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Home My WebLink AboutFood Service Establishment Inspection 52 3w Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN J3 SZS' d�itr�A4.& µ K DATE O INSP TION 0 INSPECTION FORM# REMARKS S&l.s r- o f 2,c lTt*�n•.s S7o 01\1 �, I��c�G �z,�✓� r o�e. ��I' $,€—'rr4Z C(,CWLt&4tt INITIAL(INSPECTOR) (LNG INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager EHS-106-Rev.06/01Y INSPECTION REPORT STATE OF CONNECTICUT KDREOPERATIONAL OUTINE INSPECTION 13REINSPECTION FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH 13 OTHER 410 Capitol Avenue,MS#51 FDP,Hartford,CT 06134 NAME OF C ESTABLISHMENT ESTABLISHMENT CLASS STREET TO ADDRESS ;7 LS ��tL.�.,ue). � t ll., (-�- W•r..� J OWNER or INSPECTION OPERATOR DATE and TIME Based on an inspection this day,the items marked below identify the violations in operation or facilities which must be corrected by the date specified below. SOURCES OF FOOD EQUIPMENT&UTENSILS:CLEANLINESS VERMIN CONTROL 1 Approved source,wholesome, 4 21 Pr flushed,scraped,soaked and racked 42 Presence of insects/rodents 2 nonadulterated 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of 1 2 Original container,properly labeled 1 23 Accurate thermometers provided,dish basket,9used insects/rodents 24 Sanitization rinse(hot water-chemical) 2 FOOD PROTECTION 25 Clean wiping cloths 1 F ORS,WALLS&CEILINGS 3 Potentially hazardous food meets 4 W 11bod-contact surfaces of utensils& loors:floor covering installed, temperature requirements during storage, equipment clean onstructed as required,good repair,clean preparation,display,service,and transportation 27 Nonfood-contact surfaces of utensils& 1 45 Floors,graded,drained as required equipment clean 46 Floor,wall juncture covered Adequate facilities to maintain product 72 28 1 Equipment/utensils,storage,handling 1 47 Mats removable,good repair,clean temperature,thermometers provided 5 Potentially hazardous food properly thawed 2 48 Exterior walking,driving surfaces, 1 6 Unwrapped or potentially hazardous food 4 WATER SUPPLY good repair,clean not reserved F30 Water source ade uate,safe q 4 49 Walls,ceilings attached,equipment properly 1 7 Food protected during storage,preparation, Hot and cold water under pressure, 2 constructed,good repair,clean. Wall&ceiling display,service&transportation 2 provided as required surfaces as required. od containers stored off floor 50 Dustless cleaning methods used, 1 SEWAGE DISPOSAL cleaning equipment properly stored 9 Handling of food minimized 2 31 Sewage disposal approved 4 10 Food dispensing utensils properly stored 1 32 1Proper disposal of waste water 1 LIGHTING&VENTILATION 11 Toxic items properly stored,labeled,used 4 51 Adequate lighting provided as required 1 PLUMBING 52 Room free of steam,smoke odors 1 PERSONNEL 33 Location,installation,maintenance 1 53 Room&equipment hoods,ducts,vented as required 12 1 Personnel with infection restricted 4 34 No cross connection,back siphonage,backflow, 4 DRESSING ROO &LOCKERS CLEANLINESS OF PERSONNEL TOILET FACILITIES 7ovmided, s adequat ;clean dequate lockers13 Handwashing facilities provided, 4 35 Adequate,convenient,accessible,designed, 4 facilities c can personnel hands washed clean installed 14 Clean outer clothes,effective hair restraints 1 36 Toilet rooms enclosed with self-closing door 1 15 Good hygienic practices,smoking restricted 2 37 Proper fixtures provided,good repair,clean USEKEEPING 55 Ystablishment and premises free of litter,no EQUIPMENT&UTENSILS: DESIGN, HANDWASHING FACILITIES insect/rodent harborage,no unnecessary articles CONSTRUCTION&INSTALLATION 38 Suitable hand cleaner and sanitary towels or 1 56 Complete separation from living/sleeping quarters 1 16 Food-contact surfaces designed,constructed, 2 approved hand drying devices provided, and laundry maintained,installed,located tissue waste receptacles provided J58 ENo Eguide ens stored properly 1 17 Nonfood-contact surfaces designed, 1 rtles,or other animalsconstructed,maintained,installed,located GARBAGE/RUBBISH STORAGE&DISPOSAL ogs) 18 Single service articles,storage,dispensing 2 39 1 Approved containers,adequate number, 1 19 No reuse of single service article covered,rodent proof,clean NONSMOKING AREAS 20 Dishwashing facilities approved design,adequately 2 40 Storage area/rooms,enclosures- 59 Seats 75 or more:Nonsmoking area provided, 3 constructed,maintained,installed,located properly constructed,clean sign(s)posted at entrance(s),smoking area 1 indicated by sign(s) 41 Garbage disposed of in an approved manner, at approved frequency QUALIFIED FOOD OPERATOR DEMERIT SCORE 60 Qualified Food Operator 3 4 �^— 12 RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2 ,� 3 1 62 Written documentation of training program 2 le 4 Signatur Person i arge TOTAL RATING Date Corrections Due SI (Insplov Q01 I t ?.F DESC E DEFICIENCIES ON CONTINUA HEETS . . 1�d tablishment: Cy� Date of Inspection: �ca 0 Ce dress: ^Z S S"' x4 Owner or Operator: ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. -Unwrapped foods not re-served 4 31 Sewage disposal approved. 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. 34 No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Proper ype/installation/backflow prevention device/air gap for: -Sanitizer concentration not to exceed maximum permitted -Food equipment -Hose connections -Dish machines -No unnecessary toxics on the premises -Soda system carbonator -Beverage dispensers -Toilet tanks -Pesticides/rodenticides properly dispensed -Chemical dispensers -Ice machines Proper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, -Water quality in compliance ,desi ned properly installed -Monitoring in compliance g p p y OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 0 Garbage/nabbishstorage area/rooms,enclosures-propedy constructed,clean 5 Potentially hazardous food properly thawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 43 Outer openings protected against entrance of insects/rodents 4 ors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, Floors graded,drained as required located 6 Floor,walljuncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 7 Mats removable,good repair,clean installed,located 18 Single service articles,storage,dispensing 8 Exterior walking,driving surfaces,good repair,clean 19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good 20 Dishwashing facilities approved design,adequately constructed, repair,clean.Wall&ceiling surfaces as required maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required curate thermometers provided,dish basket,if used 5 Rooms adequate,clean,adequate lockers provided,facilities clean 7 nfood-contact surfaces of utensils&equipment clean 5 stablishment and premises free of litter,no insect/rodent harborage, Equipment/utensils,storoge,handling no unnecessary articles 32 Proper disposal of wastewater 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance 57 Clean/soiled linens stored properly 36 Toilet rooms enclosed with self-closing door 58 No live birds,turtles,or other animals(except guide dogs) 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Propertoiletfixturesyrovided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean Woutine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: PERSON IN CHARGE: Obw Inspection: Demerit Score: *Include demerits from page 1 signature 4 3 2 1 Total Rating print name rint name t title ri"c 2 (h r DATE CORRECTIONS DUE: t a phone number S h 1 �-F V Q(V Page 2 of 2 plus_�continuation pages Focused Inspection 1/2002 Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME `OeF ESTABLISHMENT TOWN DATE OF INSPECTIION Gv INSPECTION FORM# REMARKS 'Z N S �'Ct UL18�L ro C LC'Ot+�sS� 5�'y� �C� q 2��. C L v ZZr►z-S� T� '�-.s S"7U sz� ►.�l�i-Z w..�� oF st o• INITIAL(INSPECTOR) x INITIAL(PERSON IN CHAR Distribution: 1st-White-Health Department 2nd-Yellow-Owner anager i Establishment: Inspection Date: 3t Time: RE[nsp Address/City: S V5 Svc-Y-,L AA sJ t+A R-t> Health De W r N _Z class: 2 3 4 Based on an inspection this day,the items marked DNC identify the violations in operation or facilities which must be corrected by the date specified on page 2. RISK FACTOR ITEMS Listing is not inclusive of all possible debitable items C N/0 WA D C KEY: C[complies] NIO[not observed] NIA[not applicable] e '°� DNC[does not comply] 0[other] RTE[ready-to-eat] "Ok4 � e F r 3 �� ILIA 4 tit Designated Al tenlate 2 q Food workers have no exposed infected lesions/burns �2 Written documentation of training program 2 B Personnel with infection restricted 1 Approved source,wholesome,nonadulterated C N/0 NIA 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Handwashing facilities prodded,handswashed,clean C N/0 N/A 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature 0 D Personnel hands washed,clean/Proper handwash procedure Handwashin E g at appropriate times 11 p� �� ill JI,0 11 . r �plitt)x� td R tr 0 eod Yrr rVAR 717 W7 C N/0 NIA 3' A Hot holding greater than or equal to 1400F. (whole beer/pork roasts 1300 F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 ol E Proper internal cooking/consumer advisory posted 0 A Approved sanitizeravailable/adequate concentration ofsanitizer } ale g tlt a t�r rota prgdCt¢tj e B Food-contact surfaces and utensils used for potentially tQmpei�t ,; nrrteters proylded „ hazardous food sanitized at least every 4 hours A� Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp B Properfood thermometer for product L Proper sanitizin rocedure E Sanitizing between raw animal origin&ready-to-eat food / C Thermometers appropriately placed in cooler units Q 0 A Cloths and/or sponges in good repair and clean dispiay,'service artd transports#fcih. B Wiping cloths kept in sanitizer between uses A Produce washed B 1 Raw meats not stored/prepared near ready-to-eat foods 0 C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards/sneeze guard B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean oFOr pooling of eggs not cooked immediately 0 8 F d containers stored off the floor ait► Fo �+a w, 10 WO X I z� A No unnecessary handling RTE and/or cooked foods with bare hands A Soap/paper towels/ drying device available B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sinks)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodborne] PHFs are hot h OF. PHFs are cold held at: OF. Describe illness conditions when you would exclude a food worker from working: Are internal cooking temperatures C . N *To what temperature do you cook: Poultry Ground Beef Pork What diseases related to FB illness are you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foods/equipment? Y N diseases to the QFO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N +Are leftovers saved? Y N Is there a Ian barrier between inspector&QFO? Y N If-yes indicate language spoken List products cooled: *Can the QFO/DA read the inspection report? Y N Describe cooling methods: Indicate who answered the above ques • Name(print): Indicate the title of above person(circle all that ap QFO DA Mgr Cook Owner FW Is cooling monitored or time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain signature of the person who received the QFO res 'bilities information at the.time of the Is there a produce washing policy? Y N *Describe what is washed and inspection: where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2