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Home My WebLink AboutFood Service Establishment Inspection 95 (2) Establishment: �,,� awl Inspection Date: 77ent , Time: R0]ns RE[nsp Address/City: e, HealthG`a �t,+2_ a : 1 2 3 4 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 N/O N/A DNC KEY: C[complies] N/0[not observed] NIA[not applicable] 0 DNC[does not comply] 0[other] RTE[ready-to-eat] QtlifSdpperar s �t 3 dR `r° 12 ` ete6hh wi h irofectiori restricted (} 4= 61 Designated Alternate 2 A Food workers have no exposed infected lesions/burns 62 Written documentation of training program LIP 2 B Personnel with infection restricted 1 Approved Source,wholesome,nonaduiterated C Nf0 C Communicable disease of worker reported to local health director A Approved shellfish,flnfish,meat&poultry USDA approved L 13 Handwashing facitittes provided,hands washed,dean C NO A 4 B I 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 7-11-1 E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean 1 Proper handwash procedure 0 E Handwashing at appropriate times $etaity haettl4lRre�#e duwog. e,pepecbn �� C N/0 " tioc� gi mess 0 A Hot holding greater than or equal to 1400F. (whole beeflpork roes,,130o F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to450F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 t✓° rt E Proper internal cooking/consumer advisory posted s ,,� f {',44-_a �. �- �.a 0 A Approved sanitizeravailable/adequate concentration ofsanitizer 4 A€legraa taciee mein prd g Food-contact surfaces and utensils used for potentially tam,peratum,fihermaorrtetdrs�prpVidid, hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 7 `F�ootaeteddif xing Tit ;r.. . display,service and transpoftatilom A Cloths and/or sponges in good repair and clean A Produce washed B Wiping cloths kept in sanitizer between uses - 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 Lo 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 Y # 0 .. �.ptoYtded' ' I�& $' 9 Handling csf food rrrinirrrized C N'Q f A 2 A Soap paper towels drying device available A No unnecessary handling RTE and/or cooked foods with bare hands e B Dispenser(s)working: ❑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 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: 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 ,,eases 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 ,c illness conditions Are temperatures recorded/logged for cold holding foods/equip N and diseases to the QFO? Y N ♦Do you , sick leave policy? Y N Are foods cooked in advance and cooled? Y N Are leftovers saved? Y N Is there a language barrier betwe ector&QFO? Y N If yes indicate language spoken List products cooled: by QFO/DA: *Can the QFO/DA read the inspection report? Y N Describe cooling methods: Indicat o answered the above questions: Name(print): Indicate the title of above person(circle all 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 the person who received the QFO responsibilities information at the time of the [where: here 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 -- — Establishment: l Date of Inspection:', Address: 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. -Potentially hazardous foods not re-served -Operating as required 34 No cross connections,back siphonage,backflow 11 Toxic chemicals. Proper type/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly t -Sanitizer concentration not to exceed maximum permitted -Food equipment -Hose connections -Dish machines_` -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticides/rodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. 1 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, -Water quality in compliance -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled �Fmj 0 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 1 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, x installed,located 7 Mats removable,good repair,clean 8 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 19 No reuse of single service articles 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 T 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 r55 Establishment and premises free of litter,no insect/rodent harborage, 8 quipmentlutensils,stprage,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 Propertoilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean ❑Routine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: PERSON IN CHARGE: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating sig ure sign e int name print name phone number title DATE CORRECTIONS DUE: Page 2 of 2 plus continuation pages Focused Inspection 112002 Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE Or INSPECTION D��It 1)111� ► INSPECTION FORM# REMARKS Uj-C #vglj/ 5),Pl F�d OLIJ INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) 77 Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager