The URL can be used to link to this page

Home My WebLink AboutFood Service Establishment Inspection 85 i Establishment: Inspection Date: Time: jQ2.:,q4o;, Oinsp REinsp Address/City: 5., "o— Health ept: S. W yk"(r- Class: 1 2®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 AVO WA NCI KEY: C[complies) N/O[not observed] NIA[not applicable] 3 DNC[does not comply] 0[other] RTE[ready-to-eat] s1 DesigirafedAltemdte 2 �2 "Pdr`s+�nnel aritFtittfedt eti restricted C A Food workers have no exposed infected lesions I burns 62 Written documentation of training program 7 7 2 1 Approved source,wholesome,nonadulterated C /0 N/A 4 B Personnel with infection restricted C Communicable disease of worker reported to local health director A I Approved shellfish,finfish,meat&poultry USDA approved 131 Handwashing facilities provided hands washed,can C XO 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 Wholesomelnonadulterated foods/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 D Personnel hands washed,clean/Proper handwash procedure 0 E Handwashing at appropriate times j z a �ON 45` `.d h lathe"practices C Nf0 NIA 2 A Hot holding greater than or equal to 140°F. (whole beef/pork roasts 1300 F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 45e F. VB Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking/consumer advisory posted W,. n.;1:, fj _< 0 A Approved sanitizer available/adequate concentration of sanitizer B Food-contact surfaces and utensils used for potentially hazardous food s ized at least every 4 hours A Food thermometer available and accurate C Adequate ishwashersanitizer ❑final rinse temp 00, B Proper food thermometer for product D Proper sa itizinrocedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 eispiayt;* rvt-4 and#rans[portation ' IF A Cloths and/or sponges in good repair and clean A Produce washed V B Wiping cloths kept in sanitizer between uses I lei' B Raw meats not stored/prepared near ready-to-eat foodsgliq _ , 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 V C Food--contact surfaces clean F No pooling of eggs not cooked immediately V 0 8 Food containers stored off the floor Vr. A No unnecessary handling RTE and/or cooked foods with bare hands A Soap I paper towels I drying device available B Dispenser(s)working: ❑Soap ❑Papertowel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice p 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 held at: IF. PHFs are cold held at: OF. Describe illness conditions when you would exclude a food worker from working: Are internal cooking temperatures taken? Y N *To what temperature do you cook: Poultry Ground Beef Pork What diseases related to FB illness are yo to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holdin ds/equipment? Y N and diseases to o? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and Goole N *Are leftovers saved? Y N Is they anguage barrier between inspector&QFO? Y N If yes indicate language spoken List products cooled: FO/DA: *Can the QFO/DA read the inspection report? Y N -000 Describe cooling met Indicate who ered the above questions: Name(print): Indicate the itle o above person(circle all that apply):QFO DA Mgr Cook Owner FW Is cooling mo red for time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain ' atu of the pe who r 'ad t QFO respon ' 'ities i ormatio t the time of the Is t produce washing policy? Y N *Describe what is washed and inspecti where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 Mile Il;i;i Establishment: �Date of Inspection: LLA Address: Owner or Operator: 2v ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. - 4 31 Sewage disposal approved. Unwrapped foods not re-served 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Proper type/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-Water quality in compliance 35 Toilet facilities. Adequate,convenient,accessible, -Monitoring in compliance ;_.; designed,properly installed OTHER ITEMS - KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storage area/rooms,enclosures-properly 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 outeropenings protected against entrance of insects/rodents , 44 Floors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, 45 Floors graded,drained as required located 6 Floor,wall juncture covered �. Nonfood-contact surfaces designed,constructed,maintained, 47 Mats removable,good repair,clean installed,located 481 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils• Cleanliness 51 Adequate lighting provided as required 1 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 2 Wash water dean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 2,1 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,no insecUrodent harborage, Equipment/utensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance 571 Clean/soiled linens stored properly 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 59 Seats 75 or more:Nonsmoking area provided,signs)posted at 37 Proper toilet Wures provided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean outine Inspection ❑Reinspection 0 Preoperational Inspection N E T R: P N IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signa ure Ognature ` p print name p nt nameL IL DATE CORRECTIONS DUE: phone number title Page 2 of 2 plus_�_continuation pages Vocused Inspection 1/2002 Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN r + DATE OF INSPECTION T~:LN !\ l� 5 . INSPECTION REMARKS FORM# 09 a VJ W=l mr, k^ INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) A?W dffeAnk Distribution: I st-White-Health Department 2nd-Yellow-Owner/Manager