A) Cooling shall be accomplished in accordance with the time and temperature criteria Priority Foundationspecified under 3-501.14 by using one or more of the following methods based on the type of FOOD being cooled: (1) Placing the FOOD in shallow pans; (Pf) (2) Separating the FOOD into smaller or thinner portions; (Pf) (3) Using rapid cooling EQUIPMENT; (Pf) (4) Stirring the FOOD in a container placed in an ice water bath; (Pf) (5) Using containers that facilitate heat transfer; (Pf) (6) Adding ice as an ingredient; (Pf) or (7) Other effective methods. (Pf) (B) When placed in cooling or cold holding EQUIPMENT, FOOD containers in which FOOD is being cooled shall be: (1) Arranged in the EQUIPMENT to provide maximum heat transfer through the container walls; and (2) Loosely covered, or uncovered if protected from overhead contamination as specified under Subparagraph 3-305.11(A)(2), during the cooling period to facilitate heat transfer from the surface of the FOOD. Item(s): Food item(s) cooled Location: On the shelf Problem(s): Improperly In large container Bus tub Bus tub Correction(s): Utilize long, shallow pans. Chicken and noodles were stored in large bus tubs for cooling. Foods were measured at 54F. USE PROPER COOLING METHODS. 3-305.12 FOOD may not be stored: (A) In locker rooms; (B) In toilet rooms; (C) In dressing rooms; (D) In garbage rooms; (E) In mechanical rooms; (F) Under sewer lines that are not shielded to intercept potential drips; (G) Under leaking water lines, including leaking automatic fire sprinkler heads, or under lines on which water has condensed; (H) Under open stairwells; or (I) Under other sources of contamination. Item(s): Food(s) stored Problem(s): In prohibited area(s) Under leaking water lines or lines with condensati Correction(s): Relocate to a suitable storage area Foods are being stored under the leaking condenser in the walk in cooler. Closing Comments: This was a routine inspection that resulted in the closure of the facility for a minimum of 7 consecutive days. No Page 9 of 10

4:01:38 PM Category Repeat Description/Remarks/Correction Schedule Correct By Corrected food service of any kind (in house, take out or other) my occur during their closure. An inspection must be conducted and the facility must be approved prior to their re-opening. EMERGENCY ACTION PLAN www.michigan.gov/documents/mda_emergencyactionplan_109428_7.pdf FDA FOOD CODE LINK http://www.fda.gov/food/guidanceregulation/retailfoodprotection/foodcode/ucm2019396.htm FOOD AWARDS www.accesskent.com/health/foodservices/awards.htm FOODBORNE OUTBREAK GUIDANCE www.cifor.us/projind.cfm FREE ON-LINE BASIC FOOD SAFETY TRAINING www.accesskent.com/health/foodservices/pdf/enrollment_flyer_kent_msue.pdf Person in charge (Name and Title) Inspected By (Name and Title) This signature does not imply agreement or disagreement with any violation noted. Katherine Sweeney Page 10 of 10