The URL can be used to link to this page

Home My WebLink AboutFood Service Establishment Inspection 98 (2) Establishment: Inspection Date: 1 Time: Jp: q,:� oinsp REinsp Address/City: � Healt Dept: �, �.,� 5 Class: 1 2 3� Based on an inspection this day,t ite s 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 40 N/A JDNC I KEY: C[complies] NIO[not observed] NIA[not applicable] 3 DNC[does not comply] 0[other] RTE[ready-to-eat] - �� 1 (li 'vi i i 1fffi0 bin r`estriete � C `1 L 61 nat d��62 Written docume A Food workers have no exposed infected lesions I burns ntatt>�of training program 2 B Personnel with infection restricted '1 Apprgved source,wholesome,noneduiterated C f NlA 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Handv ashing facifto provided,hands wasted,clean C Vf0 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 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 Illl!I! 0 M sfm C PVi3' 1310 A Hot holding greater than or equal to 1400F. (whole beef/pork roasts 130'F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450 F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 '^ r ; E Proper internal cooking/consumer advisory posted 0 A Approved sanitizer available/adequate concentration of sanitizer B Food-contact surfaces and utensils used for potentially hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp Proper B Proper food thermometer for product D E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units A Cloths and/or sponges in good repair and clean NW- - A Produce washed B Wiping cloths kept in sanitizer between uses 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/sneeze guard V B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean KA F No pooling of eggs not cooked immediately oe 8 Food containers stored off the floor 0 u�)rI A Soap/paper towels/ drying device available X. WT A No unnecessary handling RTE and/or cooked oods with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sinks)clean/waste receptacle at handwasIpsink C Adequate utensil(s)for dispensing food/ice V 0 O •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[quakW food operator],DA[designated alternate),PHF[potentially hazardous food],FB[foodbome] 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 you cook: Poultry Ground Beef Pork What diseases related to FB illness are you required to re ealth department? Roasts Other Describe re-heating procedures: Is there a written illness policy th res the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foods pmant? Y N and diseases to the CIF *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? *Are leftovers saved? Y N Is there ge barrier between inspector&CFO? Y N If ves indicate language spoken List products cooled: by QFO/DA: *Can the QFO/DA read the inspection report? Y N Describe cooling methods:---'...- Indicate who answered the above questions: Name(print): Indicate the title of above person(circle all that apply):QFO DA Mgr Cook Owner FW Is cooling mo " for time&temp? Y s the monitoring of cking recorded? Y N .Obtain signature of the person who received the QFO re ponsibilifes information at the time of the Is there a produce washing policy? Y N *Describe what is washed and in where: Note: This report is a two page form(total of 62 debitable ite s) Page 1 of 2 7rEstatlishment: A C�c, � T Date of Lnspection: :5 1 I ess: Owner or Operator: ADDITIONAL FOU POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. 4 31 Sewage disposal approved. -Unwrapped foods not re-served }$ 4 Operating as required -Potentially hazardous foods not re-served 11 Toxic chemicals. No cross connections,back siphonage,backflow Proper type/installation/backflow prevention device/air gap fo -Stored properly,labeled properly,used properly r: -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 -Chemical dispensers -Ice machines -Pesticides/rodenticides properly dispensed 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 storagearea/rooms,enclosures-properly constructed,clean Potentially hazardous food properly thawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 1 Food dispensing utensils properly stored 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected againstentrance of insects/rodents 4 Floors: Floor covering installed,constructed as required,good repair,clean 6 Food-contact surfaces designed,constructed,maintained,installed, 5 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 18 Single service articles,storage,dispensing 8 Exterior walking,driving surfaces,good repair,clean 19 No reuse of single service article 9 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 21 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 23 Accurate thermometers provided,dish basket,if used 541 Rooms adequate,clean,adequate lockers provided,facilities clean 2 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,no insect/rodent harborage, 28 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 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 entranc ),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean 10outine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTOR: PERSON IN CHARGE: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating sig ure U signature ff (0 77 print name print na a lJ�3 �� _ LE ne- phone number title DATE CORRECTIONS DUE: Page 2 of 2 plus continuation pages Focused Inspection I/2002 • NAME OF DATE OF ' • �► =I U lb NSA om•W;- I I - �V&"MOW i III .R - 1� �R�_. f �. iyl♦ - 6 MR WAR Ml _ _a%* _ 0 BLUM Jim, ill AMEX, INITIAL (INSPECTOR) INITIAL ` (PERSON y NAME OF • DATE,OF P I • III%��r7■ � �__-_'ti �l�. /� � � , W- a �r�_,...� 1..., r �� ' i • I mwj, ll NIMN—W1.11 w" . -,wi. �a I m m�_ WON, �m, W MW m -W w ml ME 2W21 mom �� t'ir vas + ��' m ::� �t,�•. 1 WL. �!ill 9J\ 1 \ 1 INITIAL OR(INSPECT ) INITIAL(PERSON IN CHARGE)