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Home My WebLink AboutFood Service Establishment Inspection 17 (3) i Establishment46 CAN Inspection Date: Time: Roinsp REinsp ddress/City: YL"fl Health ep. os: 1 Based on an inspection this day,the iterk marke IMF'1-tritify 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 deb'table items-__11 N/D KEY! G[eafnpliesj NiG[met observedj NfA[[lot applicabi I IF * pi r _ DNC[does not comply] 0[other] RTE[ready-to-eat] ,P � �, etreirr nel�nril h m ectl9n res ricted ' 61 Desj9nated Alternate z C ►10 AW 4 q Food workers have no exposed infected lesions/burns 62 Written documentation of training program 2 B Personnel with infection restricted 1 Approved source,wholesome,nonadulterated C 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Hartdwashing%C111ties provided,hands washeiii,clean C PUO 4A, 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulterated foods/safe B Handwash facilities in or immediately adjacent to toilet rooms 011 D Commercial products(no home grown/canned food) C Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature 0 D Personnel hands washed,clean/Proper handwash procedure 001,s E Handwashing at appropriate times 3 Potafi F od rest tt { � o dorieg s 2 rara9e prepaon display,serii7pp +lxodtl tirgtT�eric p`rac'tic�ee C iQ N/A A Hot holding greater than or equal to 1400F. (whole beef/pork roasts 130e F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450F. B Wounds covered adequately C Proper cooling Lo C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking/consumer advisory postedf $ rwse� ? t -CiCl), C f ,1 2 0 A Approved sanitize ravailable/adequateconcentrationofsanitizer 4 Adequate fatsi1ttles to 6n41ntsin O'eod d r � B Food-contact surfaces and utensils used for potentially temperature,tltertndrnetep, provide€° hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper sanitizin procedure 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 7 Fond pkitis w d i11gV Ty display,service and transportation A Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between usesor A Produce washed 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 B 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 , 1,77 0 Marra p`tovt _ `` 0 9' Handting cif food minimiiie! 'ft A No unnecessary handling RTE and/or cooked foods with bare hands A Soap/paper towels/ drying device available to 0.1 B Dispenser(s)working: ❑Soap ❑Papertowel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)_clean lyvaste_rEceptacle-at handwash sink 600 I'll - - --- 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[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodborne] PHFs are hot held at: IF. 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 depart Roasts Other Describe re-heating procedures: Is there a written illness policy that requires the food worker to re ecific illness conditions Are temperatures recorded/logged for cold holding foods/equipment? Y N and diseases to the QFO? Y N *Do you have_;Aalelorick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are lefto saved? Y N Is there a language barrier between inspector& Y N Iflf vas indicate language spoken List products cooled: by QFO/DA: ♦ he QFO/DA read the inspection report? Y N Describe cooling methods: 0Z Indicate who answered t�abovjestlons: Name(print): Indicate the title of aboall 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 t ved the CFO responsibilities information at the time of the rwhere: there a produce washing policy? Y N *Describe what is washed and inspection: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 "L&4�4 DEPT: w, i ADDRESSICITY: J Establishment: A 1-7 SC7 Date of Inspection. ddress: Owner or Operaf 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. 34 No cross connections,back siphonage,backfiow -Stored properly,labeled properly,used properly `1' Propertyoe/installation/backflowpreventiondevi el air gap for: -Food equipment -Hose connections -Dish machines-Sanitizer concentration not to exceed maximum permitted . -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 q -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 40 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,clean 5 Potential) hazardous food properly thawed Y P P Y 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 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outeropenings protected against entrance of insects/rodents 4 Flo rs: 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 a 17 Nonfood-contact surfaces designed,constructed,maintained, 1 6 Floor,wall juncture covered installed,located 7 Mats removable,good repair,clean 18 Single service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean : 19 No reuse of single service article 49 Walls,ceilings attached,equipment properly constructed,good 20 Dishwashing facilities approved design,adequately constructed, 2 repair,clean.Wall&ceiling surfaces as required maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 1 ' 51 Adequate lighting provided as required i , 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 urate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 27 nfood-contact surfaces of utensils&equipment clean 1 1 55 Establishment and premises free of litter,no insect/rodent harborage, 8 Equipment/utensils,stnrage,handling 1 no unnecessary articles 32 Proper disposal of waste water 1' 56 Complete separation from living/sleeping quarters and laundry -33 -Plumbing location,-installation,maintenance - _ --57 Clean/soiledlinens stored properly— - ---- 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 1 59 Seats 75 or more:Nonsmoking area provided,37 Proper toilet fixturesprovided,good repair,clean a �� 9 p ded,sign(s)posted at entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, ) rodent proof,clean W outine Inspection ❑Reinspection ❑ Preoperational Inspection IN P TO PERSON IN CHARGE: ther Inspection: Demerit Score: *Include demerits from page 1 10-V - /L 4 3 2 1 Total Rating "synature. si natureY2, print name ph T Y v— DATE CORRECTIONS DUE: phone number title Page 2 of 2 plus continuation pages Focused Inspection 1/2002 Page of 2 INSPECTION REPORT STATT. OF C ECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHME TOWN n DATE OF SPE TION i3 So y wt�-S INSPECTION FORM# REMARKS LD D"ZR vto co/Z �� > o °P �1 a bl a L+ S vor' wc�( c2- ct- r � c) 7Z T b INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager