The URL can be used to link to this page

Home My WebLink AboutFood Service Establishment Inspection 85 (9) i Establishment: Inspection Date: —i Z Time: ddress/City: is'.) V ROinsp REinsp h Dept p c � u- class: Based on an inspection this day,the items marked DNC identify the violations in Healtoperation or facilities which must be corrected by the date specified 1 2�a ed on page 2. RISK FACTOR ITEMS Listing is not inclusive of all possible debatable items C N/0 /A DNC d Icy; C[complies] N/O[not observed] N/A[not applicable] +da,F®�d trptor <� - DNC[does not comply] 0[other] RTE[ready-to-eat] 51 i es4gr atadAlternate f ,i�ewac vft fn#eCtr(xa restrteted 62 tllfri#ten docrteotation of trainin a AGO 4 a prografrt 2 A Food workers have no exposed infected lesions/burns 1 Approved source,wFt4lesfltrre,nonadubrated C ft[/0 �A 4 B Personnel with infection restricted A A roved shellfish,firl meat& oult USDA a roved C Co 11 m 11 municable disease of worker reported to local health director B Food cans in good condition(not dented,rusty,bloated,leaking) 1S ' 9 facli itieg provtdod,hands C Wholesome/nonadulterated foods/safe A Handwash facilities in all food prep/dispensing&warewash areas 4 D Commercial products(no home grown/canned food) B Handwash facilities in or immediately adjacent to toilet rooms E Potentially hazardous foodsreceivedatpropertemperature C Handwash facilities accessible/convenient to use 0 D Personnel hands washed,clean/Proper handwash procedure 11 tint hazardus foodet#sripe � 1rt #salf E Handwashing at appropriate times d u>iisg It rne,kiaepar4Bi0 d (ay,s�railse and;tapaftidtt ' �, 0 = rq A Hot holding greater than or equal to 140°F. (Wn(wholebeeflpork roasts tsoOF) > 00 NIA 2 B Cold holding less than or equal to 45°F. A El No eating Mn❑� smoking while working C Proper cooling B Wounds covered adequately C Proper sink andwas used for hhing D Proper re-heating 0 E Proper internal cooking/consumer advisory posted 9 # # 0 CNf0' 2 A Approvedsanitizeravailable/adequate concentration ofsanitizer dt Food-contact surfaces and utensils used for potentially trbfraweraturs ttRll�cimersp � B hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp B Proper food thermometer for product D Pro ersanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 0 C dtsplaY,service and transportation NO N/A 1 A Cloths and/or sponges in good repair and clean HA Produce washed B Wiping cloths kept in sanitizer between uses Raw meats not stored/prepared near ready-to-eat foods C Food covered properly D Adequate splash guards/sneeze guard Food equipment clean,utensils clean,equipment interiors clean E No unauthorized personnel B Single use gloves changed when soiled F No pooling of eggs not cooked immediately C Food--contact surfaces clean 8 Food containers stored off the floor 08 y� a " stttites povtlede,, u#tad rote G II0 A 1 A No unnecessary handling RTE and/orcooked foods with bare hands A Soap/paper towels/ drying device available B Minimize food handling,other than ready-to-eat,with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel C Adequate utensil(s)for dispensing food/ice C Handwash sinks)clean/waste receptacle at handwash sink 0 0 The following information is not debitable and does not affect your score. •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS BEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodborne] PHFs are hot held at: °F. PHFs are cold held at: o Are internal cooking temperatures taken? Y N *To what temperature do you cook:F. Describe illness conditions when you would exclude a food worker from working: Poultry Ground Beef Roasts Pork What diseases related to FB illness are you required to report to the local heal Other P ment. Describe re-heating procedures: Are temperatures recorded/logged for cold holding foods/equipment? Y N I .there a written illness policy that requires the food wor eport specific illness conditions and diseases to the QFO? Y N *Do e a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N Are lefto ved? Y N Is there a language barrier betty List products cooled: ' pector&QFO? Y N fJ -S indicate language spoken Describe cooling methods: by QFO/DA: *Can the QFO/DA read the inspection report? Y N Indicate who answered the above questions:Name(print): Is cooling monitored for time&temp? Y N Is the monitoring of cooling recorded? Y N Indicate the title of above person circle all that apply):QFO DA Mgr Cook Owner FW *Obtain signature of the person who received the QFO)responsibilities information at the time Is there a produce washing policy? Y N *Describe what is washed and inspection: of the where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 77 Establishment: ) tiJ Y ddress: Date of inspection: Owner or Operator: —� ADDITIONAL FOUR POINT ITEMS z 6 Foods not re-served. o KEY: DNC [DOES NOT COMPLY] -Unwrapped foods not re-served 4 31 Sewage disposal approved. -Potentially hazardous foods not re-served 3 -Operating as required 1 oxic chemicals. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly 4 Property a/installation ba kflow prevention rvice/nir gap for; -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 -Pesticides/rodenticides properly dispensed -Chemical dispensers -Ice machines Pro-per 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 2 Sources of food:Original container,properly labeled KEY: DNC [DOES NOT COMPLY] 0 Garbage/rubbish storage area/rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properly thawed 1 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored i 2 Vermin Control: No insects/rodents present 14 Food worker.Clean outer clothes,effective hair restraints t 3 Outeropenings protected against entrance ofinsects/rodents TTf 16 Food-contact surfaces designed,constructed, maintained,installed, 4 Floors: Floor covering installed,constructed as required,good repair,clean located 5 Floors graded,drained as required �¢; q 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, located 7 Mats removable,good repair,clean 18 Single service articles,storage,dispensing e 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 ,6 50 Dustless cleaning methods used,cleaning equipment properly stored maintained installed located Equipm nt& t n it I anlinacc 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked 22 Wash water clean,proper temperature 52 Room free of steam,smoke odors 23 te thermometers provided,dish basket,if used 53 Rooms&equipment hoods,ducts,vented as required Accura 27 Nonfood-contact surfaces of utensils&equipment clean 54 Rooms adequate,clean,adequate lockers provided,facilities clean 8 quipment/utensils,storage,handling 55 Establishment and premises free of litter,no insed/rodent harborage, no unnecessary articles 2 Proper disposal of waste water 56 Complete separation from living/sleeping quarters and laundry 3 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 entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean outine Inspection ❑Reinspection ❑ Preoperational Inspection IN E T PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 1 signature sign ture 4 3 2 1 Total Rating rint name n n t 3 -2 1 Z .5c L�g der phone number title DATE CORRECTIONS DUE: Page 2 of 2 plus continuation pages Focused Inspection 1/2002 Page C3 of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION 7Ak(44, T>0 4 v f INSPECTION FORM# REMARKS 2-� `-(� J�y4e tine — c) �P S C0Jqe061M( s a C C �O ",C4- S P ITG9` 00a- - �,Sozpn Pe T JJ PIJAj k VAII-w �," EAU IMC in 1 �tjAs ik,)& 14 3"F LL4 /AAJ2,lv S &A1 -Di.rckaA--e,t A aC � L,, - s o U (J` v(CV(J N C (1�61// INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager