Philadelphia Dept of Health Food Facility Inspection Report  
Philadelphia Dept of Health/Office of Food Protection
1930 S. Broad St. Phila., PA 19145
www.phila.gov/departments/department-of-public-health
No. of Risk Factor/Intervention Violations  5 Date  12/03/2019
No. of Repeat Risk Factor/Intervention Violations  0 Time In  02:35 PM
Number of Corrections   4 Time Out  05:00 PM
Food Facility
Pendawa Enterprises
Address
1529 MORRIS ST 19145
Telephone
(215) 755-6229
Establishment Type
Food Store: Prepackaged Food Only
District
2
Sub
1
Licensee
Iwan Santoso 
Corporate Officer
Pendawa Enterprises Inc.  
  Purpose of Inspection
Inspection 
Inspection Type
Inspection 
FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS
IN=in compliance    OUT=not in compliance    N/O=not observed    N/A=not applicable
  
COS=corrected on-site during inspection    R=repeat violation
 Compliance Status COS R
Demonstration of Knowledge
1 IN Certification by accredited program, compliance with Code, or correct responses    
Employee Health
2 IN Management awareness; policy present    
3 IN Proper use of reporting; restriction & exclusion    
Good Hygienic Practices
4 IN Proper eating, tasting, drinking, or tobacco use    
5 IN No discharge from eyes, nose, and mouth    
Preventing Contamination by Hazards
6 IN Hands clean & properly washed    
7 IN No bare hand contact with RTE foods or approved alternate method properly followed    
8 IN Adequate handwashing facilities supplied & accessible    
Approved Source
9 OUT Food obtained from approved source    
10 OUT Food received at proper temperature    
11 IN Food in good condition, safe, & unadulterated    
12 IN Required records available: shellstock tags, parasite destruction    
Protection From Contamination
13 IN Food separated & protected    
14 IN Food-contact surfaces: cleaned & sanitized    
15 IN Proper disposition of returned, previously served, reconditioned, & unsafe food    
 
 Compliance Status COS R
Potentially Hazardous Food Time/Temperature
16 IN Proper cooking time & temperature    
17 IN Proper reheating procedures for hot holding    
18 IN Proper cooling time & temperature    
19 IN Proper hot holding temperature    
20 OUT Proper cold holding temperature    
21 OUT Proper date marking & disposition    
22 OUT Time as a public health control; procedures & record    
Consumer Advisory
23 IN Consumer advisory provided for raw or undercooked foods    
Highly Susceptible Population
24 IN Pasteurized foods used; prohibited foods not offered    
Chemical
25 IN Food additives: approved & properly used    
26 IN Toxic substances properly identified, stored & used    
Conformance with Approved Procedure
27 IN Compliance with variance, specialized process, & HACCP plan    
Risk factors are improper practices or procedures identified as the most prevalent contributing factors of foodborne illness or injury. Public Health Interventions are control measures to prevent foodborne illness or injury.
GOOD RETAIL PRACTICES
Good Retail Practices are preventative measures to control the addition of pathogens, chemicals, and physical objects into foods.
 Compliance Status COS R
Safe Food and Water
28 IN Pasteurized eggs used where required    
29 IN Water & ice from approved source    
30 IN Variance obtained for specialized processing methods    
Food Temperature Control
31 IN Proper cooling methods used; adequate equipment for temperature control    
32 IN Plant food properly cooked for hot holding    
33 IN Approved thawing methods used    
34 OUT Thermometer provided & accurate    
Food Identification
35 OUT Food properly labeled; original container    
Prevention of Food Contamination
36 OUT Insects, rodents & animals not present; no unauthorized persons    
37 OUT Contamination prevented during food preparation, storage & display    
38 IN Personal cleanliness    
39 IN Wiping cloths: properly used & stored    
40 IN Washing fruit & vegetables    
Proper Use of Utensils
41 IN In-use utensils: properly stored    
 
 Compliance Status COS R
Proper Use of Utensils
42 IN Utensils, equipment & linens: properly stored, dried & handled    
43 IN Single-use & single-service articles: properly stored & used    
44 IN Gloves used properly    
Utensils, Equipment and Vending
45 OUT Food & non-food contact surfaces cleanable, properly designed, constructed, & used    
46 IN Warewashing facilities: installed, maintained, & used; test strips    
47 OUT Non-food contact surfaces clean    
Physical Facilities
48 IN Hot & cold water available; adequate pressure    
49 IN Plumbing installed; proper backflow devices    
50 IN Sewage & waste water properly disposed    
51 IN Toilet facilities: properly constructed, supplied, & cleaned    
52 IN Garbage & refuse properly disposed; facilities maintained    
53 OUT Physical facilities installed, maintained, & clean    
54 IN Adequate ventilation & lighting; designated areas used    
Philadelphia Ordinances
56 IN Person in Control of premises has not posted "No Smoking" signs.    
56+ IN Philadelphia Ordinances    
Person in Charge (Signature)    Name:  Iwan Santoso A61288 Exp. 07/01/2020 Date:  
Inspector (Signature) RaShawna Harvey 215-685-4305 Date: 12/03/2019
Philadelphia Dept of Health Food Facility Inspection Report  
Philadelphia Dept of Health/Office of Food Protection
1930 S. Broad St. Phila., PA 19145
www.phila.gov/departments/department-of-public-health
No. of Risk Factor/Intervention Violations  5 Date  12/03/2019
No. of Repeat Risk Factor/Intervention Violations  0 Time In  02:35 PM
Number of Corrections   4 Time Out  05:00 PM
Food Facility
Pendawa Enterprises
Address
1529 MORRIS ST 19145
Telephone
(215) 755-6229
Establishment Type
Food Store: Prepackaged Food Only
District
2
Sub
1
Licensee
Iwan Santoso 
Corporate Officer
Pendawa Enterprises Inc.  
  Purpose of Inspection
Inspection 
Inspection Type
Inspection 
FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS
Item/Location Temp Item/Location Temp Item/Location Temp
Vegetable Fritters / Delivery 59.0 ° F Fish / Delivery 62.0 ° F Fish / Chest Freezer -4.0 ° F
Donut Ayam (chicken) / Retail Area 56.0 ° F Sauces / Reach-In Refrigerator 26.0 ° F Chicken / Open Display Case 40.0 ° F
Chicken Fritter / Open Display Case 57.0 ° F Lemper (chicken and rice) / Retail Area 57.0 ° F /  
/   /   /  
/   /   /  
/   /   /  
/   /   /  
/   /   /  
Food Disposal
Food Types Volume Unit Pounds
OBSERVATIONS AND CORRECTIVE ACTIONS
Item
Number
Violations cited in this report must be corrected within the time frames below.
9 Violation of Code: [46.211] Food facility Person in Charge not able to provide documentation that packaged foods are from an approved source. New Violation.
10 Violation of Code: [46.241] Prepackaged ready to eat foods, prepared at Indonesia Restaurant, not received at proper temperature. Foods observed at 62 degrees F upon delivery. The person in charge was instructed to discard the foods. New Violation.
20 Violation of Code: [46.385(a)(2)] Several potentially hazardous ready to eat foods were held in the open display case between 46 and 57 degrees F rather than 41 degrees F or below as required.
-Potentially hazardous ready to eat foods were held in the retail area at 57 degrees F rather than 41 degrees F or below as required.
The person in charge was instructed to discard the foods. New Violation.
21 Violation of Code: [46.385(b)] Potentially hazardous ready to eat foods, located in the retail area, and held more than 48 hours, were not date marked. New Violation.
22 Violation of Code: [46.385(c)] Time in lieu of temperature being used in the food facility to control ready to eat potentially hazardous foods without written procedures or documentation to verify disposition of food. The person in charge was instructed to discard the foods. New Violation.
34 Violation of Code: [46.562] Temperature measuring devices for ensuring proper temperatures of equipment are not available or readily accessible. Provide where needed. New Violation.
35 Violation of Code: [46.422] Food labeling placards are not provided for self service foods. New Violation.
36 Violation of Code: [46.981(k)(l)] Live roaches observed in the retail area. New Violation.
37 Violation of Code: [46.341] Adequate protection not provided for ready to eat displayed foods in the retail area. New Violation.
45 Violation of Code: [46.671] Open display case observed used for dry storage. New Violation.
45 Violation of Code: [46.522] Crates observed used for elevation. New Violation.
47 Violation of Code: [46.711(b)(c)] Accumulation of ice observed in retail area chest freezer. New Violation.
53 Violation of Code: [46.901] Water damaged ceiling tiles observed in the retail area. New Violation.
Person in Charge (Signature) Iwan Santoso A61288 Exp. 07/01/2020 Date:  
Inspector (Signature) RaShawna Harvey 215-685-4305 Date: 12/03/2019
Philadelphia Dept of Health Food Facility Inspection Report  
Philadelphia Dept of Health/Office of Food Protection
1930 S. Broad St. Phila., PA 19145
www.phila.gov/departments/department-of-public-health
No. of Risk Factor/Intervention Violations  5 Date  12/03/2019
No. of Repeat Risk Factor/Intervention Violations  0 Time In  02:35 PM
Number of Corrections   4 Time Out  05:00 PM
Food Facility
Pendawa Enterprises
Address
1529 MORRIS ST 19145
Telephone
(215) 755-6229
Establishment Type
Food Store: Prepackaged Food Only
District
2
Sub
1
Licensee
Iwan Santoso 
Corporate Officer
Pendawa Enterprises Inc.  
  Purpose of Inspection
Inspection 
Inspection Type
Inspection 
OBSERVATIONS AND CORRECTIVE ACTIONS
Item
Number
Violations cited in this report must be corrected within the time frames below.
Summary
Statements
This inspection has revealed that the establishment is not in satisfactory compliance. Corrective action is required to eliminate these violations. Compliance status will be assessed upon reinspection.

Due to imminent health hazards observed during this inspection, the establishment has been issued a Cease Operations Order and must discontinue food operations immediately. The establishment cannot operate for a minimum of 48 hours. The establishment cannot operate until the required fee is paid and the establishment is approved by the Department to resume operations. Please contact the Sanitarian at the phone number listed below for a re-inspection once the violations have been corrected and the fee has been paid.

For an inspection over the weekend, please contact Municipal Dispatch at (215) 686 - 4514.
You are required under Section 6-502 of the Philadelphia Health Code to correct the violations listed as noted above. Your failure to correct these violations may result in the revocation of your health license and other legal action. Reinstatement of a revoked health license will require payment of another license fee. An appeal to these orders may be made to the Board of License and Inspection Review, Municipal Services Building, 1401 JFK Boulevard Philadelphia, PA 19102-1617
Person in Charge (Signature) Iwan Santoso A61288 Exp. 07/01/2020 Date:  
Inspector (Signature) RaShawna Harvey 215-685-4305 Date: 12/03/2019