The URL can be used to link to this page

Home My WebLink AboutFood Service Establishment Inspection 19 (6) Establishment: Inspection Date: 3' Z Time- ROinsp' REinsp Address/City: q Health De t: c ass: 1 2 Based on an inspection this day,the items marked Nt 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 I C N/O N/A DNC �; C[complies] N/O[not observed] N/A[not applicable] 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 2 q Food workers have no exposed infected lesions'/burns 2 B Personnel with infection restricted C Communicable disease of worker reported to local health director A A roved shellfish,finfish,meat&poultry USDA approved LY B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadulterated 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/Proper handwash procedure 0 E Handwashing at appropriate times 0 A Hot holding greater than or equal to 140°F. (whole beef/pork roasts 1300 F.) 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 0 E Proper internal cooking/consumer advisory posted A Approved sanitizer available/adequate concentration ofsanitizer Lloo g Food-contact surfaces and utensils used for potentially hazardous food sanitized at least every 4 hours A Foodthermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp B Properfoodthermometer for product Proper sanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 A Cloths and/or sponges in good repair and clean A Produce washed B Wiping cloths kept in sanitizer between uses 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 Z. No pooling of eggs not cooked immediately 0 8 Pood containers stored off the floor 0 A No unnecessary handling RTE and/or cooked foods with bare hands A Soap I paper towels/ drying device available B Dispenser(s)working: ❑Soap ❑Paper towel 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 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. J(E_Y: QFO[qualified food operator],DA[designated akemate],PHF[potentially hazardous food],FS[foodbome] 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 Roasts Other What diseas a to FB illness are you required to report to the local he partment? Describe re-heating procedures: o Is there a written illness policy that requires the food worker port specific illness conditions Are temperatures recorded/logged for cold holding foods/equipment? Y N and diseases to the QFO? Y N *Do you paid sick leave policy? Y N Are foods cooked in advance and cooed? Y *Are eftovers ed? Y N Is th re a language ba rier be weep in r QFO? f ves in ica a language po eh List products cooled: by QFO/DA: *Can the QFO/DA read the inspection report? Y N Describe cooling methods: Ir 0o, 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 for time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain signature of the person who received the QFO responsibilities information at the time of the Is there a pro uce was mg policy. Y ♦Describe what is washed and inspection: where: Note; This report is a two page form(total of 62 debitable items) Page 1 of 2 LQCALHEALTHOEPT � ..1�( �2 ADDRESSICITY: �ZJ" _, * -:„ ,�.v n "'t Establishment: � Date of Inspection. � � .� Z ddress: Owner or Operator: ADDITIONAL FOUR POINT ITEMS z' o KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. -Unwrapped foods not re-served 4 31 Sewage disposal approved. -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly 4 Propertype/installation/backflow prevention device/air gap for: -Sanitizer concentration not to exceed maximum permitted -Food equipment -Hose connections -Dish machines -No unnecessa toxics on the remises -Soda system carbonator -Beverage dispensers -Toilet tanks -Pesticides/rod nticides properly dispensed -Chemical dispensers -Ice machines Proper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines 4gi -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4a -Water quality in compliance -Monitoring in compliance designed,properly installed OTHER ITEMS .11 KEY: DNC [DOES NOT COMPLY] 2 ourcesoffood: original container,properly labeled 40 Garbage/rubbish storage area/rooms,enclosures-properly constructed,clean Potentially hazardous food properly thawed 2 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 42 Vermin Control: No insects/rodents present s; 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outer openings protected against entrance of insects/rodents 4 ors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, 2 5 Floors graded,drained as required located 6 Floor,wall juncture covered 17 onfood-contact surfaces designed,constructed,maintained, 1 installed,located 7 Mats removable,good repair,clean 18 Single service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean t 19 No reuse of single service article 9 lls,ceilings attached,equipment properly constructed,good 20 Dishwashing facilities approved design,adequately constructed, 2 repair,clean.Wall&ceiling surfaces as required w maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils• Cleanlin ss 1 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 1' 55 Establishment and premises free of litter,no insect/rodent harborage, 28 Equipment/utensils,stprage,handling 1 no unnecessary articles 32 Proper disposal of waste water 12 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 1 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, i rodent proof,clean ❑Routine Inspection ❑Reinspection ❑ Preoperational Inspection INSET PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating P M nature lessi(r. Dl i�o, f 3 print name print name Q r phone number title DATE CORRECTIONS DUE: Page 2 of 2 plus_I_continuation pages Focused Inspection 1/2002 Pap—? of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTIO oJ� s®J c�� .� �. c — z INSPECTION FORM# REMARKS c� �r GF 2- P 7,ql (i ,A-( 1 -i L11D 0j 2 (,( l vS� Vitt fS JA i -A- 544 CaA Jj Oe 9-ru 60J" C it�f tic > INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager