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Food Establishment Inspection Report Establishment Name: Date: 0 3 × 0 4 × 2 0 1 3 Status Code: A : 3 0 am Time pm 1 hr 15 minutes Time In: 0 3 Total Time: Category #: II Establishment Type: Out:
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Instructions for filling out DHHS - Food Establishment:

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Start by gathering all the necessary information and documents required to complete the DHHS - Food Establishment form.
02
Carefully read the instructions provided on the form to understand the specific requirements and guidelines for filling it out.
03
Begin by providing your personal information, such as your name, contact details, and business address. Ensure that all the information is accurate and up to date.
04
If applicable, indicate the type of food establishment you are operating, whether it's a restaurant, café, food truck, or any other type of food-related business.
05
Fill in the required details about your food establishment, such as the name, address, hours of operation, and any additional information requested, such as seating capacity or outdoor dining facilities.
06
Provide information about the type of food being served, including menu items and any special dietary options available.
07
If necessary, provide details about any food preparation methods, equipment, or processes used to ensure food safety and hygiene.
08
Provide information about the source of the ingredients used in your food establishment, such as local suppliers or farms.
09
If applicable, indicate any permits or licenses obtained related to food handling, alcohol service, or any other relevant certifications.
10
Include any additional information or documentation that may be required, such as health inspection reports, business licenses, or proof of insurance.
11
Review your completed form carefully to ensure all the information is accurate and complete.
12
Sign and date the form as required.
13
Submit the completed DHHS - Food Establishment form to the designated agency or department, following the specified submission process.
Anyone who operates a food establishment, such as restaurants, cafes, food trucks, or any other businesses involved in the preparation, service, or sale of food, needs to fill out the DHHS - Food Establishment form. This includes both new establishments and existing ones that require updates or changes to their information. It is essential to comply with DHHS regulations and maintain a safe and healthy environment for customers. Failure to fill out the form accurately or neglecting to submit it can result in penalties or the suspension of operations.
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DHHS stands for Department of Health and Human Services. A food establishment refers to any business that sells or serves food to the public.
All food establishments are required to file with DHHS in order to ensure compliance with health and safety regulations.
You can fill out the DHHS food establishment form online or submit a paper copy to the Department of Health and Human Services.
The purpose of DHHS food establishment filing is to protect public health by monitoring and regulating food businesses.
Food establishments must report information such as location, menu items, food handling practices, and sanitation procedures.
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