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Home My WebLink AboutFood Service Establishment Inspection 43 (3) �i Establishment: as Inspection Date: Time: Q/ oins REinsp Address/City: Health apt: �< «)L,,eUor Class: 1 2 3 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 00 NIA IDNCl 611 til �st 6ir , f �? 3 DNC[does not comply] 0[other] RTE[ready-t eat] 12 °, er om�el With'infeatton restricted C 0 NIA 4 81 Designated A�terna#e 2 62 Written documentation of training program 2 q Food workers have no exposed infected lesions/burns B Personnel with infection restricted 1 Approved source,wholesome,nonadulterated C V0 NIA 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultryUSDA approved 13 Handwashing facilities provided,hands washed,ciean C WONIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) V A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonaduIterated foods/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/Proper handwash procedure 0 E Handwashing at appropriate times 3 PoteTMtt t ha�Ardotts,�d meets tes t dsrin storage,preparation dtspiaY. lee alai 4 a x .� ho. raitices� C W0' NSA 2� A Hot holding greater than or equal to 1400F. (whole beef/pork roasts i&oo F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 45oF. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 O n z =` e Ica Proper internal cooking lconsumer advisory posted n Viaer. Gtier, Ni 0 A Approved sanitizeravailable/adequate concentration ofsanitizer 4 Adequate faciffttes tts Cstaif3t t1 pro 'et B Food-contact surfaces and utensils used for potentially tom perature,therntorn�rs provided k hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate dishwashersanitizer ❑final rinse temp ki B Properfood thermometer for product D Proper sanitizing procedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 "- e 7 0d sdp +scta&&ir6g`stf� ;°p 3a +,� . , �� ( .., " C . 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 M MINOR 151 C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards/sneeze guard10 B Single use gloves changed when soiled E No unauthorized personnel V, C Food--contact surfaces clean F No pooling of eggs not cooked immediately V 0 8 Food containers stored offthe floor w 08srssi' 9 14a dfirsg of food rnix had .v A No unnecessary handling RTE and/or cooked foods with bare hands V A Soap/paper towels I drying device available B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C I Handwash sink(s)clean I 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[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 fo r from working: Are internal cooking temperatures taken? Y N *To what tempera o you cook: Poultry Ground Beef Pork What diseases related to FB illness required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written policy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for col ing foods/equipment? Y N d dis o the QFO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance cooled? Y N *Are leftovers saved? Y N Is there a language barrier between inspector&QFO? Y N If-yes yes indicate language spoken List products cooled: by QFO/DA: *Can the QFO/DA read the inspection report? Y N Describe cool! ethods: Indicate who answered the above questions: Name(print): �' f� Is coo ng monitored for time&temp? Y N Is the monitoring of cooling recorded? Y N Indicate the title of above person(circle all that apply):QFO DA Mgr Cook Owner FW Obtain on: tyrae�€ peraoa who recejyed th�FO responsibilities information at the time of the Is there a produce washing policy? Y N ♦Describe what is washed and inspection: �G where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 Establishment: 0, ow�-- Date of Inspection: ddress: AlanX RwA 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. 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. 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 Ldes acilities. Adequate,convenient,accessible, -Water quality in compliance-Monitoring in compliance ed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 40 Garbage/rubbish storage area/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 Outer openings protected against entrance of insects/rodents 4 Floors: Floor covering installed,constructed as required,good repair,clean U6 Food-contact surfaces designed,constructed,maintained,installed, 5 Floors graded,drained as required located 6 Floor,walljuncture 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 repair,clean.Wall&ceiling surfaces as required 0 Dishwashing facilities approved design,adequately constructed, maintained installed located Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 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 23 Accurate thermometers provided,dish basket,if used 541 Rooms adequate,clean,adequate lockers provided,facilities clean Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,noinsect/rodentharborage, 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 ,smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean Moutine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: —SON IN CHARGE- Other Inspection: Demerit Score: *Include demerits from page t 4 3 2 1 Total Rating signs ure si natu e print name rmt name O � ' J�, f5r�C�r � 'L DATE CORRECTIONS DUE: Y(:Vo phone number o title a� l 0 Page 2 of 2 plus A continuation pages ocusedIuspectlon 1/2002 Page Of INSPECTION REPORT STATE, OF CONNECTI.C'I-?T FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION FORM# REMARKS ' D c� S� 0 b OCZ. Y\ 'L INITIAL(INSPECTOR) INITIAL(PERSON IN CHARG ) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager