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Home My WebLink AboutFood Service Establishment Inspection 51 (2) i Establishment: Inspection Date: Tim ROinsp 'REms ddress/City: Health Dept: -�',� ,E Lt�/r,� _lJ P_ Class: t 2 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 XA JDNC I KEY: C[complies] N/O[not observed] N/A[not applicable] i n�•�_� . ��..� � . . pat d �:l" it#i nfe ct#an restti�ed 61 �sgrtaiet!Alternate �. �, � 2 � C N/p Ill 4' 62 Written documentation of training program 2 A Food workers have no exposed infected lesions I burns 1 Approved source,wholesome,nonaduiterated C N/0 /A 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 faelilties provided,handswashed,cieatt C l�}/0 NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&waashedrewash areas C Wholesome/nonadulterated foods/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 I Proper handwash procedure 0 g E Handwashing at appropriate times 3' Pot tia yI�aa dvt3s f dd meat to-ft r ti � 0 durang storage,prepara'Cias,display,serrrtce a trap'ep0- s 15 Goo !hygieatic,'prac#ices C WO N/A 2 A Hot holding greater than or equal to 1400F. (Whole beeFlpork roasts 130'F.) A ❑ No eating El 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 E Proper internal cooking/consumer advisory posted t;r +e{ titfated t011 y y -6000 [ ; �. �4.. 0 A Approved sanitizeravailable/adequate concentration ofsanitizer +tom ftaRtiinnd. f B Food-contact surfaces and utensils used for potentially teImperatWro tl ilnlorttd Xs . A x.fl 4 hazardous food sanitized at least every 4 hours ti A Food thermometer available and accurate Lo C Adequate ' washersanitizer ❑final rinse temp �L Propersanitizin procedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food LOOO C Thermometers appropriately placed in cooler units 0 0 777 ° r"- V �'719Yt �f T ,. 1'.. .i .,pl display,service and transportmltm A Cloths and/or sponges in good repair and clean B 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/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 .. T7 77"isintl`dg+tif'foatl tttiti A Soap I paper towels I 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 _T44� 0 •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 you cook: Poultry Ground Beef Pork What a edfo FB illness are you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foods/equipment? and diseases to the QFO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N eftovers saved? Y N Is there a language barrier between inspector&QFO? Y N indicate spoken List products cooled: by QFO/DA: *Can the QFO/DA nspection report? Y N Describe cooling methods: Indicate who answered the above : Name(print): Is cooling monitored for tim temp? Y N Is the monitoring of cooling recorded? Y N Indicate the title of ab son(circle all that apply):QFO DA Mgr Cook Owner FW *Obtain signature o the person who received the CFO responsibilities information at the time of the Is there a produce washing policy? Y N ♦Describe what is washed and inspection: where: Note: This report is a two page form(total of 62 debitable items) Page t of 2 7-6pikilt TF11)EW: �2 " I�HDRESSt�I'fY 3 Establishment: �e1L f T - -- Date of inspection; 1-,3 12- ddress: S_1 rT �, j�l� Owner or Operator: ADDITIONAL FOUR POINT ITEMS c KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. -Unwrapped foods not re-served 4 31 Sewage disposal approved. 4s -Potentially hazardous foods not re-served -Operating as required 37 11 Toxic chemicals. ` No cross connections,back siphonage,backflow 41 -Stored properly,labeled properly,used properly Proper type/installation/backflow prevention device/air gap for: -Sanitizer concentration notto exceed maximum permitted -Food equipment -Hose connections -Dish machines -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 -Water quality in compliance ,' 35 Toilet facilities. Adequate,convenient,accessible, -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] Sources of food: Original container,properly labeled 40 Garbage/rubbish storagearea/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 2 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints jj 3 Outer openings 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, n 5 Floors graded,drained as required located 6 Floor,wall juncture covered 17 on contact surfaces designed,constructed,maintained, 7 Mats removable,good repair,clean installealle d,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 properlystored 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 54 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 Properdisposal of waste water 56 Complete separation from living/sleeping quarters and laundry lumbing location,installation,maintenance 571 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 WIRoutine Inspection ❑Reinspection ❑ Preoperational Inspection IN PET : PERSON IN CHARGE: ther Inspection: U /�X_ Demerit Score: *Include demerits from page 1 fil 0 0 aV 4 3 2 1 Total Rating s nature Si e pant name 0-rename, phone number itie DATE CORRECTIONS DUE: ,z r 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 ((jj DATE OF INSPECTION L L [Aj INSPECTION FORM# REMARKS 3— p clrkv 3elA(J o 5A,farQ j+ w r o✓ - e1/ 5AJ 5-92 1-71 0 la- Ck tl 5 (P �?vr)0 A-10 4- s S uI+ �-D X � Aj Kr6j,)A - I "'o fr. I J4-�J A- 4UAIA4e a�zj INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) C 5 Distribution: lst-White-Health Department 2nd-Yellow-Owner/Manager