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Home My WebLink AboutSchool Inspection 100 Arnold Way (2) �rexe,d•- y,�'t� Establishment: Inspection Date: Time: l R0ins REinsp Address/City: Health ept: - Class: 1 2 Q> Based on an inspection this day,the iterint marked DNC identify the violations in operation or facilities which must be corrected by the date specified on page 2. RISK FACTOR ITEMS: Listing is not inclusive of all possible debitable items C N/0 N/A IDNCI KEY: C[complies] N/O[not observed] NIA[not applicable] " ' 3 DNC[does not comply] 0[other] RTE[ready-to-eat] „ � . '. . 61 .Destgttated Alternate-g 2 12 persarenl vii fi"tc#ianes�ricfed C 0 NSA 4 62 Written documentation of training program A Food workers have no exposed infected lesions I burns 2 B Personnel with infection restricted 1 Approved source,wholesome,nonadulterated C N10 NIA 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 131 Handwaslung facilities provided,handswashed,clean C NO NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms VIf 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 an was Ing at appropriate times 000, JR 0 k e is F14oiudliygieiic lees C NIA 2: A Hot holding greater than or equal to 140eF. (whole beef/pork roasts 1300 F.) V A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 45e F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking I consumer advisory posted 0 A Approved sanitizeravailable/adequate concentration ofsanitizer j, B Food contact surfaces and utensils used for potentially z � � hazardous foods itized at least every 4 hours A Food thermometer available and accurate C I Adequate Xishwashersanitizer ❑final rinse temp B Proper food thermometer for product D Pro ersanitizingprocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 OR#WIMP r TV 71, A Cloths and/ on es in good repair and clean 1 , tce r; rrp�tta tcn g P g 9 P B I Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards I sneeze guardV 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 8 Food containers stored off the floor 0 - A Soap I paper towels I drying device available - ol A No unnecessary handling RTE and/or cooked foods with bare hands � B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands 01 C Handwash sink(s)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 O 1 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated altemate],PHF[potentially hazardous food],FB[foodborne] PHFs are hot held at: OF. 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 vo ok: Poultry Ground Beef P What diseases related to FB illness are you required to a oval health department? Roasts Other Describe re-heating procedures: Is there a written illness polic quires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holdin ds/equipment? Y N and diseases to th Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cool Y N *Are leftovers saved?I Y N 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 meth o Indicate who answered the above questions: Name(print): Indicate the title of above person(circle all that apply):QFO DA gr Cook Owner FW Is cooling 30eled for time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain signature of person who ved the QFO s ilities information at the time of the Is ttqwl produce washing policy? Y N *Describe what is washed and inspection: where: ,`,, n Note: This report is a tw page form(total of 62 debitable items) Page 1 of 2 �,�1 A (LYN\ v MEE L ISE blishment: Date of Inspection: �t -7 ess: Owner or Operator: u 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 machinesProper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, -Water quality in compliance 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 5 Potentially hazardous food properly thawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 43 Outer openings protected against entrance of insects/rodents 4 Floors: Floor covering installed,constructed as required,good repgjf;clean 16 Food-contact surfaces designed,constructed,maintained,installed, 45 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed, maintained, 7 Mats removable,good repair,clean installed,located 8 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 19 No reuse of single service article 47 Walls,ceilings attached,equipment properly constructed,good 20 Dishwashing facilities approved design,adequately constructed, repair,clean.Wall&ceiling surfaces as required maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 51 Adequate lighting provided as required 1 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 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 premisesfree of litter,no insect/rodentharborage, 8 Equipment/utensils,storage,handling no unnecessary articles 32 Proper disposal of wastewater 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance 57 Clean/soiled linens stored properly 36 Toilet rooms enclosed with self-closing door 58 No live birds,turtles,or other animals(except guide dogs) 37 Proper toilet fixtures provided,good repair,clean 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean Woutine Inspection OReinspection 0 Preoperational Inspection Other Inspection: INSPECTOR: PERSON IN CHARGE: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating si nature signature HIA /I ofe 0 y , print name print na4 [Liz, 'X X 'Z I t DATE CORRECTIONS DUE: phone number titre III Page 2 of 2 plus continuation pages Focused Inspection 1/2002 Page of 3_ INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION -5fr-lu W4_� [2-c INSPECTION REMARKS FORM# l ��'ZW \ � 1'1JU•� a tR i 6 o J G, spa O ,-NZ ,, o — GIC3vwe� � - T r. may a INITIAL(INSPECTOR) 61v INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager