HomeMy WebLinkAboutFood Service Establishment Inspection 00 (2) INSPECTION REPORT TOWN
STATE Of CONNECTICUT f ��
FOOD SERVICE ESTABLISHMENTS c
EHS-106 8/93 DEPARTMENT OF
PUBLIC HEALTH OWNER OF OPERATOR
150 Washington Street, Hartford, CT 06106
0 QUARTERLY INSPECTION ❑ REINSPECT/ON ❑ COMPLAINT ❑ INVESTIGATION ❑ OTHER
Based on an inspection this day,the items marked below identify the violations in operation of facilities which must be corrected by the data specified below.
NAME OF ESTABLISHMENT STREETADDRESS
ZtA F tie_ CW& �Or/ L GcTQS/
NOTICE:ALL SHADED AREAS ARE FOR OFFICE USE ONLY.
EST: H.D. SECT. EST.NO. rfffi CHAIN CODE LU, SAINIT.CODE YR. MO. I DAY ME TRAVEL TIME' '`' INSPECT.TIME k
LD. 1 2 3 4 5 6 "7 8 9 1O 11 12 1314 15 16 912A
19120121122MM 23124125 Nil26 M2728 :a
2 SOURCES OF FOOD 7 EQLEUIPM N T AND UTENSILS: 14 VERMIN CONTROL
1 Approved source,wholesome,non-adulterated 4 21 Preflushed,scraped,soaked and racked 1 42 Presence of insects/rodents 2
2 1 Original container,property labeled 1 221 Wash water clean,proper temperature 1 Outer openings protected against entrance of
3 FOOD PROTECTION 23 Accurate thermometers provided,dish basket, 1 43 insects/rodents 1
if use
Potentially hazardous food meets temperature 24 Sanitization rinse(hot water-chemical) 2 15 FLOORS,WALLS AND CEILINGS
3 requirements during storage,preparation,dis- 4 25 Clean wiping clothes 1 44 Floors;floor covering installed,constructed as
play,service&transportation required,good repair,clean 1
Food contact surfaces of utensils&equipment
4 Adequate facilities to maintain product temp- 2 26 clean 2 45 Floors graded drained as required 1
perature,thermometers provided 27 Non-food contact surfaces of equipment& 1 46 Floor,wall juncture covered 1
5 Potential) hazardous food properly thawed 2 utensils clean
y P P y 28 Equipment/utensils,storage handling 1 47 Mats removable,good repair,clean 1
Unwrapped and potentially hazardous food not 48 Exterior walking,driving surfaces.Good repair, 1
6 re-served 4 8 WATER SUPPLY clean
Food,protected during storage,preparation, 29 Water source adequate,safe 4 Walls,ceilings attached equipment,properly
7 display,service and transportation Hot and cold water under pressure,provides as 49 constructed,good repair,clean.Wall&ceiling 1
- 30 P P 2 ., surfaces as required
required
8 Food containers stored off of the floor 1 50 equipment properly stored Dustless cleaning method used,cleaning' 1
g Handling of food minimized 2 9 SEWAGE DISPOSAL
ip Food dispensing utensils properly stored 1
311 Sewage disposal approved 4 - 16 LIGHTING
91 Toxic items properly stored,labeled,used 4
32 Proper disposal of waste water 1 , �� 51 Adequate lighting provided as required 1
`
10 PLUMBING 17 VENTILATION
4 PERSONNEL 33 Location,installation,maintenance 1 52 Room free of steam,smoke*odors 1
12 Personnel with infection restricted 4 34 No cross connection,back siphonage,backflow 4 Room and equipment hoods,ducts,vented as
53 required 1
5 CLEANLINESS OF PERSONNEL 11 TOILET FACILITIES
18 DRESSING ROOMS AND LOCKERS
13 Hand washing facilities provided 4 35 Adequate,convenient,accessible,designed, 4
installed 54 Rooms adequate,clean,adequate lockers pro-
14 Clean outer clothes,effective hair restraints 1 36 toilet rooms enclosed with self-closingdoor 1 vided,facilities clean
15 Good hygienic practices,smoking restricted 2 37 Proper fixtures provided,good repair,clean 1
19 HOUSEKEEPING
6 EQUIPMENT AND UTENSILS: DESIGN, Established and premises free of litter,no in-
CONSTRUCTION HANDWASHING FACILITIES 55 sects/rodents harbors no unnecessary 1
CONSTRUCTION&INSTALLATION harborage, ry articles
Suitable hand cleaner and sanitary towels or Complete separation from living/sleeping
Food contact surfaces designed,constructed, 38 approved hand drying devices provided,tissue 1 56 .quarters and laundry 1
16 maintained,installed,located 2 waste receptacles provided
57 Clean/soiled linens stored properly 1
17 Non-food contact surfaces,designed,con- 1 13 GARBAGE&RUBBISH STORAGE No live birds,turtles,other animals(except
structed,maintained,installed,located &DISPOSAL 58 police guide dogs) 1
18 Single service articles,storage,dispensing 1 39 Approved containers,adequate number,cov-
ered. 1
rodent roof,clean
19 No re-use of single service article 2 Storage area/rooms,enclosures-properly 20 NONSMOKING AREAS
40 constructed clean 1 Seats 75 or more:
Dishwashing facilities approved design,ade-
20 quately constructed;maintained,installed,located 2 41 Disposed of in an approved manner,at 1 59 Non-smoking area provided,sign(s)posted at 3
approved frequency entrance(s),smoking area indicated by sign(s).
DEMERIT SCORE FOLLOW-UP RATING ACTION SIGNED(Inspector) DATE CORRECTIONS DUE
a$ Haan 4f
4 3 2 1 TOTAL ❑ YES-1 ❑ CHANGE a. L b f (L
SIG �UREOF�PERS%N CHARGE
Z 1 3 ❑ NO-2 2 7 ❑DELETE d.REMARKS: C% �►i t� fi�11
A(7 �"orJc! caK �Zt ls�t�f bt �' th ri c ona cw� r w�
DISTRIBUTION: 1st-WHITE-Health Department 2nd-Blue-Owner/Manager
INSPECTION REPORT STATE OF CONNECTICUT tOWN
IOOD SMVICI STABUSHMINTS DEPARTMENT OF HEALTH SERVICES S (,vT'tdd b,—
ENS-106 REV.9/93 150 Washington St.,Hartford,CT,06106 OYMER OR OPERATOR
0-*WTERLYMISFECTION ❑REWSPECTION ❑COMPIAWT ❑f ffSTIGATION ❑OTHER
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.
NAME OF ESTASUSHMEW STREET ADDRESS
4 Q,_t(J) &4 /
NOTICE:ALL SHADED AREAS ARE FOR OFFICE USE
EST. H.D. SECT. EST.NO. CHAIN CODE SANIT.CODE YR. I MO. DAY TRAVEL TIME NSPECT.TIM
;6 P!�1A t F
I.D.
1 2 3 1 T56 7 S 9 10 "1214115116 17 18 119 120 121 122 23 24 25 26 27 25
EQUIPMENT AND UTENSILS:
2 SOURCES OF FOOD 7 CLEANLINESS 14 VERMIN CONTROL
1 Approved source wholesome non adulterated 4 1 Preflushed scraped,soaked and racked 1
2 Original container, ro erl labeled 1 2 Wash water clean proper temperature 1 42 Presence of insects rodatnts 2
Outer openings protected against entrance of {
Accurate thermometers provided,dish basket, 43 insects rodents 1 -
2 if used 1
3 FOOD PROTECTION 24 Sonitization rinse hot water-chemicals) 2 15 FLOORS,WALLS, AND CEILINGS
Potentially hazardous food meets temperature 251 Clean wioino cloths I Floors;floor covering installed,constructed as
requirements during storage,preparation,dis• 44 required,good repair,clean
3 play,service,3 transportation
4 Food contact surfaces of utensils$equipment
Adequate facilities to maintain product temper- clean 2 45 Floorsgraded drained as required 1
4 ature thermometers provided 2 Non-food contact surfaces of equipment and _ 46 Floor,wall'uncture covered 1 ,.
27 utensils clean 1
3 Patentioliv hazardous food properly thawed 2 47 Mats removablegood repair,clean 1
Unwrapped and potentially hazardous food 28
Equipment/utensils storage handling1
PP P Y Exterior walking,driving surfaces.Good repair,
L not reserved 4 8 WATER SUPPLY 48 clean 1
Food protected during storage,preparation, Walls,ceilings,attached equipment properly
7 display,service and transportation 2 2 Water source ads uote safe 4 , " constructed,good repair,dean.Wall$ceiling
8 Food containers stored off of the floor 1 Hot and cold water under pressure,provided 49 surfaces as rs uired.
3 as required 2 Dustless cleaning methods used,cleaning
9 Handling of food minimized 2 50 a ui mentprowly prowl stored 1
10 Food dispensing utensils properly stored 1 9 SEWAGE DISPOSAL t- 5
LIGHTING
11 Toxic items ro erl stored labeled used 4 31 Sewa a die osal a roved 4equate li Hein provided as required
1
32 Proper disposal of waste water 1VENTILATION
4 PERSONNEL 10 PLUMBING om tree of steam smoke odors
121 Personnel with infection restricted 14 33 Location installation maintenance 1 Room and equipment hoods,ducts,vented as
CLEANLINESS OF
3 No cross connection back si hone a backflow 4 S3 required 1
5 PERSONNEL 11 TOILET FACILITIES 18 DRESSING ROOMS AND LOCKERS
Adequate,convenient,accessible,designed, Rooms adequate,clean,adequate lockers
13 Hand washingfacilities provided 4 35 installed 4 - 5 rovided facilities clean 1
14 Clean outer clothes effective hair restraints %`_ 36 Toilet rooms enclosed with self-closing door 1 „ : 19 HOUSEKEEPING
15 Good h ionic ractices smokin restricted 2 7 Proper fixtures oroviclqd good repair,clean 1 Establishment and premises free of litter,no in.
12 HANDWASHING FACILITIES sects rodents harbors a no unnecessary articles 1
EQUIPMENT$ UTENSILS: DESIGN, Suitable hand cleaner and sanitary towels or Complete separation from living/sleeping
6 CONSTRUCTION$ INSTALLATION approved hand drying devices provided,tissue : 56 uarters and laundry1
38 waste rocs tacles provided 1
Food contact surfaces designed,constructed, 57 Clean soiled linens stored properly1
16 maintained installed located 2 , ' 13 GARBAGE $ RUBBISH STORAGE No live birds,turtles,other animals(except
Non-food contact surf aces,desig nod,constructed DISPOSAL 56 elite uide dos 1
17 maintained installed located 1 Approved containers,adequate number, 40 NONSMOKING AREAS
18 Single service articles store a dispensing 1 39 covered rodent roof clean 1
Storage areas/rooms,enclosures-properly
o reuse of single service article 2 Seats , more: Nonsmoking area
19 N
40 constructed clean 1 � 59
- provided, sign(s) posted of entrance(s), smok- 3
Dishwashing facilities approved design,ads- Disposed of in an approved manner,at
20 uatel constructed maintained installed located 2 1 a roved fro uen i ing area indicated by sign(s).
DEMERIT SCORE fOLLOWUP RATING ACTIOId.
SIGNED(Inspedor) JDAT Cg�RECTIONS pUE
4 3 2 1 TOTAL `T/ JG `J
❑ YES•1 ❑CHAN `"(/ " e
3 ❑ NO.2 [3 DELETE NATURE Of PER ON 1 ARGE Wag
REMARKS: �[Y ^GLII.f'd fU�t CfG�LY� 1
�
�a� IOhY� 1'oGi
s
DISTRIBUTION: lit-Whits-Health Department 2nd•Blue•Owner/Manager
HEALTH DEPARTMENT
INSPECTION REPORT STATE OF CONNECTICUT TOWN
POOD=VICE ESTABLISHMENTS DEPARTMENT OF HEALTH SERVICES f
EW106 REV.9/83 130 Washington St.,Hartford,CT,06106 OWNER OR OPERATOR
❑pWRTERLYINSFEC"ON ❑REMIS►ECTION ❑COMPLAINT ❑INVESTIGATION ❑OTHER
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.
NAME OF ESTABLISHMENT STREET ADDRESS JJ
i/ y!! f 011 .
NOTICE:ALL SHADED AREAS ARE FOR OFFICE USE
EST. M.D. SECT. EST.NO. CHAIN CODE SANIT.CODE YR. I MO. DAY TRAVEL TIME NSPECT.TIM
LD. D -7
1 1 2 1 3 41 51 61 71 1 19r7CLEANLINESS
"151617118 19 20 21 22 23 24 25 26 27 28
ENT AND UTENSILS:
2 SOURCES OF FOOD 14 VERMIN CONTROL
1 A roved source wholesome non adukeratedcra ed soaked and racked 1
2 Ori inal container ro erl labeled clean Proper temperature 1 d43
Presence of insects rodents 2
Outer openings protected against entrance of '
Accurate thermometers provided,dish basket, z
2 if used 1 treacle rodents i --
3 FOOD PROTECTION 24 Sonitization rinse hot water-chemical: 2 15 FLOORS, WALLS, AND CEILINGS
Potentially hazardous food meets temperature 251 Clean wioina cloths I Floors,floor covering installed,constructed as
requirements during storage,preparation,dis- 44 required, ood repair,clean 1 �
3 lay,service,&trans rtation 4 Food contact surfaces of utensils&equipment
2 '� 4S 1
Adequate facilities Floors, drained as required
iss to maintain product temper- Non-food contact surfaces of s morel ui and
4 ature thermometers provided 2 q p I6 Floor,wall'uncture covered 1
27 utensils clean 1 w
5 Potentially hazardous food properly thawed 2 ._ 47 Mats removable good repair,clean 1
Unwrapped and potentially hazardous food 2 E ui ment utensils store a handlin 1 Exterior walking,driving surfaces.Good repair,
6 not re-served 4 8 WATER SUPPLY 48 clean 1 N-5
Food protected during storage,preparation, Walls,ceilings,attached equipment,properly k"
7 display,service and transportation 2 2 Water source adequate,safe 4 constructed,good repair,clean.Wall&ceiling
8 Food containers stored off of the floor I Hot and cold water under pressure,provided 49 surfaces as required. 1
as required 26 Dustless cleaning methods used,cleaning
9 Handlingof food minimized 2 50 a ui ment properly stored
10 Food dispensing utensils properly stored 1 9 SEWAGE DISPOSAL 16 LIGHTING
11 Toxic items ro erl stored labeled used 4 31 Sewa s disposal approved 4 _- 51 Ads uate lighting provided as required
1
t435
Proper disposal of waste water 1 17 VENTILATION
4 PERSONNEL PLUMBING 52 Room tree of steam smoke odors
12 Personnel with infection rostricted location installation maintenance 1 Room and equipment hoods,ducts,vented as
CLEANLINESS OF No cross connection back si hone a backflow 4 S3 required I
5 PERSONNEL TOILET FACILITIES 18 DRESSING ROOMS AND LOCKERS
Adequate,convenient,accessible,designed, Rooms adequate,clean,adequate lockers
13 Hand washingfacilities provided installed 4 5 rovided facilities clean14 Clean outer clothes effective hair restraints Toilet rooms enclosed with self-closin door 1 .^' 19 HOUSEKEEPING
15 Good h ienic ractices smokin restricted Pro er fixtures Provided,cood re air clean 1 r-
Establishment and premises free of litter,no in.
12 HANDWASHING FACILITIES sects rodents harbors a no unnecessary articles i
EQUIPMENT& UTENSILS: DESIGN, Suitable hand cleaner and sanitarytowels or Com lete separation from living/sleeping
6 CONSTRUCTION & INSTALLATION a roved hand drying devices provided,tissue, P P g/steeping
PP n g P 5b uarters and laundry
1
38 waste receptacles provided 1
Food contact surfaces designed,constructed, 57 Clean soiled linens stored properly1
16 maintained installed located Id
3 GARBAGE & RUBBISH STORAGE No live birds,turtles,other animals(except .,
Non-food contact surf aces,designed,constructe & DISPOSAL 58 olice uide dos 1
17 maintained installed located Approved containers,adequate number, 20 NONSMOKING AREAS
18 Single service articles stores dispensing covered rodent roof,clean 1
Storage areas/rooms,enclosures-properly Seats 75 or more:Nonsmoking area a
19 No re-use of single service article 0 constructed clean 1 59 provided, sign(s) posted at entrance(s), smok• 3
Dishwashing facilities approved design,ade- Disposed of in an approved manner,at ing area indicated by sign(s).
20 uatel constructed maintained installed located1 a roved fro uen 1
DEMERIT SCORE FOLLOW-UP RATING ACTION ;Pjr) DATE CORRECTIONS DUE
4 3 2 1 TOTAL (��YES-1 ❑ CHANGE cV❑NO.2 i ❑DELETE d. RSON IN C RGE
REMARKS:
DISTRIBUTION: 1st-White-Health Department 2nd-Blue-Owner/Manager
HEALTH DEPARTMENT
INSPECTION REPORT STATE OF CONNEC11CUT TOWN
lOOD SBRVKX BSTABLISNMBNTS DEPARTMENT OF HEALTH SERVICES 6:!A.)r lk or-
ENS•106 REV.9/83 150 Washington St.,Hartford,CT,06106 OWNER OR OPERATOR
IGWRTERLYINSPECTION ❑REINSPECTION ❑COMPLAINT ❑INVESTIGATION ❑OTHER
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.-
NAME OF ESTABUSNMENT STREET ADDRESS
rl l�iV J'o�.Str � CI=v CVW. I GeV,
NOTICE:All SHADED AREAS ARE FOR OFFICE USE
EST. H.D. SECT. EST.NO. CHAIN CODE SANIT.CODE Q YR. MO. DAY TRAVEL TIME NSPECT.i1M
I.D. I
WTTRT
1 2 1 31 41 5 61 71 8 19 110 it 12 13 14 15 16KI 171 1S 119 120 121 22 23 24 25 26 27 28
EQUIPMENT AND UTENSILS:
2 SOURCES OF FOOD 7 CLEANLINESS 14 VERMIN CONTROL
1 Aooroved source wholesome non adulterated 21 Preflushed scraped,soaked and racked
42 Presence of insects rodenh 2
2 Original container,properly labeled 1 Wash water dean proper temperature Outer openings protected against entrance of
Accurate thermometers provided,dish basket, 43insects rodents 1
2 if used
3 FOOD PROTECTION 2 Sanitization ring hot water-chemicals) 21
15 FLOORS,WALLS, AND CEILINGS
Potentially hazardous food meets temperature 2 Clean wi in cloths Floors,floor covering installed,constructed as
requirements during storage,preparation,dis- 44 required,good repair,clean 1
3 lay,service,&transportation 4 Food contact surfaces of utensils&equipment
Adequate facilities to maintain product temper- clean 45 Floors graded drained as required 1 `"
4 ature thermometers provided 2 - Non-food contact surfaces of equipment and46 Floor,wall'uncture covered 1
2 utensils clean
5 Potential) hazardous food properly thawed 2 ,_ 47 Mats removable good repair,clean 1 z
Unwrapped and potentially hazardous food 2 Equipment/utensils storage handlin Exterior walking,driving surfaces.Good repair,
6 not reserved 4 8 WATER SUPPLY 48 clean 1
Food protected during storage,preparation, Walls,ceilings,attached equipment,properly
7 display,service and transportation 2 2 Water source adequate,safe 4 - constructed,good repair,clean.Wall&ceiling
Hot and cold water under pressure, rovided 49 surfaces as required. 1
8 food containers stored off of the floor 1 P P Dustless cleaning methods used,cleaning
as required 2 g g Et"
9 Handlingme of food minimized 2 50 a ui nt properly stored 1
10 Food dispensing utensils properly stored 1 9 SEWAGE DISPOSAL 16 LIGHTING
111 Toxic items Properly-stored,labeled used 4 311 Sewage die oral approved 4 51 Ade uate lighting provided as required 1 rZ
32 Proper disposal of waste water 1 17 VENTILATION
4 PERSONNEL 10 PLUMBING Room tree of steam smoke odors
12 Personnel with infection restricted 4 `` 33 Location installation maintenance 1 Room and equipment hoods,ducts,vented as €
CLEANLINESS OF
3 No cross connection back si Hans a backflow 4 S3 required 1
5 PERSONNEL 11 TOILET FACILITIES its DRESSING ROOMS AND LOCKERS
Adequate,convenient,accessible,designed, Rooms adequate,clean,adequate lockers T
13 Hand washingfacilities provided 4 35 installed 4
54 provided,facilities clean
14 Clean outer clothes effective hair restraints 1 ; 36 Toilet rooms enclosed with self-closin door 1 19 HOUSEKEEPING
15 Good hyalonic practices,smoking restricted 2 7 Proper fixtures Provided.good repair,clean 1
Establishment and premises free of litter,no in.
12 HANDWASHING FACILITIES sects rodents harbors a no unnecessary articles 1
EQUIPMENT& UTENSILS: DESIGN, Suitable hand cleaner and sanitary towels or Complete seporation from living/sleeping
approved hand drying devices rovided,tissue
6 CONSTRUCTION & INSTALLATION PP r1 g P S6 uarters and laund 1
38 waste receptacles provided 1
Food contact surfaces designed,constructed, 57 Clean soiled linens stored properly
16 maintained installed located 2 13 GARBAGE & RUBBISH STORAGE No live birds,turtles,other animals(except
Non-food contact surfaces,designed,constructed & DISPOSAL 58 elite uide dos 1
17 maintained installed located 1 Approved containers,adequate number, 20 NONSMOKING AREAS
39 covered rodent roof clean 1
LBSingle service articles storage,dis ensin 1 Storage areas/rooms,enclosures-properly Seats 75 or more: Nonsmoking area
19 No reuse of single service article 2 40 constructed clean 1 59 provided, sign(s) posted at entrance(s), smok- 3
Dishwashing facilities approved design,ode- Disposed of in an approved manner,at ing area indicated by sign(s).
20 uatol constructed maintained installed located 2 1 approved fro uen 1
DEMERIT SCORE FOLLOW-UP RATING ACTION SIGNED(Inspector) DATE CORRECTIONS DUE
4 3 2 1 ILTOTAL [IYES•1 [3CHANGE c e r t7f fooA� our
ri,JJ e
22V
❑NO-2 ❑DELETE d. SIGNATURE OF PERSON IN CHARGE q.
REMARKS ) ` /4°7C /V t rTj�DM OI? f/`!(iG/�LtJa`� J'
;0(yg- Pants ,ty 'wow► irGt h�a w
DISTRIBUTION: ip-White-Health Department 2nd-glue•Owner/Manager
HEALTH DEPARTMENT
INSPECTION REPORT STATE OF CONNECTICUT TOWN
ROOD SERVICE OTABUSNMBNTS DEPARTMENT OF HEALTH SERVICES .S,GA.,)4A1_d'5_CV1
E143S106 REV.9/93 150 Washington St.,Hartford,CT,06106 OWNER OR OPERATOR
MOUARTERLYMIS/ECTION [3 REIISPECT►ON ❑COMPLAINT ❑MIVESTIGATION ❑OTHER
Based on an Inspection this day,the items marked below identify the violations in operation or facilities which must be corroded by the date specified below.
NAME OF ESTA8U81001EENT STREET ADDRESS 1
NOTICE:All SHADED AREAS ARE FOR OFFICE USE
ONLY-
EST. H.D. I SECT. EST.NO. CHAIN CODE SANIT.CODE YR. MO. DAY TRAVEL TIME NSPECT.TIM
I.D. ! l 1
1 2 9 4 5 6 7 ! 9 10 11 12 13 14 15 16 17118 19 20 21 22 23 24 25 26 27 28
EQUIPMENT AND UTENSILS:
2 SOURCES OF FOOD 7 CLEANLINESS 14 VERMIN CONTROL
1 Approved source wholesome non adulteratetl
W22
1 Proflushod scraped,soaked and racked 1
42 Presence of insects rodents 2
2 Ori final container,properly labeled Wash water clean Proper temperature 1 = Outer openings protected against entrance of
Accurate thermometer provided,dish basket, 43 insects rodents 1
2 if used 1 'B
3 FOOD PROTECTION L4 Sonitization rinse hot water-chemicals 2 15 FLOORS,WALLS, AND CEILINGS
Potentially hazardous food meets temperature Floor,floor covering installed,constructed as
2 Clean wi in cloths 1 x"+ g
requirements during storage,preparation,dis- y;
3 ploy,service,3 trans Ration 4 Food contact surfaces of utensils d equipment ► uirod ood repair,clean 1 r
Adequate facilities to maintain product temper- clean 2 45 Floorsgraded drained as required 1
4 ature thermometers provided 2 Non-food contact surfaces of equipment and ax 46 Floor,wall'uncture covered 1
27 utensils clean I
5 Potentially hazardous food properly thawed 2yi 47 Mats removablegood repair,clean 1
Unwrapped and potentially hazardous food 28 E ui ment utensils storage handling
Exterior walking,driving surfaces.Good repair,
6 not re-sorved 4 _- 8 WATER SUPPLY 48 clean 1
Food protected during storage,preparation, Walls,ceilings,attached equipment,properly
7 display,service and transportation 2 2 Water source adequate,safe 4 constructed,good repair,clean.Wall 3 ceiling '
8 Food containers stored off of the floor 1 Hot and cold water under pressure,provided _, 49 surfaces as required. 1
3 as required 2 Dustless cleaning methods used,cleaning
9 Handlingof food minimized 2 50 a ui inert properly stored
10 Food die ensin utensils properly stored 1 9 SEWAGE DISPOSAL 16 LIGHTING
111 Toxic items Pr000rly stored labeled used 4 31 Sewage dis osal approved E4 _' 51 Adequate li htin provided as required 1
32 Proper disposal of waste water 1 17 VENTILATION
4 PERSONNEL 10 PLUMBING 572 Room tree of steam smoke odors
12 Poronnel with infection restricted 14 331 location installation maintenance 1 Room and equipment hoods,ducts,vented as
CLEANLINESS OF
34 No cross connection back si hone a backflow 4 53 required 1
5 PERSONNEL 11 TOILET FACILITIES 18 DRESSING ROOMS AND LOCKERS
7-7-777
Adequate,convenient,accessible,designed, Rooms adequate,clean,adequate lockers
13 Hand washingfacilities provided 4 35 installed 4 5provided,facilities clean 1
14 Clean outer clothes effective hair restraints 1 36 Toilet rooms enclosed with self-closing door 1 19 HOUSEKEEPING
16 Good hyaienic Practices,smokina restricted 371 Pr sr fixtures Provided.cood repair,clean 1 Establishment and premises free of IiMer,no in 471
-
12 HANDWASHING FACILITIES sects rodents harbors a no unnecessary articles 1
EQUIPMENT& UTENSILS: DESIGN, Suitable hand cleaner and sanitary towels or Complete separation from living/sleeping
6 CONSTRUCTION & INSTALLATION approved hand drying devices provided,tissue, S uarters and laundry1 "
38 waste receptacles provided 1
Food contact surfaces designed,constructed, 57 Clean soiled linens storedproperly1 f
16 maintained installed located 2 13 GARBAGE &RUBBISH STORAGE No live birds,turtles,other animals(except
Non-food contact surf aces,designed,constructed & DISPOSAL 58 police guide dos) 1 .I
17 maintained installed located 1 Approved containers,adequate number, 40 NONSMOKING AREAS
18 Single service articles stores die ensin 1 39 covered rodent proof,clenn 1
Storage areas/rooms,enclosures-properly Seats 75 or more:Nonsmoking area
L91 No re-use of single service article 2 40 constructed clean 1 59 provided, sign(s)posted at entronce(s), smok- 3
Dishwashing facilities approved design,ado- Disposed of in an approved manner,at ing area indicated by sign(s).
20 quately constructed maintained installed located 2 41 aocrovod Ireauency1
DEMERIT SCORE FOLLOW-UP RATING AIDELETE
SIGNED Inspector) DATE CORRECTIONS DUE
4 3 2 ' 1 ' TOTAL QS S/JQJ�.
❑ YES-1 ❑ CCC �Tf/
Z C 3 ❑NO-2 ® 9 ❑ SI=E9 IN CH GE
REMARKS:
, �rrr rills ~
DISTRIBUTION: let-White-Health Department 2nd-Blue-Owner/Manager
HEALTH DEPARTMENT
EHs-1063-Rev.06101 INSPECTION REPORT STATE OF CONNECTICUT 0411!66TINE INSPECTION ❑ REINSPECTION
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ PREOPERATIONAL ❑ OTHER
410 Capitol Avenue,MS#51FDP,Hartford,CT 06134
NAME OF ESTABLISHMENT
ESTABLISHMENT �'yL^�• �� CLASS f1-0—
STREET ",/" TOWN
ADDRESS 6-pt/- �rjeHLt.rt� S G-.,OWNER or
OPERATOR i�ref 'Mtu5 -J' ft fy11�f4� _,'VVr INSPECTION 3let®3 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 Preflushed,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 I used insects/rodents
24 Sanitization rinse(hot water-chemical) 2
FOOD PROTECTION 25 Clean wiping cloths 1 FLOORS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 26 Food-contact surfaces of utensils& 44 Floors:floor covering installed,
temperature requirements during storage, equipment clean constructed as required,good repair,clean
preparation,display,service,and
transportation 27 Nonfood-contact surfaces of utensils& 45 Floors,graded,drained as required 1
equipment clean 46 Floor,wall juncture covered
4 Adequate facilities to maintain product 28 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 29 Water source adequate,safe q 4 49 Walls,ceilings attached,equipment properly
7 Food protected during storage,preparation, 30 Hot and cold water under pressure, 2 constructed,good repair,clean. Wall&ceiling
display,service&transportation 2 provided as required surfaces as required.
8 Food containers stored off floor 50 Dustless cleaning methods used, 1
SEWAGE DISPOSAL I cleaning equipment properly stored
9 Handling of food minimized 2 Sewage disposal approved 410 Food dispensing utensils properly stored 1 [321Proper disposal of waste water 1 LIGHTING&VENTILATION
•11 Toxic items properly stored,labeled,used 4 [53
Adequate lighting provided as required 1
PLUMBING Room free of steam,smoke odors 1
PERSONNEL 33 Location,installation,maintenance 1 Room&equipment hoods,ducts,vented as required
12 1 Personnel with infection restricted 14 34 No cross connection,back siphonage,backflow 4
DRESSING ROOMS&LOCKERS
CLEANLINESS OF PERSONNEL TOILET FACILITIES 54 Rooms adequate,clean,adequate lockers 1
13 Handwashing facilities provided, 4 35 Adequate,convenient,accessible,designed, 4 provided,facilities clean
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 HOUSEKEEPING
55 Establishment and premises free of litter,no 1
EQUIPMENT&UTENSILS: DESIGN, HANDWASHING FACILITIES insect/rodent harborage,no unnecessary articles
CONSTRUCTION&INSTALLATION 38 Suitable hand cleaner and sanitary towels or 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
57 Clean/soiled linens stored properly 1
17 Nonfood-contact surfaces designed, 1 58 1 No live birds,turtles,or other animals 1
constructed,maintained,installed,located GARBAGEIRUBBISH STORAGE&DISPOSAL (except guide dogs)
18 Single service articles,storage,dispensing 2 39 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 F62
Qualified Food Operator 3
4 3 2 1 RISK FACTOR VIOLATIONS IN RED Designated alternate 2
6 3 Written documentation of training program 2
Signa e f Pers ' charge
TOTAL RATING Date Corrections Due
SI. (Inspector)
v��DEES, BE DEFICIENCIE9 ON CONTINUATION SHEETS
Page_of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
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Inspation Form N Remarks:
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INITIAL(INSPECTOR) ) INITIAL(PERSON IN CHARGE)
Distribution: lst-White-Health Department 2nd-Yellow-Owner/Manager
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INSPECTION REPORT STATE OF CONNECTICUT
X=SERVICE ESTANUSHMENTS DEPARTMENT OF HEALTH SERVICES
EHS-106 REV.9/63 ISO Washington St.,Hartford,CT,06106 OWNER OR OPERATOR
�OUARTERLV INSPECTION ❑MINSPECTION ❑COMPIAINT ❑INVES111"I'm ❑OTHER
Based on an inspection this day,the Hems marked below identify the violations in operation or facilities which must be cor►sded by the date specified below.
NAME OF ESTAKMWM W STREET ADDRESS
v r�trss /►L SH /�Gv. 173— 6-
NOTICE:ALL SHADED AREAS ARE FOR OFFICE USE
QNly-
EST. M.D. SECT, I EST.NO. CHAIN CODE SANIT,CODE PsA
(,YR. MO. DAY TRAVEL TIME INS CT..TIM
LD. L Y 61 �
1 2 3 4 5 6 7 S 9 10 11 J13 14 IS 16 17119119 Yj 121 122 23 24 25 26 27 2S
EQUIPMENT AND UTENSILS:
2 SOURCES OF FOOD 7 CLEANLINESS 14 VERMIN CONTROL
1 Assarovod source wholesome non adulterated 4 1 Preflushod scraped,soaked and racked 1
2 Original container, ro labeled 1 42 Presence of insects rodents Jim
2 Wash water clean proper temperature I Outer openings protected against entrance of
Accurate thermometers provided,dish basket, 43 insects'rodents 1
2 if used 1
3 FOOD PROTECTION 24 if used
rinse hot water-chemicals) 2 15 FLOORS, WALLS, AND CEILINGS
Potentially hazardous food meets temperature p Clean wi in cloths 1 Floors;floor covering installed,constructed as
rst wromonts durina storage,preparation,dis- 44 required,good repair,clean 1
3 play.
service,3 trans rtation 4 Food contact surfaces of utensils 3 equipment
clean 2 45 Floors raded drained as required
1
Adequate facilities to maintain product temper. Nonfood contact surfaces of equipment and
4 ature thermomoteeters provided46 Floor,wall'uncturs covered 1
S Potentially hazardous food properly J. 2 utensils clean 1 thawed 2 47 Mats removable good repair,clean. 1
Unwrapped and potentially hazardous food 2 Equipment/utensils storage handling 1
ppe po yExterior walking,driving surfaces.Good repair,
6 not re-servod 4 8 WATER SUPPLY 48 dean 1
Food protected during storage,preparation, Walls,coilings,attached equipment,properly
7 display,service and transportation 2 24 Water source adequate,safe 4 constructed,good repair,clean.Wall ft coiling
8 Food containers stored off of the floor 1 Hot and cold water under pressure,provided 49surfaces as required.
Dustless cleaning methods used,cleaning
as required 2 g g
9 Handling of food minimized 2 501 equipment properly stored 1
10 Food dispensing utensils ro • stored 1 9 SEWAGE DISPOSAL 16 LIGHTING
11 Toxic items properly stored labeled used 4 '° 311 Sewa •disposal approved 4 31 Adeguate lighting rovided as r uired 1
3 Proper disposal of waste water 1 17 VENTILATION
4 PERSONNEL 10 PLUMBING -521 Room tree of steam smoke odors
12 Personnel with infection restricted 4 3 Location installation maintenance 1 Room and equipment hoods,ducts,vented as
CLEANLINESS OF 3 No cross connection back si hone a backflow 4 S required 1
5 . PERSONNEL 11 TOILET FACILITIES
18 DRESSING ROOMS AND LOCKERS
Adequate,convenient,accessible,designed, Rooms adequate,clean,adequate lockers
13 Hand washing facilities provided 4 35 installed 4 provided,facilities clean 1
14 Clean outer clothes effective hair restraints 1 Toilet rooms enclosed with self-closin door 1 19 HOUSEKEEPING
1S Good h ienic radices smokingrestricted 2 Prover fixtures rovided good repair,clean 1 _ Establishment and premises free of litter,no in. -
12 HANDWASHING FACILITIES sech rodents harbors a no unnecessary articles 1
EQUIPMENT dr UTENSILS: DESIGN, Suitable hand cleaner and sanitary towels or Complete separation from living/sleeping
6 CONSTRUCTION&INSTALLATION approved hand drying devices provided,tissue, quarters and laundry1
38 waste rocs tacles rovided 1
Food contact surfaces designed,constructed, 5 Clean soiled linens storedproperly1
16 maintained installed located 2 13 GARBAGE & RUBBISH STORAGE No live birds,turtles,other animals(except
Non-food contact surfaces,designed,constructed DISPOSAL ice guide dogs) 1
17 maintained installed located 1 Approved containers,adequate number, 20 NONSMOKING AREAS
LeSingle service articles store • dis ensin 1 3 covered rodent root clean 1
Storage areas/rooms,enclosures.properly Seats 75 or more:Nonsmoking area
19 No re-use of sin le service article 2 constructed clean 1 59 provided, sign(s)posted at entronce(s),smok- 3
Dishwashing facilities approved design,ado- Disposed of in an approved manner,at ing area indicated by sign(s).
20 not constructed maintained installed located 2 1 a rev fr• uen 1
DEMERIT SCORE OLLOW-UP RATING ACTION SIGNED(Inspector) DATE CORRECTIONS DUE
4 3 2 1 TOTAL f f 0-P A% 'aj
�— ❑YES•1 [3 CHANGE c
[3NO.2 [1 [3DELETE d. RGON 7mlOIN CHAR
REMARKS: fo►�+e �l1C/NaD f4rLa�C`�! It V-0 C!1e "&1 -rv"+ c ry &reels .0.2 all
Coy asKerl n1Ls !� 6 cllwn '-I e.^S. G o¢ "; yer. �7 M?ker c�t�vr tees
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DISTRIBUTION: 1 st-White-Health Department 2nd-Blue-Owner/Manager
NEALTH DEPARTMENT
INSPECTION REPORT STATE OF CONNECTICUT TOWN
FOOD SERVICE OTAIILISHMENTS DEPARTMENT OF HEALTH SERVICES
�;ENyLUARRE 106 V.9/83 150 Washington St.,Hartford,CT,06106 R OR OPERATOR
{SOTERIYRrSPECTION ❑REINSPECTION ❑COMPLAINT ❑gdVESTIGATION ❑OTHER
Bawd on an inspection this day,the items morked below identify the violations in operation or facilities which must be corrected by the date specified below.
NAME OF ESTABLISHMENT STREET ADDRESS
(fy+se Grl6S) Gov_ �Y�.tGv�ty/
NOTICE:All SHADED AREAS ARE FOR OFFICE USE
EST. H.D. SECT. EST.NO. CHAIN CODE Klq SANIT.CODE YR. MO- DAY TRAVEL TIME NSPECT.TIM
I.D.
Mgr v
1 1 2 1 31 4 S 6 71 8 19 110 rl 1 1 12 113 M 14113 116 17 18 19 120 21 22 23 24 23 26 27 28
EQUIPMENT AND UTENSILS:
2 SOURCES OF FOOD 7 CLEANLINESS 14 VERMIN CONTROL
1 roved source wholesome non adulterated 4 1 Preflush•d scraped,soaked and racked 1
2 Original container, ro labeled ) 42 Presence of insects rodents 2
Wash water clean proper temperature 1 Outer openings protected against entrance of
Accurate thermometers provided,dish basket, 43 insects rodents 1
2 if used 1
r.
3 FOOD PROTECTION 24 Sanitization rinse hot water•chemicols 2 15 FLOORS, WALLS, AND CEILINGS
Potentially hazardous food meets temperature 2 Clean wi in cloths 1 Floors;floor covering installed,constructed as
requirements during storage,preparation,dis• 44 Floors;
required,good repair,clean 1
3 play,service,6 transportation 4 Food contact surfaces of utensils&equipment
clean 2 45 Floors rod•d drained as required 1
Adequate facilities to maintain product temper. Nonfood contact surfaces of equipment and
4 oture thermometers provided 246 Floor,wall Puncture covered 1
2 utensils clean 1
5 Potential hazardous food properly thawed 2 47 Mats removable good repair,clean 1
Unwrapped and potentially hazardous food 2 E ui ment utensils storage handling1
PP Po Y Exterior walking,driving surfaces.Good repair,
6 not re-carved 4 8 WATER SUPPLY 48 dean 1
Food protected during storage,preparation, Walls,ceilings,attached equipment,properly
7 display,service and transportation 2 2 Water source adequate,safe 4 constructed,good repair,clean.Wall 6 ceilling
8 Food containers stored off of the floor 1 Hot and cold water under pressure,provided 49 surfaces as required. 1
as required 2 _ Dustless cleaning methods used,cleaning
9 Handling of food minimized 2 SO equipment properly stored 1
10 Food dis onsin utensils properly stored 1 9 SEWAGE DISPOSAL 16 LIGHTING
11 I Toxic items ro nl stored labeled used 4 31 Sewa o disposal approved 4 51 Adequate lightina provided as required Ilia
3 Proper disposal of waste water 1 " 17 VENTILATION
4 PERSONNEL 10 PLUMBING 572 Room tree of steam smoke odor
121 Personnel with infection restricted 4 3A location installation maintenance 1 I Room and equipment hoods,ducts,vented as
CLEANLINESS OF 34 No cross connection back siphon a backflow 4 S3 required 1
S PERSONNEL 11 TOILET FACILITIES
18 DRESSING ROOMS AND LOCKERS
Adequate,convenient,accessible,designed, Rooms adequate,clean,adequate lockers
13 Hand washing facilities provided 4 35 installed 4 5 rovided facilities clean 1
14 Clean outer clothes effective hair restraints 36 Toilet rooms enclosed with self-closina door L 19 HOUSEKEEPING
15 Good hygionic Practices,smoking restricted 2 7 Proper fixtures provided.good re air,clean 1 Establishment and premises free of litter,no in-
12 HANDWASHING FACILITIES sects rodents harbors a no unnecessary articles 1
EQUIPMENT&UTENSILS: DESIGN, Suitable hand cleaner and sanitary towels or Complete separation from living/sleeping
38
6 CONSTRUCTION &INSTALLATION approved hand drying devices provided,tissue, uarters and lound 1
waste receptacles provided 1
Food contact surfaces designed,constructed, 5 Clean soiled linens storedproperly1
16 maintained installed located 2 13 GARBAGE & RUBBISH STORAGE No live birds,turtles,other animals(except
Non-food contact surfoces,designed,construded DISPOSAL 58 police cuide dos) 1
17 maintained installed located 1 Approved containers,adequate number, 40 NONSMOKING AREAS
18 Sin le service articles store • dispensing 1 39 covered rodent proof,clean 1
Storage areas/rooms,enclosures-properly Seats 75 or more:Nonsmokin area
19 No reuse of sin le service article 2 constructed clean 1 59 0
provided, sign(s)posted at entrance(s), smoke 3
Dishwashing facilities approved design,ade- Disposed of in an approved manner,at ing area indicated by sign(s).
