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Home My WebLink AboutFood Service Establishment Inspection 40 (5) NO�; `".s Establishment: Inspection Date: Time: ROinsp REinsp Address/City: Heal ept:_ S. 1,ti`r-aLgr-- Class: 1 2 3 a Based on an inspection this day, a it s marked DNC ideriltify the violations in operation or facilities which must be corrected by the date specified on page 2. RISK FACTOR ITEMS:Listing is not inclusive of all possible debitable items C N/0 WA JDNC I KEY: C[complies] NIO[not observed] NIA[not applicable] 60 Qualrfietl Food OpeFator 3 DNC[does not comply] 0[other] RTE[ready-to-eat] tit Designated Alternate ` 12 Persortnel with mfectionrestrrcted , C N/A. 4 62 Written documentation of tral9ing program 2 A Food workers have no exposed infected lesions I burns B Personnel with infection restricted 1 Approved source,wholesome,,nonadultekated - C9V0 N/A 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 ilHandwatshing.facilities provided,handswashed,clean ',C_" I0 N/A`4 ? B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulteratedfoods/safe V B Handwash facilities in or immediately adjacent to toilet rooms c D Commercial products(no home grown/canned food) VC Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean/Proper handwash procedure vrl 0 E Handwashing at appropriate times 3 Pote"nti'ally hazardous food meets temperature equ[rements C N/0 N/A 4 during storage;.preparation,display;=service and transportation' 01 15 Good hygrenic?practiges C.>0 NIA 2 A Hot holding greater than or equal to 1400F. (whole beefipork roasts 1300 F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to450F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking/consumer advisory posted 24 `-Sanitizationrinse(hotuvater'=che►nical)� C rN/O N/A 2 0 A Approved sanitizeravailable/adequate concentration ofsanitizer 4 Adequate#adilities<to maintain pro8uct C"" N/0WAI 2 g Food-contact surfaces and utensils used for potentially teriiperature;A.ermometers;-provided , , hazardous food sanitized at least every 4 hours A Food thermomete r available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp Proper sanitizing B Properfood thermometerfor product D E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 25 r;Cleari:wrprng Moths C-N 6.NIA-al 7 Food protected d�rmg stgrage,preparation, C Nl0 NIA 2' d Isplay,serurce and fransportatton A Cloths and/or sponges in good repair and clean A Produce washed B Wiping cloths kept in sanitizer between uses B Raw meats not stored/prepared near ready-to-eat foods 26 Food contact surfaces clean C N10 NI C Food covered properly A Food equipment clean utensils clean,equipment interiors clean D Adequate splash guards/sneeze guard B Single use gloves changed when soiled E No unauthorized personnel C Food contact surfaces clean F No pooling of eggs not cooked immediately 0 Food containers stored off the floor 30 -Hot and,cold waterunder pressure,prowtled asregwre <C 10. NIA 2 0 38 Hand washmg.accessones prov►ded C 9 Handling of food'mmrmrzed C ;NIO N/A 2 A No unnecessary handling RTE andlorcooked 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 0 O •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 w 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 ness are you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a, en illness policy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foods ment? Y N anddidases to the QFO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? *Are leftovers saved? Y N Is there a language barrier between inspector&QFO? Y N If Yes indicate language spoken List products cooled: by QFO/DA: *Can the QFO/DA read the inspection report? Y N Describe cooling metho Indicate who answered the above questions: Name(print):KD e Indicate the title of 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 signature of the pe o received the QFO responsibilities information at the time of the Is there a produce washing policy? Y N *Describe what is washed and inspection: where: Note: This r ort is a two page form(total of 62 debitable items) Page 1 of 2 Establishments. d' ,c��: Date of Inspection 11 Address Owner or:Operator ADDITIONAL FOUR DINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. " -Unwrapped foods not re-served 4 31 Sewage disposal approved. 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. 34 No cross connections,back siphonage,backflow 4 4 Proper type/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration not to exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticides/rodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines 4 -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4 -Water quality in compliance designed,properly installed -Monitoring in compliance 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 1: 5 Potentially hazardous food properly thawed 2 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored ]. 2 Vermin Control: No insects/rodents present 2 a 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outer openings protected against entrance of insects/rodents 4 Yoors. Floor covering installed,constructed as required,good repair,clean 1 Food-contact surfaces designed,constructed,maintained,installed, 2= 4 Floors graded,drained as required located 6 Floor,wall juncture covered 17 )Nonfood-contact surfaces designed,constructed,maintained, 1 47 Mats removable,good repair,clean installed,located _ 49 Exterior walking,driving surfaces,good repair,clean 1 18 Single service articles,storage,dispensing 2 19 No reuse of single service article 49 Walls,ceilings attached,equipment properly constructed,good 1 repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1 Equipment&Utensils: Cleanliness 51 Adequate lighting provided as required 1- 1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 23 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1 27 Nonfood-contact surfaces of utensils&equipment clean 1 55 Establishment and premises free of litter,no insect/rodent harborage, 1' 28 Equipmentlutensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 1 ; 56 Complete separation from living/sleeping quarters and laundry T; 57 Clean/soiled linens stored properly 33 Plumbing location,installation,maintenance p p y 58 No live birds,turtles,or other animals(except guide dogs) 1 36 Toilet rooms enclosed with self-closing door ARM1 37 Proper toilet fixtures provided,good repair,clean 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at ��; t3 entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean outine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTOR: PERSON IN CHARGE: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signa re gnature print name nprrint name p-S�w�-aSl� mc'64' phone number title LJ `i" ✓ � DATE CORRECTIONS DUE: Page 2 of 2 plus _continuation pages Focused inspection 1/2002 Page Of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION FORM# REMARKS t �. Cie Q►. �-�., - c, a� 00 c-�, \A,A vt 0 on 4,010 as g�\ ,n .,�, b� INITIAL(INSPECTOR) INITIAL(PERSON IN CHARG Distribution: I st-White-Health Department 2nd-Yellow-Owner/Manager Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN i a DATE OF INSPECTION kv\01 1S�A� �• W� b I" �I INSPECTION FORM# REMARKS \\ l \ 6 '39n1s�, qq `l 1st` r\ ,. f S=4 Oro qq d ico 1 i � s Q C r INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager