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Home My WebLink AboutSchool Inspection 949 Avery Street (3) i Establishment: Phdy 4L- Sy-,tVL Inspection Date: Time: ; ROins REinsp Address/City: Healt Fi ass t: <; _ � .r cl ; t 2 04 Based on an inspection this day,fhe 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 0 N/A DNC KEY: C[complies] NIO[not observed] NIA[not applicable] r � s DNC $ o er K I E[ready-to-ea -fig,Wro 61 LjesgrriEeditte � 2 .2' `1Fs» f`yiritfew'restrta# d C ", 4 62 Wtttten documentation of training program 2 A Food workers have no exposed infected lesions I burns B Personnel with infection restricted 1 Approved source,wholesome,nonedottereted CJ000 NIA 4' C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultryUSDA approved 13; Handthin faeflities rovided;hapd�' �c JW B Food cans in good condition(not dented,rusty,bloated,leaking) ` '° 0 A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulteratedfoods/safe VZ 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 3 potett€- wamo6S-1, d reeefe t ,p � fog , o during s fags,pmt�er t rn,.dispi Y,sers B �tf d � : 15 C W6 WA 2' A Hot holding greater than or equal to 1400F. (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 �, e( ai> sniN� t;.„ iA: 2 �L .4, 0 A Approved sanitizeravailable/adequate concentration of sanitizer Food-contact surfaces and utensils used for • terrip 8 eire,t#ferrrtixtieters prp �d *p "��,, B hazardous food sanitized at least every 4 hours potentially n E A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp Pro B Properfood thermometer for product rocedure D Proper sanitizing C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 777. dt�cil pfoteCttil tll � 3 0 .> �. display,service and transporta{tan, A Cloths and/or sponges in good repair and clean A Produce washed B Wiping cloths kept in sanitizer between uses 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 C Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor 44 9 Handling of food minimized � 1..'. A No unnecessary handling RTE and/or cooked foods with bare hands A Soap paper towels I drying device available B Dispenser(s)working: ❑Soap El 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 0 -DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualfied food operator],DA[designated alternate],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 t•-1 Poultry Ground Beef erl What diseases related to FB illness are you required to report to th department? Roasts Other Describe re-heating procedures: Is there a written illness policy that require od worker to report specific illness conditions Are temperatures recorded/logged for olding foods/equipment? Y N and diseases to the QFO? Y *Do you have a paid sick leave policy? Y N Are foods cooked in adywerand cooled? Y N *Are leftovers saved? Y N Is there a I artier between inspector&QFO? Y N Iflf ves indicate language spoken List products cool by O/DA: *Can the QFO/DA read the inspection report? Y N Descr' cooling methods: Indicate who answered the above questions: Name(print): y�y�A Indicate the title of above person(circle all that apply):CIF DA Mg 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 rec ive the QFO response ilities 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 1 of 2 Establishment: 4\C: f` 4-� Date of Inspection; ?� ? Owner or Operator: ADDITIONAL FOUR POINT ITEMS 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. 34 No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Proper type/installation/backflow prevention device/air 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 Proper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, -Monitoring in compliance -Water quality 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,dean 5 Potentially hazardous food properly thawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected against entrance of insects/rodents 24 Floors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, 45 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed, maintained, 7 Mats removable,good repair,clean installed,located 8 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 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 501 Dustless cleaning methods used,cleaning equipment properly stored EEquipment&Utensils• Cleanliness 511 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 541 Rooms adequate,clean,adequate lockers provided,facilities clean 27 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,noinsect/rodentharborage, 28 Equipment/utensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 56 Complete separation from living/sleeping quarters and laundry 33 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 Other Inspection: INSPECTOR: PERSON IN CHARGE: Demerit Score: *Include demerits from page 1 1�U 4 3 2 1 Total Rating signature 0 signature prin name print name X X() Z <AA_ l ILZ-- DATE CORRECTIONS DUE: ,� ; phone number title Page 2 of 2 plus continuation pages Focused lnspectlon //2002 Page of a� INSPECTION REPORT STATE OF CnNNF,C T ICITT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION )2 S v INSPECTION REMARKS FORM# F1 CW1 -3s° ; k- 0 INITIAL(INSPECTOR) Svv INITIAL(PERSON IN CHARGE) , Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager