HomeMy WebLinkAboutFood Service Establishment Inspection 85 (10) EHS-106-Rev.06101 INSPECTION REPORT STATE OF CONNECTICUT )C&OUTINE INSPECTION ❑ REINSPECTION
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH !❑ PREOPERATIONAL ❑ OTHER
410 Capitol Avenue,MS#51 FDP,Hartford,CT 06134
NAME OFA /I ^ ESTABLISHMENT
ESTABLISHMENT 6 CLASS
STREET 5—(p '
ADDRESS � TOWN
OWNER or INSPECTION
OPERATOR DATE and TIME
Based on an inspection this day,the items marked below identify the violations in operation or facilities which must be corre ed the date specified below.
SOURCES OF FOOD EQUIPMENT&UTENSILS:CLEANLINESS VERMIN CONTROL
1 Approved source,wholesome, 4 21 Preflushed,scraped,soaked and racked 42 Presence of insects/rodents 2
nonadulterated 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of 1
2 Original container,properly labeled 1 23 Accurate thermometers provided,dish basket,if used insects/rodents
24 Sanitization rinse(hot water-chemical) 2
FOOD PROTECTION A Clean wiping cloths 1 FLOORS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 26 Food-contact surfaces of utensils& 2 44 Floors:floor covering installed,
temperature requirements during storage, equipment clean constructed as required,good repair,clean
preparation,display,service,and
transportation 27 Nonfood-contact surfaces of utensils& 1 45 Floors,graded,drained as required 1
equipment clean 46 Floor,wall juncture covered
4 Adequate facilities to maintain product 2 28 1 Equipmentlutensils,storage,handling 1 47 Mats removable,good repair,clean
tem erature thermometers provided
5 Potentially hazardous food properly thawed 2 48 Exterior walking,driving surfaces, 1
6 Unwrapped or potentially hazardous food 4 WATER SUPPLY good repair,clean
not reserved FT30_
Water source adequate,safe
_ q � 4 49 Walls,ceilings attached,equipment properly 1
7 Food protected during storage,preparation, Hot and cold water under pressure, 2 constructed,good repair,clean. Wall&ceiling
display,service&transportation 2 provided as required surfaces as required.
8 Food containers stored off floor 50 Dustless cleaning methods used, 1
SEWAGE DISPOSAL cleaning equipment properly stored
9 Handling of food minimized 2 31 Sewage disposal approved 4
10 Food dispensing utensils properly stored 1 32 Proper disposal of wastewater 1 LIGHTING&VENTILATION
11 1 Toxic items properly stored,labeled,used 14 51 Adequate lighting provided as required 1
PLUMBING 52 Room free of steam,smoke odors 1
PERSONNEL 33 Location,installation,maintenance 1 53 Room&equipment hoods,ducts,ventedas rep dred
12 1 Personnel with infection restricted 14 34 No cross connection,back siphonage,backillow 4
DRESSING ROOMS&LOCKERS
CLEANLINESS OF PERSONNEL TOILET FACILITIES 54 Rooms adequate,clean,adequate lockers 1
13 Handwashing facilities provided, 4 35 Adequate,convenient,accessible,designed, 4 provided,facilities clean
personnel hands washedj clean installed
14 Clean outer clothes,effective hair restraints 1 36 Toilet rooms enclosed with self-closing door 1
15 Good hygienic practices,smoking restricted 2 37 Proper fixtures provided,good repair,clean HOUSEKEEPING
55 Establishment and premises free of litter,no 1
EQUIPMENT&UTENSILS: DESIGN, HANDWASHING FACILITIES insect/rodent harborage,no unnecessary articles
CONSTRUCTION &INSTALLATION 38 Suitable hand cleaner and sanitary towels or 1 56 Complete separation from living/sleeping quarters 1
16 Food-contact surfaces designed,constructed, 2 approved hand drying devices provided, and laundry
maintained,installed,located tissue waste receptacles provided
57 Clean/soiled linens stored properly 1
17 Nonfood-contact surfaces designed, 1 58 1 No live birds,turtles,or other animals 1
constructed,maintained,installed,located GARBAGE/RUBBISH STORAGE&DISPOSAL (except guide dogs)
18 Single service articles,storage,dispensing 2 39 Approved containers,adequate number, 1
19 No reuse of single service article covered,rodent proof,clean NONSMOKING AREAS
20 Dishwashing facilities approved design,adequately 2 40 Storage area/rooms,enclosures— I
Seats 75 or more:Nonsmoking area provided, 3
constructed,maintained,installed,located properly constructed,clean sign(s)posted at entrance(s),smoking area
1 indicated by sign(s)
41 Garbage disposed of in an approved manner,
at approved frequency QUALIFIED FOOD OPERATOR
DEMERIT SCORE 60 Qualified Food Operator 3
4 YD
2 1 RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2
o 62 Written documentation of training program 2
TOTAL RATING Date Corrections Due Signature of Person in charge
SIGNED(Ins ecor)
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DESCRIBE DEFICIENCIES ON CO TINIJ ION SHEE S
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INSPEGTION REPORT STATE OF - -!CUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN ��". ) �� DATE OF IN ECTION
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INSPECTION
FORM# REMARKS
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHAR
Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager