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Home My WebLink AboutSchool Inspection 100 Arnold Way (2) i stablishment: Inspection Date: Time: :trio Ed In REinsp Address/City: Health ept: S Class: 1 2 Qb4 Based on an inspection this day,the items marked DLqC 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 N/A DNCI KEY: C[complies] N/0[not observed] NIA[not applicable] firm W 2 A Food workers have no exposed infected lesions/burns 62 WWII, 2 B Personnel with infection restricted C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulteratedfoods/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 VT I 0 E Handwashing at appropriate times 0 A Hot holding greater than or equal to 1400F. (Whole treef/pork roasts 1300 F.) A E] No eating ❑ No smoking while working B Cold holding less than or equal to 450 F. 1'1B Wounds covered adequately C Proper cooling V C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking/consumer advisory posted 0 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 Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 A Cloths and/or sponges in good repair and clean -1� 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 V0 8 Food containers stored off the floor 0 A No unnecessary handling RTE and/or cooked foods with bare hands MC -Handa Soap/paper towels I drying device available Dispenser(s)working: ❑Soap ❑Papertowel B Minimize food handling,other than ready to eat,with bare hands wsh sink(s)clean/waste receptacle at handwash sink 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. _M: QFO[qualified food operator],DA[designated alternate],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 hat diseases rela ed to FB illness Ire to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written i ss policy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding fo quipment? Y N and diseases to the CFO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and Goole N *Are leftovers saved? Y N Is there a language barrier between inspector&CFO? Y N If-yes indicate language spoken List products cooled: by QFO/DA: *Can the QFO/DA read the inspection report? Y N Describe cooling methods: Indicate who answered the above questions: Name(print): Indicate the title of above person(circle all that apply):QFO DA Igr Cook Owner FW Is cooling monitored for time&temp? Y N is the monitoring of cooling recorded? Y N [Note: Obtain signature o the person wh eceived the QFO responsibilities Information at the time of the Is there a produce washing policy? Y N *Describe what is washed and inspection: where: This report is a o page form(total of 62 debitable items) Page 1 of 2 i IMP 71ishment: ' we J Date of Inspection: M,!L Owner or 0 or: ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. -Unwrapped foods not re-served 4 31 Sewage disposal approved. 4,. -Potentially hazardous foods not re-served I =R -Operating as required 11 Toxic chemicals. 34 No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Proper type/installation/back low prevention device/air gapfor: -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, -Water quality in compliance designed,properly installed -Monitoring in compliance 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 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected against entrance of insects/rodents 4 Floors: Floor covering installed,constructed as required,good repair,clean 1 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 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 501 Dustless cleaning methods used,cleaning equipment properly stored EEquipment&Utensils: Cleanliness 5 11 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 231 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,no insect/rodent harborage, 28 Equipment/utensils,storoge,handling no unnecessary articles 32 Proper disposal of waste water 561 Complete separation from living/sleeping quarters and laundry 33 Plumbing 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) 59 Seats 75 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 gRoutine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signatu e signature � O � i not name e 1 p print n eZk UCYUr b_{ t'ea�J 1 phone number title DATE CORRECTIONS DUE: C �` a` Page 2 of 2 plus continuation pages V Focused Inspection1/2002 Page_ of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION FORM# REMARKS h- `"Zar �.x nt ,W I a c sc" zee i Z� -- UU 0 6 � LL -5(:,o -Tv,&-5oAA� 7�� vv uprU m co rvl<�A- 0 (-\0U\k4 ko Va* 6-c- 1L - INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) �Z/. Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager