HomeMy WebLinkAboutSchool Inspection 91 Ayers Road (4) i
Establishment: Inspection Date: zrS Time: pz" of REinsp
Address/City: Health Dept: sav_+�"C8"d,�= class: 1 2 404
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 /0 I N/A JDNC I KEY: C[complies] NIO[not observed] NIA[not applicable]
3 DNC[does not comply] 0[other] RTE[ready-to-eat]
61 Designated Alternate 2
e s natty in 6 on' �strii c#ed" C N/A 4
62 Written documentation of training pregram 2 A Food workers have no exposed infected lesions/burns
B Personnel with infection restricted
1 Approved source,wholesome,nonatlutterated C N/A 4 C Communicable disease of worker reported to local health director
A Approved shellfish,finfish,meat&poultry USDA approved Vil 1 1S Handwashing faci ides pt vided,Viand washed,clean C p ] 4
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/Proper handwash procedure
Loo
E Handwashmg at appropriate times
Ptttertt+aiiv hazardous foots m t1. temperature re iremle Q IT O
tturing s oraga, re rat d !*f s® is and ®rtttr#t
f 6 `hYietl' cifcfle$ C N/ NfA 2
A Hot holding greater than or equal to 1400F. (whole beef/pork roans isoo F.) A ❑ No eating ❑ No smoking while working
B Cold holding less than or equal to 450 F. VB Wounds covered adequately
C Proper cooling C Proper sink used for handwashing
D Proper re-heating 0
�T
E Proper internal cooking I consumer advisory posted g pe 00
r1 ( t>t 3elatet *ttFi � {. 2„
0 A Approved sanitizer available/adequate concentration of sanitizer
4 Adecivate faotitties to maintain product C; ��; B Food-contact surfaces and utensils used for potentially
ternperature,thenrtorrteters provided hazardous food sanitized at least every 4 ho s
A Food thermometer available and accurate C Adequate ❑dishwashersanitizer final rinse temp
B Proper food thermometer for product
L Proper sanitizin rocedure
C Thermometers appropriately placed in cooler units
E Sanitizing between raw animal origin&ready-to-eat food 0 O
� -or
7 Food protected during storage;'prepairit; .° 'C'7
display,service and transportation A Cloths and/or sponges in good repair and clean
A Produce washed V.
B Wiping cloths kept in sanitizer between uses
B Raw meats not stored/prepared near ready-to-eat foods V
0
C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean
D Adequate splash guards/sneeze guard V, 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 V0
8 Food containers stored off the floor $
d $Or ; ¢ 1<
9 Handling of food mirtilmized ► � �
A No unnecessary handling RTE and/or cooked foods with bare hands A Soap I 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 V C Handwash sink(s)clean/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 aftemate],PHF[potentially hazardous food], FB[foodborne]
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 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 re ood worker to report specific illness conditions
Are temperatures recorded/logged for cold holding fo quipment? Y N and diseases to the QFO?_Y *Do you have a paid sick leave policy? Y N
Are foods cooked in advance and cooled? N *Are leftovers saved? Y N Is there a language barrier between inspector&QFO? Y N ayes 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):
Is cooling 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 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
low_
7Establishment: i` � Date of inspection:
VV
Owner or Operator:
ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served. 4 31 Sewage disposal approved.
-Unwrapped foods not re-served 4
-Operating as required
-Potentially hazardous foods not re served
11 Toxic chemicals. No cross connections,back siphonage,backflow
-Stored properly,labeled properly,used properly Propertype/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 35 Toilet facilities. Adequate,convenient,accessible,
-Water quality in compliance designed,properly installed
-Monitoring in compliance
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
2 Sources of food: Original container,properly labeled 401 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
16 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 50 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 54 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,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)
59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at
37 Propertoiletfixturespmvided,good repair,clean entrance ,smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered,
rodent proof,clean I ISIRoutine Inspection ❑Reinspection ❑ Preoperational Inspection
Other Inspection:
INSPECTOR: PERSON IN CHARGE: Demerit Score: *Include demerits from page 1
G►J'k�v r'g
4 3 2 1 Total Rating
nature s nature
4 v ZOe t name y d 1
r phone number DATE CORRECTIONS DUE: ., o�
• title
e� - Page 2 of 2 plus 1 continuation pages Focused Inspection 1/2002
- Page of
�v
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN_ DATE OF INSPECTION
L/�1L'c�w3Ur---
INSPECTION REMARKS
FORMf,,#
l/Vim-
o
OI/t-
ov- _ 3`1°
Ply� ��--
INITIAL(INSPECTOR) l INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager