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Home My WebLink AboutFood Service Establishment Inspection 65 i Establishment: Inspection Date: L, a1,k Time: 10:30 nsp REinsp Address/City: Health ept: 45;'. J� car- Class: 1 2 3 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 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] ;> .* motif-E� 2 .b. . .,. � a pietltaiilh �ram 2 A Food workers have no exposed infected lesions I burns 1 Vr Ar pfdYed s0urtse,whcfe9nme,nsdsduitet ;v! CflA 4' B Personnel with infection restricted C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Handwashing fatCiNes prcMded,handswashed,c�att: .C 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 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 0 A Hot holding greater than or equal to 1400F. (Whole beef/pork roasts MO r.) 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 E Proper internal cooking/consumer advisory posted 0 A Approved sanitizeravailable/adequateconcentratonofsanitizer B Food-contact surfaces and utensils used for potentially hazardous food sanitized at least every 4 hou A Food thermometer available and accurate C Adequate ❑dishwashersanitizer Xnal rinse temp L Proper sanitizin B Proper food thermometer for product procedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 won-FRIM-9mm A Cloths and/or sponges in good repair and clean A Produce washed B Wiping cloths kept in sanitizer between uses 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/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 8 Food containers stored off the floor 0 Soap/paper towels/ drying device available A No unnecessary handling RTE and/or cooked foods with bare hands B ispenser(s)working: ❑Soap ❑Paper towel D B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sinks)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 0 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 aftemate],PHF[potentially hazardous food],FB[foodbome] PHFs are hot held at: OF. PHFs are cold held at: OF. Describe illn onditions 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 hat diseases related to FB illness are you required to r e local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy that r the food worker to report specific illness conditions Are temperatures recordedhogged for cold holding foods/equip men? N and diseases to the QFO? Y *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N e leftovers saved? Y N Is there a Ian gua trier between inspector&QFO? Y N If yes indicate language spoken List products cooled: by QFO/ *Can the QFO/DA read the inspecti report? Y N 001 Describe cooling methods: Indicate who answered the above q lions: Na (pri Is cooling monitored f &temp? Y N Is the monitoring of cooling recorded? Y N Indicate the title of above erson( r all that a ly):QF�DA r Cook Owner FW Obtain signature oft perso w ecei he FO responsibilities information at the time of the Is there a rCtFuce washing policy? Y N *Describe what is washed and inspection: where: Note: This report i two pag form(to debatable items) Page 1 of 2 Serve— Establishment: \} �r�2 Q�.�`5 Date of Inspection: o 11 Address: a Owner or Operator: bc� ADDITIONAL FOUR POINT 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. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Proper type/installation/backflow prevention device/air gap for: -San itizer 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 35 Toilet facilities. Adequate,convenient,accessible, -Water quality in compliance -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,dean 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 4 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 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 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 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 231 Accurate thermometers provided,dish basket,if used 541 Rooms adequate,clean,adequate lockers provided,facilities clean 27 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 581 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,sign(s)posted at 37 Propertoiletfixturesproyided,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 ❑ Preoperational Inspection INSP9CT0R: PERSO IN CHAR ; Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signature 0igna ur ` ffo z print nme QZ_Z_ 1� DATE CORRECTIO phone number title NS 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 `j�•QQ_` `S �• W 1 t►g��0� INSPECTION FORM# REMARKS ' .-. a o a � r�V.� r` vrco` � sw.��i2� w C'��-h vk�re..c• � � how v h �cr r ,. INITIAL(INSPECTOR) INITIAL(PERSO IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager