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Home My WebLink AboutFood Service Establishment Inspection 65 (5) I J" Establishment: 7 caZA I s Inspection Date: !a ,r 6z Tit11� Oin p REinsp Address/City: v (—L- Health ept: d� t.c,�J 2— : 1 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/0 NIA DNCtA y; C[complies] NIO[not observed] N/A[not applicable] $ DNC[does not comply] 0[other] RTE[ready-to-eat] Food workers have no exposed infected lesions/burns ,2Personnel with infection restricted Communicable disease of worker reported to local health director Approved shellfish,finfish,meat&poultry-USDA approved B Food cans in good condition(not dented,rusty,bloated,leaking) Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadulteratetlfoodslsafe 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 140eF. (whole 7b-eef1porkasts 1300 F.) ❑ No eating ❑ No smoking while working B Cold holdingless than or equal to450F. 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 of sanitizer B Food-contact surfaces and utensils used for potentially hazardous food sanitized at least every 4 hours A Foodthermometer available and accurate Adequate ❑dishwashersanitizer ❑final rinse temp B Properfoodthermometer for product D Proper sanitizin rocedure s appropriately placed in coolerSanitizing between raw animal origin&ready-to-eat food C Thermometer 0 Q A Cloths and/or sponges in good repair and clean duce washed B Wiping cloths kept in sanitizer between uses A Pro 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 g Single use gloves changed when soiled E No unauthorized personnel LC Food contact surfaces clean F No pooling of eggs not cooked immediately ood containers stored off the floor A No unnecessary handling RTE and/or cooked foods with bare hands Soap I paper towels/ drying device available B Dispenser(s)working: ❑Soap ❑Paper towel Loo B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean/waste receptacle at handwash sink 6,00 C Adequate utensil(s)for dispensing food/ice 0 01 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. JSEY: QFO[qualified food operator],DA[designated aftemate],PHF[potentially,hazardous food],FB[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 What diseases related to 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 s _00ellifFess conditions Are temperatures recorded/logged for cold holding foods/equipme� N and diseases to the QFO? Y N *Do you have a paid ' ave policy? Y N Are foods cooked in advance and cooled? Y N ♦ eftovers saved? Y N Is there a language barrier between inspector&QF N Iflf ves indicate language spoken List products cooled: by QFO/DA: the QFO/DA read the inspection report? Y N Describe cooling methods: Indicate who answered th ve questions: Name(print): Indicate the title answered 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 sig2eree of the person who received the QFO responsibilities information at the time of the Is there a produce washing y, inspection: p g policy? Y N *Describe what is washed and where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 , ;�, $.e LOCAL HEALTH DEPT. 1 kDDRESS1ClTY:1,tY Establishment: L a4 Date of Inspection. ddress: 1- ( t'e Owner or Operator: ADDITIONAL FOUR POINT ITEMS o 6 Foods not re-served. KEY: DNC [DOES NOTCOMPLY] ' 4 31 Sewage disposal approved. -Unwrapped foods not re served -Operating as required -Potentially hazardous foods not re-served 11 oxic chemicals. 34 No cross connections,back siphonage,backflow Proper type/installation/backflow prevention device/air gapfor: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines m -San itizer concentration notto 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. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4 -Water quality in compliance-Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 1 ' 0 Garbage/rubbish storage area/rooms,enclosures-properly constructed,dean 1.: Potentially hazardous food properly thawed 2 1 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 2 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outer openings protected against entrance of insects/rodents 4-4 ors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, 2 Floors graded,drained as required located ` 6 Floor,wall juncture covered , 17 Nonfood-contact surfaces designed,constructed, maintained, 1 7 Mats removable,good repair,clean installed,located C18 Single service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean 19 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, 2 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equiipment&Utensils: Cleanliness r7 , 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 2 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 7 Nonfood-contact surfaces of utensils&equipment clean 1 44 55 Establishment and premises free of litter,no insect/rodent harborage, quipment/utensils,storage,handling Z771 no unnecessary articles 32 Proper disposal of wastewater 1 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance l i 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) 1 59 Seats 11 or more:Nonsmoking area provided,sign(s)posted at 37 Propertoiletfixturesprovirled,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean Routine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: IN PECT R: PER IN HARG Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating si ature signature print name print namej� hone number tide DATE CORRECTIONS DUE: ® �2CCC2lll—(t Z"'444ddd"' 'n K 2T ,Y 111page2of2plus continuation pages Focused Iuspectio:-E-1' 11 -I • NAME OF • DATE OF • OAS hMA �Fff ff4 ,fAW,&%T4UJmrAp� MUM I I ',M W"AN �M N, �� Wol • • &MLA. i • i. r (INSPECTOR) ' . • C Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF ON te-PA (S �� wtwv ,�R— r0 (1'SPEC I Z INSPECTION REMARKS FORM# 2L 40(J-% f- —2 KA,,,,j co, / 7 A v C6 Se ti Poll k ML C JAtJ sall.f e /t ocY INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager