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HomeMy WebLinkAboutFood Service Establishment Inspection 10 (2) Establishment: VP Inspection Date: Time: �ROins REinsp ddress/City: Heat De9 ass; 1 2 3� Based on an inspection this day,t items marked DNC id ntify 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 I N/0 I N/A NC a6 �#ualiged FobrtQf * DNC�[doe§not comply] 0[other] RTE[ready-to-eat] �,. 21'F P filid ti W itti i° ect1ADn restrreted 61 Designated Afternate C' Nl A '4 Written documentation of training program 2 A Food workers have no exposed infected lesions/burns 7 A Approved source,wholesome,nflnaduiterated C N/0 /A B Personnel with infection restricted C Communicable disease of worker reported to local health director A roved shellfish,finfish,meat& oult USDA a roved 13 Handwashing facilities provided,hands abashed,clean C N/ A 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 01 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 3 Potentiaiiy hazardous fo©d meefs teaapture regitirei�ents � #� Q t andwashing at appropriate times rang sbrag�,PFeParatiesn,dleptay rn1e� 1 pfr i�t�chw i5 Good'hrygienicpracticas C NlO; WA 2': A Hot holding greater than or equal to 1400F. (whole beef/po,k roasts 1300 e) 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 ? Al #� ttbta t iks W #er' clpl ` 0 A Approved sanitizer available/adequate concentration of sanitizer 4 Adegwate° o {se to "tarn pf`tad �­11 g Food contact surfaces and utensils used for potentially terrtratu tittolet � rdvtddc hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp B Proper food thermometerfor product L Proper sanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 Y Food prated t!u rhb WiR , display,service and transportation 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 0 C Food covered properly 0, 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 &or _7 Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor 0 ///��� 9 Handling of food nanirmzed ` 7. A No unnecessary handling RTE and/or cooked foods with bare hands er towel / drying device available ;00- Tll­spe orking: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean/waste receptacle at handwash sink Adequate utensil(s)fordispensing food/ice 0 O 1 •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: OF. PHFs are cold held at: F. 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 r ort specific illness conditions Are temperatures recorded/logged for cold holding foods/e ent? Y N and diseases to the QFO? Y N ♦Do you have sick leave policy? Y N Are foods cooked in advance and cooled? Y *Are leftovers saved? Y N Is there a language barrier between inspector O? Y N IIfy indicate language spoken List products cooled: by CFO/DA: *Can the QFO/DA read the inspection report? Y N Describe cooling method Indicate who answers above questions: Name(print): Is cooling mo ' red for time&temp? Y N Is the monitoring of cooling recorded? Y N Indicate the o above person(circle all that apply):QFO DA Mgr Cook Owner FW *Obtain signature of the person who received the QFO responsibilities 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 LOCAL HEALTH DEPT:j TOIL ADDRfSSICITY: � -- , Establishment: -1 OL 44 i? Date of Inspection: ADDITIONAL F UR POINT IT MS o KEY: DNC [DOES NOT COMPLY] z 6 Foods not re-served. -Unwrapped foods not re-served 4 31 Sewage disposal approved. 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow 01 v 4 Proper type/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration not to 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: t 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, -Water quality in compliance -Monitoring incompliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storage arealrooms,enclosures-properly constructed,dean 5 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 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outer openings protected against entrance of insects/rodents Flo s: Floor covering installed,constructed as required,good repair,clean ` 16 Food-contact surfaces designed,constructed,maintained,installed, 2 -Floors graded,drained as required Gated 6 Aor,wall juncture covered 7 nfood-contact surfaces designed,constructed,maintained, 1 7 Mats removable,good repair,clean installed,located 18 Single service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean 9 Walls,ceilings attached,equipment properly constructed,good 19 No reuse of single service article 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 Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked ;JRoom free of steam,smoke odors 22 Wash water clean,proper temperature ooms&equipment hoods,ducts,vented as required curate thermometers provided,dish basket,if used 54 Aoms adequate,clean,adequate lockers provided,facilities clean onfood contact surfaces of utensils&equipment clean 1'E 55 Establishment and premises free of litter,no insect/rodent harborage, 8 Equipment/utensils,storage,handling .; no unnecessary articles 32 Proper disposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance 1 571 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 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 1 Approved garbage/rubbish containers,adequate number,covered, w1 rodent proof,clean outine Inspection OReinspection 0_Preoperational Inspection Other Inspection: IN P7TRJ: PER E: Demerit Score: *Include demerits from page 1 Ala, 4 3 2 1 Total Rating si ature natur print a �y Z print name l `, A7.,, 7 6� f S�� 5�� Lln� en'nn DATE CORRECTIONS DUE: p one number title Page 2 of 2 plus—�continuation pages Focused�.mp,,.m Page S of 3 INSPEC110NREPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF IN PECTION tilly J7 INSPECTION REMARKS FORM# L n k t,4 9 r"A =2 c2-7 v cJJ,-Ti ::2�� r�L J " -� i j,,. 4 �,,,A- L W f-5S 1,o c, 4 Irl-t C Of S t C S rb C 1 -7 k4c v .e CjreA, S Lo 0 P Lo e,11 KA u1L5 s aW 76 39" I'vLIE idCLA10 QJA-A 4ocue,� � v CCTV � �"ssi ti 1 -7 64 lj� I vt f -T0-f-0 (-�A le�) —�7 clt4i^� - 4 �e - 7)0 CA, 0,4�/ -S' 4 /(-IV em ro 0 4 04/, 6-c �- )D C �Jk ✓40 - INITIAL(INSPECTOR) INITIAL(PERSON IN CHA GE Distribution: 1st-White-Health Department 2nd-Yellow- ager