20quately constructed maintained installed Ioeoted 2 1 rov fnauencv 1
DEMERIT SCOREFOLLOW-UP RATING ACTION SIGNED(Inspoctor) DATE CORRECTIONS DUE
4 3 2 1 TOTAL ❑YES-1 ufsD Ok �f
❑CHANGE c
` /It ❑NO.2 a ❑DELETE d. SON IN C RGE
7 a,
)yF
REMARKS:
tt-�I e�' E&d cL �Jt D c�ve� Oh r/dog K cif u�i� —1 ti
DISTRIBUTION: 1st-White-Health Department 2nd-Blue-Owner/Manager
NEALTN DEPARTMENT
INSPECTION REPORT STATE OF CONNECTICUT TOWN
FOOD SERVICE ISTABUSHMENTS DEPARTMENT OF HEALTH SERVICES
EHS--106 REV.9/83 150 Washington St.,Hartford,CT,06106 OWNER OR OPERATOR
M11U RTERLYINSMCiION ❑REINSPECIION ❑COMPLAWT ❑INVESTIGATION ❑OTHER
Based on an inspection this day,the items marked below identify the violations in operation or facilities which must be corroded by the date specified below.
NAME OF ESTABLISHMENT STREET ADDRESS
NOTICE:ALL SHADED AREAS ARE FOR OFFICE USE
EST. H.D. SECT. I EST. YR. I MO. DAY TRAVEL TIME NSPECT.TIM
LD. O 1 Ad j,
1 2 3 4 6 5 71 8 19 110 11 12 13 14 15 16 17118 119 120 121 1 22 23 24 25 26 27 28
EQUIPMENT AND UTENSILS:
2 SOURCES OF FOOD 7 CLEANLINESS 14 VERMIN CONTROL
1 Approved source wholesome non adulterated 4 - 1 Preflushed scraped,soaked and racked 1
42 Presence of inseds rodents 2
2 Original container,properly labeled 1 22 Wash water clean Proper temperature 1 =3 Outer openings protected against entrance of
Accurate thermometers provided,dish basket,
4323 if used 1 inseds rodents 1
3 FOOD PROTECTION 24 Sanitization rinse hot water-chemicals 2 ' 15 FLOORS, WALLS, AND CEILINGS
Potentially hazardous food meets temperature 25 Clean wi in cloths ) Floors,floor covering installed,constructed as
requirements during storage,preparation,dis-
3play,service,NL trans rtatton 4 Food contact surfaces of utensils 6 equipment 44 required,good repair,clean 1
Adequate facilities to maintain product temper-
clean 2 45 Floorsgraded drained as required i '"o#;
4 ature thermometer provided 2 Non-food contact surfaces of equipment and x 27 utensils clean 46 Floor,wall juncture covered
5 Potential) hazardous food properly thawed 2 ;_ ) 47 Mats removable good repair,clean 1
Unwrapped and potentially hazardous food N 2 E ui merit utensils store a handlina
1 Exterior walking,driving surfaces.Good repair,
6 not re-served 4 8 WATER SUPPLY 48 clean 1 = ;
Food protected during storage,preparation, Walls,ceilings,attached equipment,properly
7 display,service and transportation 2 - 2 Water source adequate,safe 14 constructed,good repair,clean.Wall 3 ceiling
8 Food containers stored off of the floor ) Hot and cold water under pressure,provided 49 surfaces as required. 1
as required 2 " Dustless cleaning methods used,cleaning
9 Handling of food minimized 2 50 equipment properly stored 1 �
10 Food dispensing utensils properly stored ) 9 SEWAGE DISPOSAL 16 LIGHTING
11 Toxic items Properly stored labeled used 4 311 Sewage disposal approved 4 51 Ads uate lighting rovided as required 1 `
32 Proper disposal of waste water 1 17 VENTILATION
.¢
4 PERSONNEL 10 PLUMBING Room tree of steam smoke odors
12 Peronnel with infection restricted 14 331 location installation maintenance i Room and equipment hoods,duds,vented as
s4 )
CLEANLINESS OF 34 No crass connection back si hone a 53 required backflow 4 '�' 18 DRESSING ROOMS AND LOCKERS
5 PERSONNEL 11 TOILET FACILITIES
Adequate,convenient,accessible,designed, Rooms adequate,clean,adequate lockers
13 Hand washing facilities provided 4 35 installed 4fik 54 provided,facilities clean 1 "
14 Clean outer clothes effective hair restraints 1 R 36 Toilet rooms enclosed with self-closina door ) 19 HOUSEKEEPING
15 Good hy ionic Practices,smoking restricted 2 371 Proper fixtures Provided,cood repair,clean 1 .ww-v` Establishment and premises free of litter,no in.
12 HANDWASHING FACILITIES sects rodents harbors a no unnecessary articles 1
EQUIPMENT 8 UTENSILS: DESIGN, Suitable hand cleaner and sanitary towels or Completeorte separation from living/sleeping `
6 CONSTRUCTION & INSTALLATION approved hand drying devices provided,tissue, 56 urs and laundry1
38 waste receptacles provided i
571 Clean soiled linens stored properly1
Food contact surfaces designed,constructed, 13 GARBAGE & RUBBISH STORAGE No live birds,turtles,other animals(except
16 maintained installed located 2 ( P
Non-food contact surf oces,designed,construded DISPOSAL 58 olice uide dos i s
17 maintained installed located 1 Approved containers,adequate number, 20 NONSMOKING AREAS
18 Single service articles stores dispensing 1 39 covered rodent proof,denn i
Storage areas/rooms,enclosures-properly
Seats 75 or more:Nonsmoking area
19 No re-use of single service article 2 40 constructed clean 1 59 provided, sign(s)posted at entronce(s), smok- 3
Dishwashing facilities approved design,ado- Disposed of in an approved manner,at ing area indicated by sign(s).
2Oquately constructed maintained installed located 2 1 a roved fro uen 1
DEMERIT SCORE FOLLOW-UP RATING ACTION SIGNED(Inspect DATE CORRECTIONS DUE
4 3 2 1 TOTAL - c
❑YES-1 ❑ CHANGE c
❑NO.2 1 Q v [2 DELETE d. E PE IN CMAQqE
REMARKS:
DISTRIBUTION: 1st-White-Health Department 2nd-Blue-Owner/Manager
HEALTH DEPARTMENT