HomeMy WebLinkAboutFood Service Establishment Inspection 75 (2) INSPECTION REPORT STATE OF CONNECTICUT TOWN
P000 SBRV110 OTABUSHMINTS DEPARTMENT OF HEALTH SERVICES
EI43•106 REV.9/83 150 Washington St.,Hartford,CT,06106 OWNER OR OPERATOR
M-WMIERLY INSPECTION ❑REINSPECTION ❑COMPLAINT ❑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
d
NOTICE:ALL SHADED AREAS ARE FOR OFFICE USE
EST. H.D. SECT. EST.NO. CHAIN CODE SANIT.CODE YR. MO. DAY TRAVEL TIME NSPECT.TIM
I.D. I I I I I I I I I I mg- r C) 7— v
1 1 2 1 31 41 31 61 71 8 19 10 11 12 13 14115 116 KA 17118 1191 120 121 122 23 24 23 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 Ori inal container,Properly labeled 1 '' 2 Wash water clean proper temperature 1 Outer openings protected against entrance of
Accurate thermometers provided,dish basket, 1
2 if used 1 43 insects rodents
3 FOOD PROTECTION 2 Sanitization rinse hot water-chemicals) 2 15 FLOORS, WALLS, AND CEILINGS
Potentially hazardous food meets temperature 251 Clean wipina cloths 1 Floors,floor covering installed,constructed as I
requirements during storage,preparation,dis-
play, 44 n ulna ood repair,clean 1
3 service,3 transportation 4 Food contact surfaces of utensils A equipment
Adequate facilities to maintain product temper- clean v 45 Floor graded drained as required 1 , ?
4 stun thermometers provided 2 Non-food contact surfaces of equipment and 46 ploor,wall'unduro covered
2 utensils clean °" '
5 Potentially hazardous food prope thawed 2 28 E 47 Mats removable repair,air clean 1 ;
Unwrapped and potentially hazardous food ui ment utensils store a handlin 1 Exterior walking,driving surfaces.Good repair,
6 not reserved 4 8 WATER SUPPLY 48 clean 1
Food protected during storage,preparation, s,ceilings,attached equipment,properly `
7 display,service and transportation 2 2 Water source adequate,safe 4 conWallstructed,good repair,clean.Wall&ceiling
8 Food containers stored off of the floor 1 Hot and cold water under pressure,provided 49 surfaces as required.
3 as required p Dustless cleaning methods used,cleaning
9 Handlingof food minimized 2 , 50 a ui ment ro erl stored 1
10 Food dis ensin utensils properly stored 1 9 SEWAGE DISPOSAL 16 LIGHTING
11 Toxic items Properly stored labeled used 4 31 Sewage disposal approved 4 litinrovided
32 Proper disposal of waste wafer 51 as required 1
17 VENTILATION
4 PERSONNEL 10 PLUMBING
52rR.r tree of steam smoke odors
12 Personnel with infection restricted 14 A location installation maintenance 1 Room and equipment hoods,duds,vented as
CLEANLINESS OF 3 No cross connection back siphon 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 washin facilities provided 4 35 installed 4 54 rovided facilities clean 1 -
14 Clean outer clothes effective hair restraints 1 36 Toilet rooms enclosed with self-closina door 1 19 HOUSEKEEPING
15 Good hygionic practices,smokins restricted 2 7 Proper fixtures rovided ood 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 8 INSTALLATION approved hand drying devices provided,tissue, 5 uarters and Leona 1
38 waste rocs tacles provided
Food contact surfaces designed,constructed, 57 Clean soiled linens stored properly 1
Pl
16 maintained installed located 2 13 GARBAGE & RUBBISH STORAGE No live birds,turtles,other animals(except
Non-food contact surfaces,designed,constructed DISPOSAL 58 police guide dos) 1
17 maintained installed located 1 Approved containers,adequate number, 20 NONSMOKING AREAS
18 Single service articles storage,dispensing 1 39 covered rodent proof,clean 1
Storage areas/rooms,enclosures-properly 1 59 Seats 75 or more:Nonsmoking area :
19 No n•use of sin le service article 2 40 constructed clean provided, signs)posted at entrance(s), amok• 3
Dishwashing facilities approved design,ade• Disposed of in an approved manner,at ing area indicated by sign(s).
20 uatel constructed maintained installed located 2 1 approved f►s uen 1
DEMERIT SCORE FOLLOW-UP RATING ACTIOId.
SIGNED(Inspedor) DATECORRECTIONS DUE
4 3 2� 1 �` TOTAL yE5.1 fbAt
❑ CHANGE
❑NO-2 .1 C� ❑DELESIGNATURE NCJ ( c
REMARIfs: c�c1_C� 'f fir! Loc1p^ tXl�!!1 #Y� Cls*t •u czfi .S>at w QpC41
Y3 (3"40-&rs1 a Y (V ---- I%vyo&Med XN7 &
A,ud J1 Jt •f 0to"r ®hC 144411 - [A ea0 a^t4 •7Gcikaf
1 cJeur 5 ao .7 Y n � iN!f 7-F.•
DISTRIBUTION: 1st•White•Health Department 2nd•Blue•Owner/Manager
HEALTH DEPARTMENT
INSPECTION REPORT STATE OF CONNECTICUT TOWN
PROD SERVICE ESTABLISHMENTS DEPARTMENT OF HEALTH SERVICES t-/_
[115-106 REV.9/83 150 Washington St.,Hartford,CT,06106 WNER OR OPERATOR
ff UQWTEKVINSPECTION ❑NINSPECTION ❑COMPLARVT ❑INVESTIGATION ❑OTHER
Bawd on an inspection this day,the hems marked below identify the violations in operation or facilities which must be corrected by the date specified below.
