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HomeMy WebLinkAboutFood Service Establishment Inspection 46 (2) PEstablishment: -5 Inspection Date: Time: Roinsp REinsp Address/City: �� Health ept: S u').nd'mn Class: 1 2 3 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 N/O WA NCI KEY: C[complies] N/O[not observed] NIA[not applicable] 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 12 ' ei�sor 60 Hrith tnfec icn'ret3t�icteid C Np, 4 ' 67 'i esigpated' Iterrids P s �' 2 62 ,W n documentation of training program 2 A Food workers have no exposed infected lesions/burns B Personnel with infection restricted 1 Apprdved source, 11liblesome,nottadutterated CPW WA 4 Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 'Handwashing facilities provided,;hands WA ted,dean 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 f N 010 raff ` 's� po�8 1 ood hygienic practices C ► WA A Hot holding greater than or equal to 1400F. (whole beef/pork roasts 1300 F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450 F. t B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating S '4*1 E Proper internal cooking/consumer advisory posted 0 A Appmvedsanitizeravailable/adequateconcentrationofsanitizer B Food-contact surfaces and utensils used for potentially f hazardous food sanitized at least every 4 hours W-101ism A Food thermometeravailableandaccurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 k he n s A Cloths and/or sponges in good repair and clean WW MIN, § °° - B Wiping cloths kept in-�etweenuses A Produce washed 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 I No pooling of eggs not cooked immediately V 0 8 Food containers stored off the floor ` 0 �k 1-1-1 11 11, ­ t 1 11 A 9,.. w ° a A Soap/paper towels/ drying device available 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 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: OF. PHFs are cold held at: OF. Describe illness conditions when you would exclude a food wor 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 your to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness Rowt5alt requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold Iding foods/equi Y N and diseases tot ? Y N *Do you have a paid sick leave policy? Y N Are foods Cooke in e d d? Y +Are leftovers saved? Y N Is the anguage barrier between inspector&QFO? Y N If yes indicate language spoken List products co y 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 monitored time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain signatur the pe on who received the QFO responsibilities information at the time of the Is the oduce washing policy? Y N ♦Describe what is washed and inspection: re where: Note: This report is a two page form(total 0162 Zlebitable items) Page 1 of 2 i r. Establishment: Date of Inspection: 7 ddress: ( Q Owner or Operator: 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 1 1 oxic chemicals. No cross connections,back siphonage,backflow ro erl ,labeled properly,used properly Proper type/installation/backflow prevention device/air goo fo -Stored r: -Food equipment -Hose connections -Dish machines -ban d izerconcen ration 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 -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 ISources of food: Original container,properly labeled 40 Garbage/rubbish storage area/rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properly thawed �)Garbageftubbish disposed of in an approved manner,at approved frequency 1 ood dispensing utensils properly stored 2>rmin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 43 Outer openings protected against entrance of insects/rodents 4 loors: 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 7 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 9 No reuse of single service article 9 alls,ceilings attached,equipment properly constructed,good repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, maintained installed located 5 ustless 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 JE54 Rooms adequate,clean,adequate lockers provided,facilities clean 7 Nonfood-contact surfaces of utensils&equipment clean )Establishment and premises free of litter,no insect/rodent harborage, Equipment/utensils,storage,handling no unnecessary articles Proper disposal of wastewater 56 Complete separation from living/sleeping quarters and laundry 3 lumbing location,installation,maintenance 57' anlsoiled linens stored properly 8 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 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) 3 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean outine Inspection OReinspection 0 Preoperational Inspection Other Inspection: I PE T R: PERSON IN CHARGE: Demerit Score: •Include demerits from page 1 4 3 2 1 Total Rating s' nature signature pp�y �Ix V print name print name 1/1 /�. �©� DATE CORRECTIONS DUE: phone number title Page 2 of 2 plus 22— continuation pages V Focused Inspection 1/2002 -kic 'N' cv.\ ire rsA-r bp- i 1, •• ' i • ' 1 NJ 1 NAME OF iLISHMENT DATE OF • NON1 A / 1 M• IN N _a.� Jl1+L _ ram—ma- L/ OR � �s • it !t Tyr , L .�f.ta• - V '- �\• i. •� ems. � � . , s � �r • s 3 1l NAME OF • OF • m JARS llll (. Bill WOOL 111150111im Ilk • . Ri ji 9-IV,69 INITIAL •' • � � EHS-106-Rev.06101 INSPECTION REPORT STATE OF CONNECTICUT ❑ ROUTINE INSPECTION Lg`REINSPECTION • FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ PREOPERATIONAL ❑ OTHER 410 Capitol Avenue,MS#51 FDP,Hartford,CT 06134 NAME OF ESTABLISHMENT ESTABLISHMENT S CLASS STREET ADDRESS �i Ls �t& TOWN , n; OWNER or INSPECTION W t OPERATOR � DATE and TIME Based on an inspection this ay,the items marked below identify the violations in operation or facilities which must be corrected y the date specified below. SOURCES OF FOOD EQUIPMENT&UTENSILS:CLEANLINESS VERMIN CONTROL 1 Approved source,wholesome, 4 21 Preflushed,scraped,soaked and racked 42 Presence of insects/rodents 2 nonadulterated 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of 1 2 Original container,properly labeled 1 23 Accurate thermometers provided,dish basket,if used insects/rodents 24 Sanitization rinse(hot water-chemical) 2 FOOD PROTECTION 25 Clean wiping cloths 1 FLOORS,WALLS&CEILINGS 3 Potentially hazardous food meets 4 26 Food-contact surfaces of utensils& 2 4 Floors:floor covering installed, temperature requirements during storage, equipment clean constructed as required,good repair,clean preparation,display,service,and 27 Nonfood-co transportationntact surfaces of utensils& 1 45 Floors,graded,drained as required equipment clean 46 Floor,wall juncture covered 4 Adequate facilities to maintain product 2 28 Equipment/utensils,storage,handling 1 47 Mats removable,good repair,clean temperature,thermometers provided 5 Potentially hazardous food properly thawed 2 48 1 Exterior walking,driving surfaces, 1 6 Unwrapped or potentially hazardous food 4 WATER SUPPLY good repair,clean not reserved 29 Water source adequate,safe 4 1 Walls,ceilings attached,equipment properly 1 7 Food protected during storage,preparation, 30 Hot and cold water under pressure, 2 constructed,good repair,clean. Wall&ceiling display,service&transportation 2 provided as required surfaces as required. 8 Food containers stored off floor 50 Dustless cleaning methods used, 1 SEWAGE DISPOSAL cleaning equipment properly stored 9 Handling of food minimized 2 31 Sewage disposal approved 4 10 Food dispensing utensils properly stored 1 32 Proper disposal of waste water 1 UQHTING&VENTILATION 11 Toxic items properly stored,labeled,used 14 51 dequate lighting provided as required 1 PLUMBING Room free of steam,smoke odors 1 PERSONNEL 33 Location,installation,maintenance 1 53 Room&equipment hoods,ducts,vented as required 12 1 Personnel with infection restricted 14 34 No cross connection,back siphonage,barrow 14 DRESSING ROOMS&LOCKERS CLEANLINESS OF PERSONNEL TOILET FACILITIES 54 Rooms adequate,clean,adequate lockers 1 13 Handwashing facilities provided, 4 35 Adequate,convenient,accessible,designed, 4 provided,facilities clean personnel hands washed clean installed 14 Clean outer clothes,effective hair restraints 1 36 Toilet rooms enclosed with self-closing door 1 15 Good hygienic practices,smoking restricted 2 37 Proper fixtures provided,good repair,clean HOUSEKEEPING 55 Establishment and premises free of litter,no 1 EQUIPMENT&UTENSILS: DESIGN, HANDWASHING FACILITIES insect/rodent harborage,no unnecessary articles C NSTRUCTION&INSTALLATION 38 Suitable hand cleaner and sanitary towels or 1 56 Complete separation from living/sleeping quarters 1 6 1 Food-contact surfaces designed,constructed, approved hand drying devices provided, and laundry maintained,installed,located tissue waste receptacles provided 57 Clean/soiled linens stored property 1 17 Nonfood-contact surfaces designed, 1 58 No live birds,turtles,or other animals 1 constructed,maintained,installed,located GARBAGE/RUBBISH STORAGE&DIS I (except guide dogs) 18 Single service articles,storage,dispensing 2 39 Approved containers,adequate number, 1 19 No reuse of single service article covered,rodent proof,clean NONSMOKING AREAS 20 Dishwashing facilities approved design,adequately 2 40 Storage area/rooms,enclosures— 59 1 Seats 75 or more:Nonsmoking area provided, 3 constructed,maintained,installed,located properly constructed,clean sign(s)posted at entrance(s),smoking area 1 indicated by sign(s) 41 Garbage disposed of in an approved manner, at approved frequency QUALIFIED FOOD OPERATOR DEMERIT SCORE 60 Qualified Food Operator 3 4 0 3� 2 ` RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2 62 Written documentation of training program 2 � 0 Signature of Person in cha TOTAL RATING Date Corrections Due D(Inspector) DESCRIBE DEFICIENCIES ON CO INUATION SHEETS Page of 2- INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWNC ` 1 DATE OF INSPECTION INSPECTION U REMARKS FORM# O 'r lace ° koY oA 4�' Ao a\ x ti INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager