HomeMy WebLinkAboutFood Service Establishment Inspection 86 (4) `EHS-106•Rev.06/01 INSPECTION REPORT STATE OF CONNECTICUT
\ 13 ROUTINE INSPECT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ P EOPERATIONALION ❑ OTHER REINSPECTION
410 Capitol Avenue,MS#51FDP,Hartford,CT 06134
NAME OF
ESTABLISHMENT ESTABLISHMENT
STREET CLASS
ADDRESS TOWN
OWNERor
OPERATOR INSPECTION
DATE and TIME $ g
Based ota
n this ,t e items arke below identify the violations in operation or facilities which must be corrected by the date specified below.
SOURCD EQUIPMENT&UTENSILS:CLEANLINESS VERMIN CONTROL
1 Apprholesome, 4 21 Preflushed,scraped,soaked and racked 42 Presence of insects/rodents
nona 2
22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of 1 2 Origioperly labeled 1 Accurate thermometers provided,dish basket,if used insects/rodents
24 Sanitization rinse(hot water-chemical) 2
FOOD PROTECTION 25 Clean wiping cloths FLOORS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 Food-contact surfaces of utensils& 2 44 Floors:floor covering installed,
temperature requirements during storage, equipment clean
preparation,display,service,and constructed as required,good repair,clean
transportation Nonfood-contact surfaces of utensils& 1 45 Floors,graded,drained as required
equipment clean 46 Floor,wall juncture covered 1
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
6 Unwrapped or potentially hazardous food 48 Exterior walking,driving surfaces, 1
not reserved 4 WATER SUPPLY good repair,clean
_7 29 Water source adequate,safe 4 49 Walls,ceilings attached,equipment properly 1
Food protected during storage,preparation, TO 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 LIGHTING&VENTILATION 11 Toxic items properly stored,labeled,used 4 51 Adequate lighting provided as required 1
PLUMBING 52 Room free of steam,smoke odors
PERSONNEL 33 Loc!E:
ation,maintenance 1 53 Room&equipment hoods,ducts,vented as required 1
12 Personnel with infection restricted 4 34 No ction,back siphonage,backflow 4
DRESSING ROOMS&LOCKERS
CLEANLINESS OF PERSONNEL TOILELITIES 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
15 Good hygienic practices,smoking restricted 37 Proper fixtures provided,good repair,clean 1
HOUSEKEEPING
55 Establishment and premises free of litter,no 1
EQUIPMENT&UTENSILS: DESIGN, HANDWASHING FACILITIES insect/rodentharborage,no unnecessary articles
CONSTRUCTION&INSTALLATION 38 Suitable hand cleaner and sanitary towels or 1 56 Complete separation from living/sleeping quarters 1 6 Food-contact surfaces designed,constructed, approved hand drying devices provided, and laundry
maintained,installed,located tissue waste receptacles provided
57 Clean/soiled linens stored properly 1
17 Nonfood-contact surfaces designed, 1 58 No live birds,turtles,or other animals 1
constructed,maintained,installed,located GARBAGEIRUBBISH STORAGE&DISPOSAL (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
20 Dishwashing facilities approved design,adequately 2 40 Storage area/rooms,enclosures— NONSMOKING AREAS
constructed,maintained,installed,located 59[i!nddicat7edby
ore:Nonsmoking area provided, 3
properly constructed,clean sign(s) at entrance(s),smoking area
1 n s
41 Garbage disposed of in an approved manner,
at approved frequency QUALIFIED FOOD OPERATOR
DEMERIT SCORE 60 Qualified Food Operator 3
4 3 2
0 t� RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2
d 62 Written documentation of training program 2
TOTAL RATING IZIBEDEFIC
7,
Signature of Person in charge
SIGNED(Ins or)
ENCIES CONTINUATION SHEETS
•�+' Page of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
S g
INSPECTION
FORM# REMARKS
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager
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