NAME OF ESTAIWSHMENT STREET ADDRESS
w , ll u
NOTICE:All SHADED AREAS ARE FOR OFFICE USE
EST. N.D. SECT. EST.NO. CHAIN CODE SANIT.CODE r4 YR. MO DAY TRAVEL TIME NSPECT.Tim
I.D. I I I I I I I I q I it 6 O
1 1 2 1 31 41 51 61 71 8 19 10 11 .12 13 14 15 16 17 18 19- 20 121 122 23 24 25 26 27 28
EQUIPMENT AND UTENSILS:
2 SOURCES OF FOOD 7 CLEANLINESS 14 VERMIN CONTROL
1 Approved source wholesome,non adulterated 14 11 Preflushed scraped,soaked and racked 1
2 1 Original container,properly labeled I 42" Presence of insects rodents 2
2 Wash water dean proper temperature I Outer openings protected against entrance o4
Accurate thermometers provided,dish basket, 43 insects'rodents 1
23 if used 1 N
3 FOOD PROTECTION 24 Sanitizat;on rinse hot water-chemicals) 2 'wr 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,die- a Food contact surfaces of utensils 3 equipment 44 re uired good repair,clean 1 {
3 play,service,&transportation 4
Adequate facilities
clean 3�. 45 Floors graded drained as requiredfacilities to maintain product temper- Nonfood contact surfaces of equipment and 4 ature thermometers provided46 Floor,wall'unsure covered 1
2 utensils clean I
S Potential hazardous food properly thawed 2 47 Mats removable good repair,dean 1
Unwrapped and potentially hazardous food 2 Equipment/utensils storage handling1
6 not r appedd P y 4 Exterior walking,driving surfaces.Good repair,
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.
as required 2 Dustless cleaning methods used,cleaning
9 Handlin of food minimized 2 50 equipment properly stored i
10 Food dispensing utensils properly:toed 1
9 SEWAGE DISPOSAL 16 LIGHTING
11 Toxic items Properly pored labeled used 4 31 Sewa •ells osal approved 4
51 Adequate lightina provided as re uired 1
A Proper disposal of waste water 1 ' 17 VENTILATION
4 PERSONNEL 10 PLUMBING
Room tree of steam smoke odors
121 Personnel with infection restricted 4 34 location installation maintenance 1 '` - Room and equipment hoods,ducts,vented as
CLEANLINESS OF
34 No cross connection back si hone a backflow 4' .:_`' 33 required 1
S PERSONNEL 11 TOILET FACILITIES
18 DRESSING ROOMS AND LOCKERS
Adequate,convenient,accessible,designed, ,_ Rooms adequate,clean,adequate lockers
13 Hand washin facilities rovided 4 35 installed g 4 ';' 3 provided facilities clean 1
14 Cloan outer clothes effective hair restraints i Toilet rooms enclosed with self-closin door 1 -,X 19 HOUSEKEEPING
13 Good hygienic practices,smoking restricted 2 = " 7 Proper fixtures Provided.good re air clean _L Establishment and premises free of litter,no in.
12 HANDWASHING FACILITIES sects rodents harbors s no unnecessary articles 1
EQUIPMENT&UTENSILS: DESIGN, Suitable hand cleaner and sanitary towels or §=g Complete separation from living/sleeping
6 CONSTRUCTION&INSTALLATION approved hand drying devices provided,tissue 5 uarters and lound 1
38 waste receptacles provided .
Food contact surfaces designed,constructed, 37 Clean soiled linens stored properly1
16 maintained installed located 2 13 GARBAGE & RUBBISH STORAGE No live birds,turtles,other animals(except
Non-food contact surfaces,designed,constructed
& DISPOSAL 58 police guide dos I _ s
17 maintained installed located 1 Approved containers,adequate number, 20 NONSMOKING AREAS
39 covered rodent roof,clean 1
18 Single service articles storage,dis eosin 1 Storage areas/rooms,enclosures-properly °` :
191 No reuse of single service article 2 Seats 75 or more:Nonsmoking area z
40 constructed clean 1 _i 59
w provided, sign(s)posted at entronce(s), amok. 3
Dishwashing facilities approved design,ade- Disposed of in an approved manner,at I t,r ;ng area indicated by sign(s).
20 uat• constructed maintained installed located 2 a 1 rev d f►• u•n 1 _
DEMERIT SCORE OLLOWUP RATING ACTION SIGNED(Inspedor) DATE CORRECTIONS QUE
4 3 2 1 TOTAL ,4J
3 ❑YES•1 ❑CHANGE
6 ❑NO-2 6 2 ❑DELETE d. 'N PE`SON IN E
f7( redo
REMARKS: %7— C&e'61 r✓n rrl'ia� rn y rene "yg r At ce t i c kf
C&C11 Xv L-e 4&40-[( aP1'?AX c jrrw rG "f�`f os t.tlr 4 esl do d aIL Lktcrad r tbo L �-
1-6ss ts, Oy v'e f^ rs .G, F0- as-0C_14-� Re f 're&*'f jW k0J
a 5Co F 07 9 a I•u r A,r9 Coverer At& W00% ro wet
irk e05
DISTRIBUTION: 1st-White-Health Department 2nd-Blue-Owner/Manager
HEALTH DEPARTMENT
INSPECTION REPORT STATE OF CONNEMUT TOWN
FOOD S=VICE STARLISMM4tITS DEPARTMENT OF HEALTH SERVICES ,$,-Gt�I'ut Sv•'
EW106 REV.9/83 150 Washington St.,Hartford,CT,06106 OWNER OR OPERATOR
0-OUARTERIYMISNCWN ❑NINSIECTION ❑COMMAINT ❑WVESIPGADON ❑OTHER
Based on an inspedlon this day,the items marked below identify the violations in operation or facilities which must be corroded by the date specified below.
NAME OF ESTABUSHMENT STREET ADDRESS
NOTICE:All SHADED AREAS ARE FOR OFFICE USEQNLY
EST. H.D. SECT. EST.NO. CHAIN CODE Vn SANIT.CODE r,,q YR. I MO. DAY TRAVEL TIME NSPECT.TIM
LD. Z Dt/ /
1 2 3 4 S b 7 8 9 10914112 13 14 15 16 17118119- 2i 21 22 -23 2d 25 26 27 28
EQUIPMENT AND UTENSILS:
2 SOURCES OF FOOD [.2L3
CLEANLINESS 14 VERMIN CONTROL
1 roved sours wholesome non adulterated 4 Preflushed scraped,soaked and racked 1 F
2 Ori inal container, ►o r labeled 1 42' Presence of insects rodents 2 ;
Wash water clean proper temperature _ 1 Outer openings protected against entrance of
Accurate thermometers provided,dish basket, y 43 insects rodents 1
3 FOOD PROTECTIONif used 1
Sonitization rinse hot wator•chemicals 2 s I S FLOORS, WALLS, AND CEILINGS
Potentially hazardous food meets temperature 2 Clean wi in clotfis 1 Floors;floor covering installed,constructed as
requirements during storage,preparation,die- Food contact surfaces of utensils 3 equipment ` 44 required,good repair,clean 1
11
3 play,service,d transportation 4
clean `
Adequate facilities to maintain product tomper- 2 4S Floors redact drained as required 1
4 oture thermometers y Non-food contact surfaces of equipment and Y 46 Floor wall'unsure covered 1
2 utensils clean 1 3
5 Potentially hazardous food properly thawed 2 5t 47 Mats removablegood repair,clean 1
Unwrapped and potentially hazardous food 2 E ui moot utensils store a hondl;n 1 Exterior walking,driving surfaces.Good repair,
6 not re-served 4 8 WATER SUPPLY 48 clean 1
Food protedod during storage,preparation, Walk,coilings,attached equipment properly r
7 display,service and transportation 2 2 Water source ads uate safe 4 `= constructed,good repair,clean.Wall 3 ceiling
Hot and cold water under ressure,provided
7 49 surfaces as re uired. 1
8 food containers stored off of the floor 1 P p �,,,
as required 2 ;•_ Dustless cleaning methods used,cleaning
9 Handling of food minimized 2 n. SO a ui ment properly stored 1
10 Food dispensing utensils properly stored 1 .' 9 SEWAGE DISPOSAL 16 LIGHTING
11 Toxic items oroporly stored labeled used 4 31 Sewa •die sol approved 4 51 Adequate lighting rovided as required 1
321 Proper disposal of waste water 1 17 VENTILATION
4 PERSONNEL 10 PLUMBING52 Room the of steam smoke odors
121 Personnel with infection restricted 4 34 location installation maintenance 1 '='k Room and equipment hoods,duds,vented as
CLEANLINESS OF 34 No cross connection back si hone a backflow 4
>' 531required 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 provided,facilities clean 1 `
14 Clean outer clothes effective hair restraints 1 Toilet rooms enclosed with self•closin door 1 " 19 HOUSEKEEPING
15 Good hygienic practices,smoking restricted 2 37 Proper fixtures Provided.nood repair.clean 1 Establishment and premises free of litter,no in.
12 HANDWASHING FACILITIES secs rodents harbors s no unnecessary articles 1
EQUIPMENT 8r UTENSILS: DESIGN, Suitable hand cleaner and sanitary towels or Complete separation from living/sleeping
6 CONSTRUCTION A INSTALLATION aPProved hand drying devices provided,tissue ;, 56 quarters and lcwndry1 -
38 waste receptacles provided 1 s
Food contact surfaces designed,constructed, 57 Clean soiled linens stored properly1
13 GARBAGE& RUBBISH STORAGE No live birds,turtles,other animals(except
4
16 maintained installed located 2 ( p
Non-food contact surfaces,designed,constructed & DISPOSAL 58 police ouide dos 1
17 maintained installed located 1 Approved containers,adequate number, ~F 20 NONSMOKING AREAS
39 covered rodent proof,clean 1 -v--
lO Single service articles stora 411 dispensing1 Storage areas/rooms,enclosures•properly
19 No reuse of sin le service article 2 constructed clean 1 59 Seats 75 or more:Nonsmoking area
provided, signs) posted at entrance(s), smok- 3
Dishwashing facilities approved design,ode- Disposed of in an approved manner,of ;ng area indicated by s;gn(s). — } +
20 uat constructed maintained installed located 2 1 a rove fr Pauencv1 ;
DEMERIT SCORE FOLLOW-UP RATING ACTION SIGNED(Inspector) DATE CORRECTIONS DUE
1 3 2 1 TOTAL At.f /jr lob/q e:tf
❑YES-1 ❑CHANGE c �jfj
2 L/ [3NO.2 O (A / ❑DELETE d. 'NAT RE SON IN CM E
REMARKS: �..'� W� /y /
7— Cvr,'r lbc�rrSc s u lr NrsTP�c f !��
f14 NCI X ry r�c%1
ce-44/,C 6—
DISTRIBUTION: 1 st-White-Health Department 2nd-Blue-Owner/Manager
HEALTH DEPARTMENT
INSPECTION REPORT STATE OF CONNECTICUT TOWN
FOOD SOW"INTAI ISHM ANTS DEPARTMENT OF HEALTH SERVICES rrLA_) &,,&Ot-
INS.106 REV.9/93 150 Washington St.,Hartford,CT,06106 OWNER OR OPERATOR
0-a l"TERLY104PECTION ❑MiNSPECTM ❑COMMARrT ❑INVESTIGATION ❑OTHER
load 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 ESTAWSHMENT STREET ADDRESS
�Q U^, ^l1 t
ILV-
NOTICE:ALL SHADED AREAS ARE FOR OFFICE USE
EST. M.D. SECT, EST.NO. CHAIN CODE SANIT.CODE YR. MO I DAY TRAVEL TIME NSPECT.Tim
I.D. d
1 1 2 1 3 1 41 -5 61 71 S 19 10 11 12 13 14 15 16 l7 15 19 hi 121 22 23 24 25 26 27 26
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
2 Origin container,pro r labeled ) 47 Presence of insects'rodenh 2
Wash water c can proper tent erasure 1 1 Outer openings protected against entrance of
Accurate thermometers provided,dish basket, 43 insects'rodents 1
3 FOOD PROTECTION 2 if used 1
15 FLOORS, WALLS, AND CEILINGS
24 Sanitization rime hot water-chemicals) 2
Potentially hazardous food meets temperature 2 Clean wi in cloths ) Floors;floor covering installed,constructed as
requirements during storage,preparation,die- food contact surfaces of utensils d equipment re wired mood repair,clean t
3 play,service,8 transportation 4
Adequate facilities to maintain product temper- clean 45 Floors redact drained as required 1
4 ature thermometers provided Non-food contact surfaces of equipment and 46 Floor,wolf Puncture covered 1
2 utensils clean ,
S Potential hazardous food properly thawed 2 47 Mats removable good repair,clean 1
Unwrapped and potentially hazardous food 2 Equipment/utensils store a handlin ) Exterior walking,driving surfaces.Good repair,
6 not re-served 4 8 WATER SUPPLY 48 clean 1
Food protected during storage,preparation, Walls,csiling:,ottoched equipment,properl�
7 display,service and transportation 2 Water source ade vats safe 4 constructed,good repair,clean.Wall L esi ing
8 Food containers stored off of the floor 1 Hot and cold water under pressure, provides ; 49 surfaces as re wired.
Dustless cleaning methods used,cleaning
as required 2 g g
9 Handling of food minimized 2 50 equipment properly stored 1
10 Food dispensing utensils properly stored1 9 SEWAGE DISPOSAL 16 LIGHTING
11 Toxic items ro erl storod labeled used 4 .,:i 31 Sewo a disposal approved 14 S1 Adequate lighting provided as ris uirod 1
3 Proper disposal of waste water 1 1 VENTILATION
4 PERSONNEL 10 PLUMBING572 Room tree of steam smoke odors
121 Personnel with infection restricted 4 A location installation maintenance 1 'T Room and equipment hoods,duds,vented as
CLEANLINESS OF
34 No cross connection back siphon a backffaw 41., S3 required 1 <
S PERSONNEL 11 TOILET FACILITIES
18 DRESSING ROOMS AND LOCKERS
Adequate,convenient,accessible,designed, `* Rooms adequate,clean,adequate lockers
q g r.:':
13 Hand washin facilities provided 4 35 installed 4 5 rovided facilities clean 1
14 Clean outer clothes effective hair restraints 1 Toilet roams enclosed with self•closin door 1 °n_. 19 HOUSEKEEPING
1S Good hygienic Practices,smoking restricted 2 7 Procigir fixtures arovidaid,good re air clean 1 Establishment and premises free of litter,no in.12 HANDWASHING FACILITIES sects rodents harbors a no unnecesso articles 1
EQUIPMENT dr UTENSILS: DESIGN, Suitable hand cleaner and sanitarytowels or
6 CONSTRUCTION & INSTALLATION Complete separation from living/sloe m
approved hand drying devices provided,tissue S uorters and laundryP g 1 ''
38 waste rote tacles provided
Food contact surfaces designed,constructed, 37 Clean soiled linens stored properly1
16 maintained installed located 2 13 GARBAGE & RUBBISH STORAGE No live birds,turtles,other onimols(except
Non-food contact surf aces,designed,construded 8 DISPOSAL 58 ol)ce vide dos) 1
17 maintained installed located 1 Approved containers,adequate number, 20 NONSMOKING AREAS
18 Single service articles stora a dispensing 1 39 covered rodent proof,clean 1
Storage areas/rooms,enclosures•properly
Seats 75 or more:Nonsmoking area
191 No re-uso of single service article 2 40 constructed clean 1 M: S9 provided, sign(s)posted at entrance(s), amok-
3 ��
Dishwashing facilities approved design,ad*- Disposed of in an approved manner,at ing area indicated by sign(s). .
20quately constructed maintained installed located 2 1 acoraved froauencv1
DEMERIT SCORE FOLLOW-UP RATING ACTION SIGNED(Inspector) D/iT�O�RECTIO►JS DUE
4 3 2*„/f 1 TOTAL CE 3a�!? @f
/(✓//f,'� 2 ❑YES-1 ❑CHANGE c
^ ❑NO-2 ❑DELETE d. SIGNATURE I CHARGE
O[ c
REMARRs: 1 Chun xkikD y»l Y�' 5/9—R -C� revs l c >±ak Ih J 41Z. t"1tCtlr�lr�
40'�"t� 2 i1A kz ded
DISTRIBUTION: 1st-White-Health Department 2nd-Blue-Owner/Manager
HEALTH DEPARTMENT
INSPECTION REPORT Town Of South Windsor Date of Inspection
FOOD SERVICE ESTABLISHMENTS HEALTH DEPARTMENT
Time 2—
QUARTERLY INSPECTION ❑ REINSPECTION Owner o�ctwe
NAME OF ESTABLISHMENT STREET ADDRESS Licensee
Fll - Person Seen
Based on an inspect on this day, the items marked below identify the violations in operation or facilities which must be corrected by the date specified below
2. SOURCES OF FOOD 1. EQUIPMENT AND UTENSILS:CLEANLINESS 14. VERMIN CONTROL
1 Approved source,wholesome,non adulterated 4 21 Preflushed,scraped,soaked and racked 1 42 Presence of insects/rodents 2
2 Original container,properly labeled 1 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of
23 Accurate thermometers provided,dish basket,if used 1 insects/rodents 1
3. FOOD PROTECTION 24 Sanitization rinse(hot water—chemical) 2
25 Clean wiping cloths 1 15. FLOORS, WALLS, AND CEILINGS
3 Potentially hazardous food meets temperature 26 Food contact surfaces of utensils and equipment clean 2 —
requirements during storage,preparation,display, 27 Non-food contact surfaces of equipment and utensils 44 Floors:floor covering installed,constructed asrequued,
service,&transportation 4 clean good repair,clean i
4 Adequate facilities to maintain product temperature, 28 Equipment/utensils,storage handling 1 45 Floors,graded,drained as required i
thermometers provided 1 46 Floor,wall juncture covered 1
5 Potentially hazardous food properly thawed 2 8. WATER SUPPLY 47 Mats removable,good repair,clean 1
6 Unwrapped and potentially hazardous food not re-served 4 48 Exterior walking,driving surfaces.Good repair,clean 1
7 Food protected during storage,preparation,display, 29 Water source:adequate,sale 4
49 Walls,ceilings.attached equipment:properly
service,and transportation 2 30 Hct and cold water under pressure,providedasrequired 2 constructed,good repair,clean.Wall and ceiling
8 food containers stored off of the floor 1 surfaces as required 1
9 Handling of food minimized 2 9. SEWAGE DISPOSAL 50 Dustless cleaning methods used,cleaning equipment
properly stored i
10 Food dispensing utensils properly stored 1 31 Sewage disposal approved 4
11 Toxic items properly stored,labeled,used 4 32 Proper disposal of waste water 1 16. LIGHTING
4. PERSONNEL 10. PLUMBING
51 Adequate lighting provided as required I 1
33 Location,installation,maintenance 1
12 Personnel with infection restricted 4 34 No cross connection,back siphonage,backflow 4 17. VENTILATION
5. CLEANLINESS OF PERSONNEL 11. TOILET FACILITIES 52 Room free of steam,smoke odors 1
35 Adequate,convenient,accessible,designed,installed 4 53 Room and equipment-hoods,ducts vented as required 1
13 and washing facilities provided 4 36 Toilet rooms enclosed with self-closing door 1
14 Clean outer clothes.effective hair restraints 37 Proper fixtures provided,good repair,clean i 18. DRESSING ROOMS AND LOCKERS
15 Good hygienic practices,smoking restricted 2 12. HANDWASHING FACILITIES
54 Rooms adequate,clean,adequate lockers provided
6. EQUIPMENT AND UTENSILS:DESIGN, 38 Suitable hand cleanerand sanitary towels or approved facilities clean 1
CONSTRUCTION AND INSTALLATION hand drying devices provided,tissue,waste i
receptacles provided. i
19. HOUSEKEEPING
16 Food contact surfaces:designed,constructed, 13. GARBAGE AND RUBBISH STORAGE
maintained,installed,located 2 &DISPOSAL 55 Establishment and premises free of litter,no insect/
17 Non-food contact surfaces:designed,constructed, 39 Approved containers,adequate number,covered, rodent harborage,no unnecessary articles I
maintained.installed,located 1
rodent proof,clean 1 56 Complete separation from living/sleeping quarters
18 Single service articles:storage,dispensing 1 and laundry 1
40 Storage areas/rooms,enclosures—properly
19 No re-use of single service article 2 constructed clean 1 51 Clean/soiled linens stored properly i
20 Dishwashing facilities:approved design,adequately 41 Disposed of in an approved manner,at approved 58 No live birds,turtles,other animals(except.
constructed,maintained,installed,located 2 frequency 1 police guide dogs) 1
DEMERIT SCORE RATING SIGNED(Certified Officer) DATE CORRECTIONS DUE SIGNATURE OF PERSON
4�— �2k1 TOTAL / !L B1SInterviewed
43
Z q 9
REMARKS
l -44v-- 0,i/
SWHD 2/79 EHFS1
INSPECTION REPORT Town of South Windsor Date of Inspesfian
FOOD SERVICE ESTABLISHMENTS HEALTH DEPARTMENT
Time Z 0)
Ownera„�,Ic
T QUARTERLY INSPECTION ❑ REINSPECTION
NAME OF ESTABLISHMENT STREET ADDRESS LFCenSee
QL"-' 7J— ! j Person Seen
Based on an inspection Mis day, the items marked below identify the violations in operation or facilities which must be corrected by the date specified below
2. SOURCES OF FOOD 7. EQUIPMENT AND UTENSILS: 14. VERMIN CONTROL
CLEANLINESS
1 Approved source,wholesome,non adulterated 4 21 Preflushed,scraped,soaked and racked 1 42 Presence of insects/rodents 2
2 Original container,properly labeled 1 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of
23 Accurate thermometers provided,dish basket,if used 1 insects/rodents
3. FOOD PROTECTION 24 Sanitization rinse(hot water—chemical) 2
_ 25 Clean wiping cloths 1 15. FLOORS, WALLS, AND CEILINGS
3 Potentially hazardous food meets temperature 26 Food contact surfaces of utensils and equipment clean
requirements during storage,preparation,display, 27 Non-food contact surfaces of equipment and utensils
44 Floors:floorcovennginstalled,constructedasrr.quued,
service,&transportation 4 clean I good repair,clean 1
4 Adequate facilities to maintain product temperature, 28 Equipment/utensils,storage handling 45 floors,graded,drained as required 1
thermometers provided 2 46 Floor,wall juncture covered 1
5 Potentially hazardous food properly thawed 2 8. WATER SUPPLY 47 Mats removable,good repair,clean 1
6 Unwrapped and potentially hazardous food notre-served 4 48 Exterior walking,driving surfaces.Good repair,clean 1
7 Food protected during storage,preparation,display, 29 Water source:adequate,safe 4
t g p p30 Hctandcoldwaterunder r 49 Walls,ceilings,attached equipment properly
service,and transportation 2 pressure, 2 constructed,good repair,clean.Wall and ceiling
8 Food containers stored off of the floor 1 surfaces as required 1
9. SEWAGE DISPOSAL 50 Dustless cleaning methods used,cleaning equipment
iment
9 Handling of food minimized 2 g g q f
properly stored 1
10 Food dispensing utensils properly stored 1 T32Proper
wage disposal approved 4
11 Toxic items properly stored,labeled,used 4 disposal of waste water 1 16. LIGHTING
4. PERSONNEL 10. PLUMBING
51 Adequate Fighting provided as required I 1
33 Location,installation,maintenance 1
12 1 Personnel with infection restricted 4 34 No cross connection,back siphonage,backflow 4 17. VENTILATION
11. TOILET FACILITIES —
5. CLEANLINESS OF PERSONNEL 52 Room free of steam,smoke odors t
35 Adequate,convenient,accessible,designed,installed 4 53 Room and equipment-hoods,ducts vented as required 1
13 Hand washing facilities provided 4 36 Toilet rooms enclosed with self-closing door 1
14 Clean outer clothes.effective hair restraints 1 37 Proper fixtures provided,good repair,clean 1 18. DRESSING ROOMS AND LOCKERS
15 Good hygienic practices,smoking restricted 2 12. HANDWASHING FACILITIES
54 Rooms adequate,clean,adequate lockers provided
6. EQUIPMENT AND UTENSILS:DESIGN, 38 Suitable hand cleaner and sanitary towels or approved facilities clean I 1
CONSTRUCTION AND INSTALLATION hand drying devices provided,tissue,waste
receptacles provided.
19. HOUSEKEEPING
16 Food contact surfaces designed,constructed, 13. GARBAGE AND RUBBISH STORAGE
maintained,installed,located 2 &DISPOSAL 55 Establishment and premises free of litter,no insect/
17 Nun-food contact surfaces:designed,constructed, rodent harborage,no unnecessary articles 1
maintained.installed,located 1 39 Approved containers,adequate number,covered,
rodent proof,clean 1 56 Complete separation from living sleeping quarters
18 Single service articles:storage,dispensing 1 and laundry 1
40 Storage areas/rooms,enclosures—properly
19 No re-use of single service article 2 constructed clean 1 57 Clean/soiled linens stored properly 1
20 Dishwashing facilities:approved design,adequately 41 Disposed of in an approved manner,at approved 58 No live birds,turtles,other animals(except:
constructed,maintained,installed,located 2 frequency 1 police guide dogs) 1
DEMERIT SCORE RATING SIGNED(Certified Officer) DATE CORRECTIONS DUE SIGNATURE OF PERSON
Interviewed
4 2/ 1 2 TOTAL
2 3 �•Y7 dQ /h/
REMARKS
704 — Jo orf Gu f,t cis �w.rf 6t c�o.s�/ o �s chcAliitcCIL/ /
-14,3$'r ✓'oa f� 9% w 1rG� s�tG� /1 .0
7c' Jl sit v�S�t c
#D?6 — G`�u,� Ivii •es /�ii X ram` %h v�Lire
� s c,✓ro DH CD�sa r/�
7
SWHD 2/79 EHFS1
INSPECTION REPORT Town of South Windsor Date of Inspection S=/2 -�; /
FOOD SERVICE ESTABLISHMENTS HEALTH DEPARTMENT
Time
Owner Jtii�c i• „❑'QUARTERLY INSPECTION ❑ REINSPECTION c
NAME OF ESTABLISHMENT STREET ADDRESS Licensee
_ • , 9) c h. �'�'c`"r![c.k — `.<<f1_11r J Person Seen S'&
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
2. SOURCES OF FOOD T EQUIPMENT AND UTENSILS: 14. VERMIN CONTROL
CLEANLINESS
1 Approved source,wholesome,non adulterated 4 21 Preflushed,scraped,soaked and racked 1 42 Presence of insects/rodents
2 Original container,properly labeled 1 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of
23 Accurate thermometers provided,dish basket,if used 1 insects/rodents
3. FOOD PROTECTION 24 Sanitization rinse(hotwater—chemical) 2
25 Clean wiping cloths 1 15. FLOORS, WALLS, AND CEILINGS
3 Potentially hazardous food meets temperature - 26 Food contact surfaces of utensils and equipment clea
requirements during storage,preparation,display, 27 Non-food contact surfaces of equipment and utensils 44 Floors:floor covering instal led,constructed asrerluired,
service,&transportation 4 clean 1 good repair,clean I
4 Adequate facilities to maintain product temperature, 28 Equipment/utensils,storage handling 45 Floors,graded,drained as required 1
thermometers provided 2 46 Floor,wall juncture covered i
5 Potentially hazardous food properly thawed 2 8. WATER SUPPLY 47 Mats removable,good repair,clean 1
6 Unwrapped and potentially hazardous food not re-served 4 48 Exterior walking,driving surfaces:Good repair,clean 1
1 Food protected Bunn storage,preparation,display, 29 Water source:adequate,safe 4
P g g p P49 Walls,ceilings,attached equipment:properly
service,and transportation 2 30 HGtandcold water under pressure,provided asrequired 1 constructed,good repair,clean.Wall and ceiling
8 Food containers stored off of the floor 1 surfaces as required I
9. SEWAGE DISPOSAL 50 Dustless cleaning methods used,cleaning equipment
9 Handling of food minimized p g g q r
i
10 Food dispensing utensils properly stored 1 31 Sewage disposal approved 4 properly stored
11 Toxic items properly stored,labeled,used 4 32 Proper disposal of waste water 1 16. LIGHTING
4. PERSONNEL 10. PLUMBING
51 Adequate lighting provided as required I 1
33 Location,installation,maintenance 1
12 1 Personnel with infection restricted 4 34 No cross connection,back siphonage,backflow 4 17. VENTILATION
5. CLEANLINESS OF PERSONNEL 11. TOILET FACILITIES
52 Room free of steam,smoke odors 1
35 Adequate,convenient,accessible,designed,installed 4 53 Room and equipment-hoods,ducts vented as required 1
Eea
ing facilities provided 4 36 Toilet rooms enclosed with self-closing door i
r clothes.effective hair restraints 1 37 Proper fixtures provided,good repair,clean 1 18. DRESSING ROOMS AND LOCKERS'
nic practices,smoking restricted 2
12. HANDWASHING FACILITIES
54 Rooms adequate,clean,adequate lockers provided
6. EQUIPMENT AND UTENSILS:DESIGN, 38 Suitable hand cleanerand sanitary towels or approved facilities clean I C
CONSTRUCTION AND INSTALLATION hand drying devices provided,tissue,waste
receptacles provided.
19. HOUSEKEEPING
16 Food contact surfaces:designed,constructed, 13. GARBAGE AND RUBBISH STORAGE
maintained,installed,located 2 &DISPOSAL 55 Establishment and premises free of litter,no insect/
17 Non-food contact surfaces:designed,constructed, 39 Approved containers,adequate number,covered, rodent harborage,no unnecessary articles I
maintained.installed,located 1 rodent proof,clean 1 56 Complete separation from living sleeping quarters
18 Single service articles:storage,dispensing 1 and laundry 1
40 Storage areas/rooms,enclosures—properly
19 No re-use of single service article 2 constructed clean 1 57 Clean/Soiled linens stored properly 1
20 Dishwashing facilities:approved design,adequately 41 Disposed of in an approved manner,at approved 58 No live birds,turtles,other animals(except:
constructed,maintained,installed,located 2 frequency 1 police guide dogs) I
DEMERIT SCORE RATING SIGNED(Certified Officer) DATE CORRECTIONS DUE SIGNATURE OF PERSON
Y)V12' 1 TOTAL �J ��:�,�r `;� _ InterYl2Wed
171-1 `, �' ` .X�
REMARKS `)
vky„7 'xc' �Sis F its
/.J �— C'lcs� �v j�,�/c�3� r mar C/r cr/, /
,J�— SCc�;/� rjaw�rri �aa`Es jt�Tl�
,xJ';�5 — ,S'fC��r .` �C,..sils 6. ,�l, �►..o��l i,�ci�:� CYZ'6���r
SWHD 2/79 EHFS1
INSPECTION REPORT Town of South Windsor Date of Inspection r =•- �-•
FOOD SERVICE ESTABLISHMENTS HEALTH DEPARTMENT
Time
❑ r„i'i.;;, f r QUARTERLY INSPECTION ❑ REINSPECTION Owner
NAME OF ESTABLISHMENT STREET ADDRESS Licensee
Person Seen
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
2. SOURCES OF FOOD 7. EQUIPMENT AND UTENSILS:CLEANLINESS 14. VERMIN CONTROL
1 Approved source,wholesome,non adulterated 4 21 Preflushed,scraped,soaked and racked 1 42 Presence of insects/rodents 2
2 Original container,properly labeled 1 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of
23 Accurate thermometers provided,dish basket,if used 1 insects/rodentsti
3. FOOD PROTECTION. 24 Sanitization rinse(hot water—chemical) 2
25 Clean wiping cloths 1 15. FLOORS, WAILS, AND CEILINGS
3 Potentially hazardous food meets temperature 26 Food contact surfaces of utensils and equipment clean
requirements during storage,preparation,display, 27 Non-food contact surfaces of equipment and utensils 44 Floors:floor covering installed,constructed asrequned,
service,&transportation 4 clean 1 good repair,clean 1
4 Adequate facilities to maintain product temperature, 28 Equipment/utensils,storage handling 1 45 Floors,graded,drained as required 1
thermometers provided 2 46 Floor,wall juncture covered 1
5 Potentially hazardous food properly thawed 2 8. WATER SUPPLY 47 Mats removable,good repair,clean 1
6 Unwrappedand potentially hazardous food not re-served 4 48 Exterior walking,driving surfaces:Good repair,clean 1
7 Food protected during storage,preparation,display, 29 Water source:adequate,safe 4
service,and transportation 2 30 HGt and cold water under pressure,provided asrequired 2 49 Walls,ceilings,attached equipment:properly
constructed,good repair,clean.Wall and ceiling
8 Food containers stored off of the floor 1 surfaces as required 1
9 Handling of food minimized 2. 9. SEWAGE DISPOSAL 50 Dustless cleaning methods used,cleaning equipment
properly stored i
10 Food dispensing utensils properly stored 1 31 Sewage disposal approved 4
it Toxic items properly stored,labeled,used 4 32 Proper disposal of waste water 1 16. LIGHTING
4. PERSONNEL 10. PLUMBING
51 Adequate fighting provided as required 1
33 Location,installation,maintenance 1
12 Personnel with infection restricted 4 34 No cross connection,back siphonage,backflow 4 17. VENTILATION
5. CLEANLINESS OF PERSONNEL 11. TOILET FACILITIES
52 Room free of steam,smoke odors i
35 Adequate,convenient,accessible,designed,installed 4 53 Room and equipment hoods,ducts vented as required i
13 Hand washing facilities provided 4 36 Toilet rooms enclosed with self-closing door 1
14 Crean outer clothes.effective hair restraints 37 Proper fixtures provided,good repair,clean 1 18. DRESSING ROOMS AND LOCKERS
15 Good hygienic practices,smoking restricted 1 12. HANDWASHING FACILITIES
54 Rooms adequate,clean,adequate lockers provided
6. EQUIPMENT AND UTENSILS:DESIGN, 38 Suitable hand cleaner and sanitary towels or approved facilities clean I 1
CONSTRUCTION AND INSTALLATION hand drying devices provided,tissue,waste
receptacles provided.
19. HOUSEKEEPING
16 Food contact surfaces:designed,constructed, 13. GARBAGE AND RUBBISH STORAGE
maintained,installed,located 2 &DISPOSAL 55 Establishment and premises free of litter,no insect/
17 Non-food contact surfaces:designed,constructed, 39 Approved containers,adequate number,covered rodent harborage,no unnecessary articles 1
maintained.installed,located 1 ,
rodent proof,clean 1 56 Complete separation from living sleeping quarters
18 Single service articles:storage,dispensing 1 and laundry 1
40 Storage areas/rooms,enclosures—properly
19 No re-use of single service article 2 constructed clean 1 57 Clean/soiled linens stored properly 1
20 Dishwashing facilities:approved design,adequately 41 Disposed of in an approved manner,at approved 58 No live birds,turtles,other animals(except:
constructed,maintained,installed,located 1 frequency 1 police guide dogs) 1
DEMERIT SCORE RATING'SIGNED(Certified Officer) DATE CORRECTIONS DUE SIGNATURE OF PERSON
Interviewed
4 2 YD1 TOTAL
—
REMARKS
,.. 1{:. f.'- ci<y i , � � �• ..� r. f.Via. a '�- Ll /\. ..sky F, ! •i..t,.�i , ..r �, �;
'!;/y'P�i, (`a c>C �`P r Ei li \[, 'F` V l + j.'. ,-E� •_ �''T i a� ti
�p�rrr• r' • �:FF,.'�` !i' 1•, •�t. •1 fi.. 1 i : :. �f � i � , . '�' r `F c. -, 4 . f � i•„ �l ; . �, , �,. .�i
SWHD 2/79 EHFS1
REMARKS
INSPECTION REPORT Town of South Windsor Date of Inspection —� 7y
FOOD SERVICE ESTABLISHMENTS HEALTH DEPARTMENT
Time
R"QUkkTERtY INSPECTION ❑ REINSPECTION OwnerRjk�41,,od jj L,,c c.
NAME OF ESTABLISHMENT STREET ADDRESS Licensee
13
�t r wet cz.ir ^�em ///r� �ocz Person Seen ;7•cc�.
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 bel
2. SOURCES OF FOOD 7. EQUIPMENT AND UTENSILS: 14. VERMIN CONTROL
CLEANLINESS
1 Approved source,wholesome,non adulterated 4 21 Preflushed,scraped,soaked and racked 1 42 Presence of insects/rodents
2 Original container,properly labeled 1 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of
23 Accurate thermometers provided,dish basket,if used 1 insects/rodents
3. FOOD PROTECTION 24 Sanitization rinse(hot water—chemical) 2
25 Clean wiping cloths 1 15. FLOORS, WALLS, AND CEILINGS
3 Potentially hazardous food meets temperature 26 Food contact surfaces of utensils and equipment clean
requirements during storage,preparation,display, 27 Non-food contact surfaces of equipment and utensils 44 floors:floor cover mg installed,constructed asregwred,
service,&transportation 4 clean I good repair,clean
4 Adequate facilities to maintain product temperature, 28 Equipment/utensils, handling 1 45 Floors,graded,drained as required
thermometers provided 2 46 Floor,wall juncture covered
5 Potentially hazardous food properly thawed 2 8. WATER SUPPLY 47 Mats removable,good repair,clean
6 Unwrappedand potentially hazardous food not re-served 4 48 Exterior walking,driving surfaces.Good repair,clean
7 Food protected duringstorage,pp
stora ,preparation,display, 29 Water source:adequate,sate q
service,and transportation 2 30 Hct and cold water under pressure,providedasrequired 2 49 Walls,ceilings.attached equipment:properly
constructed,good repair,clean-Wall and ceding
8 Food containers stored off of the floor t 9 surfaces as required
9 Handling of food minimized . SEWAGE DISPOSAL 50 Dustless cleaning methods used,cleaning equipment
10 food dispensing utensils properly stored 1 31 Sewage disposal approved 4 properly stored
11 Toxic items properly stored,labeled,used 4 32 Proper disposal of waste water 1 16. LIGHTING
4. PERSONNEL 10. PLUMBING
5i Adequate fighting provided as required
33 Location,installation,maintenance 1
12 Personnel with infection restricted 4 -34 No cross connection,back siphonage,backflow 4 11. VENTILATION
5. CLEANLINESS OF PERSONNEL 11. TOILET FACILITIES 52 Room free of steam,smoke odors
35 Adequate,convenient,accessible,designed,installed 4 53 Room and equipment-hoods,ducts vented as required
13 and washing facilities provided 4 36 Toilet rooms enclosed with self-closing door 1
14 Clean outer clothes,effective hair restraints 1 37 Proper fixtures provided,good repair,clean 1 18. DRESSING ROOMS AND LOCKERS
15 Good hygienic practices,smoking restricted 2 12.HANDWASHING FACILITIES
54 Rooms adequate,clean,adequate lockers provided
6. EQUIPMENT AND UTENSILS:DESIGN, 38 Suitable hand cleaner and sanitary towels orapproved facilities clean
CONSTRUCTION AND INSTALLATION hand drying dunces provided,tissue,waste
receptacles provided.
19. HOUSEKEEPING
16 Food contact surfaces:designed,constructed, 13. GARBAGE AND RUBBISH STORAGE
maintained,installed,located 2 &DISPOSAL 55 Establishment and premises free of litter,no insect/
17 Non-food contact surfaces:designed,constructed, rodent harboiage,no unnecessary articles
maintained.installed,located 1 39 Approved containers,adequate number,covered,
rodent proof,clean 56 Complete separation from living/sleeping quarters
18 Single service articles:storage,dispensing 1 and laundry
40 Storage areas/rooms,enclosures—properly
191 No re-use of single service article 2 constructed clean 1 57 Clean/soiled linens stored properly
20 Dishwashing facilities:approved design,adequately 41 Disposed of in an approved manner,at approved 58 No live birds,turtles,other animals(except:
constructed,maintained,installed,located 2 frequency 1 police guide dogs)
DEMERIT SCORE RATING SIGNED(Certified Officer) DATE CORRECTIONS DUE SIGNATURE OF PERSON Interviewed
4 2• 1. TOTAL «S Sov�ti Ct!
a 6.,02
REMARKS
8'— FeJ cl fl r'ei dv c,�s G u a vto br sy4 rid obi fC'/oar• c� cite
rCcar'_d. 4 16 Nwnd rrir j f ce -
'�{ Q�- 3r.C�C.P h �
p2E rrT i/�i J"dtcz Yee ill i Xc'."- J4 r r, a(s G It uv i✓�j J
,3�., N cc,.r d it tcc�+,►er� -a"
..��...//�j��'+y, / ,,/ J {=c�••+ fwc5 thersG
GaL'e f,tf' Ylf L4 d� Q
lV'1- Fkol' vvl dcr� tic mac Lit vte n E d-) `"'y
SWHD 2/79 EHFS1
INSPtGIIUIY IitruKI JIAlt Utr CUNISILCTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF HEALTH TOWN
EHS-106 REV.12-74 /
S`
DATE OF INSPECTION
❑ QUARTERLY INSPECTION ElREINSPECTION S_Is-TI
NAME OF ESTABUSHMENT//�� STREET ADDRESS OWNER OR OPERATOR
` IIIPC 0-1t 7 S— `KAVk ar e e
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
he,- F o d ot/ 7Z�Aw C-P _-Xa
2. SOURCES OF FOOD 7. EQUIPMENT AND UTENSILS: 14.VERMIN CONTROL
CLEANLINESS
1 Approved source,wholesome,non adulterated 4 21 Preflushed,scraped,soaked and racked 1 42 Presence of insects/rodents 2
2 Original container,properly labeled 1 22 Wash water clean,proper temperature _ 1 43 Outer openings protected against entrance of
23 Accurate thermometers provided,dish basket,if used 1 insects/rodents 1
3. FOOD PROTECTION 24 Sanitization rinse(hot water—chemical) 2
25 Clean wiping cloths 1 15. FLOORS, WALLS, AND CEILINGS
3 Potentially hazardous food meets temperature 26 Food contact surfaces of utensils and equipment clean 2
requirements during storage,preparation,display, 27 Non-food contact surfaces of equipment and utensils 44 floors:floor covering installed,constructed as required,
service,&transportation 4 clean 1 good repair,clean 1
4 Adequate facilities to maintain product temperature, 28 Equipment/utensils,storage handling 1 45 Floors,graded,drained as required 1
thermometers provided 2' 46 Floor,wall juncture covered 1
5 Potentially hazardous food properly thawed 2 8. WATER SUPPLY 47 Mats removaole,good repair,clean 1
6 Unwrapped and potential ly.haza rdous food not re-served 4 48 Exterior walking,driving surfaces:Good repair,clean 1
7 Food protected dorm storage,preparation,display, 29 Wates source:adequate,safe 4
t g P p 30 Hot and cold water under 49 Walls,ceilings,attached equipment:properly
service,and transportation 2 pressure,provided as required 2 constructed,good repair,clean.Wall and ceding
8 Food containers stored off of the floor 1 surfaces as required 1
9. SEWAGE DISPOSAL 50 Dustless cleaning methods used,cleaning equipment
9 Handling of food minimized 2 g g
properly stored 1
10 Food dispensing utensils properly stored 1 31 Sewage disposal approved 4
11 Toxic items properly stored,labeled,used 4 32 Proper disposal of waste water 1 16. LIGHTING
4. PERSONNEL 10. PLUMBING
51 Adequate lighting provided as required 1
33 Location,installation,maintenance 1 —
12 Personnel with infection restricted 4 34 No cross connection,back siphonage,backflow 17. VENTILATION
11. TOILET FACILITIES
5. CLEANLINESS OF PERSONNEL 52 Room free of steam,smoke odors t
35 Adequate,convenient,accessible,designed,installed 4 53 Room and equipment-hoods,ducts vented as requned 1
13 Hand washing facilities provided q 36 Toilet rooms enclosed with self-closing door
14 Clean outer clothes,effective hair restraints 1 37 Proper fixtures provided,good repair,clean 1 18. DRESSING ROOMS AND LOCKERS
15 Good hygienic practices,smoking restricted 2 12. HANDWASHING FACILITIES
54 Rooms adequate,clean,adequate lockers provided
6. EQUIPMENT AND UTENSILS:DESIGN 38 Suitable handcleanerand sanitary towels or approved facilities clean 1
CONSTRUCTION AND INSTALLATION hand drying devices provided,tissue,waste
receptacles provided. 1
19. HOUSEKEEPING
16 Food contact surfaces:designed,constructed, 13. GARBAGE AND RUBBISH STORAGE
maintained,installed,located 2 &DISPOSAL 55 Establishment and premises free of litter,no insect/
17 Non-food contact surfaces:designed,constructed, rodent harborage,no unnecessary articles 1
maintained,installed,located Ja 39 Approved containers,adequate number,covered,
rodent proof,clean 1 56 Complete separation from living sleeping quarters
18 Single service articles:storage,dispensing 1 and laundry 1
40 Storage areas/rooms,enclosures—properly
19 No re-use of single service article 2 constructed clean 1 57 Clean/soiled linens stored properly 1
20 Dishwashing facilities:approved design,adequately 41 Disposed of in an approved manner,at approved 58 No live birds,turtles,other animals(except:
constructed,maintained,installed,located 2 frequency 1 police guide dogs) 1
DEMERIT SCORE RATING SIGNED IINSPECTORI DATE CORRECTIONS DUE SIGNATURE OF PERSON IN CHARGE
:4/__�21 TOTAL
REM/�iy(y ?���>�t�a�f �ZG' C� °l�fay' @�C<Y tT J d/"�� E✓i1 i Tx
3 izlp-c
o,5d cd�-c� r-- .Sit 0—f. noto .k r� o.3s a ai c.Ia�
Sty ' Cow �- crhC At 61-H d0w i4o2A,741 X S,-4&d a:2a Az.9 w0-1/�(
_ a