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Home My WebLink AboutFood Service Establishment Inspection 95 (9) Establishment: al?X441 fj)Z6A Inspection Date: 3 Time:hP;c REinsp ddress/City: }' Heaf be6t: " 51. g, Class; I z 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/0 N/A JDNC I ttt C[complies] NIO[not observed] NIA[not applicable] f r r.x DNC[does not comply] O[other] RTE[ready-to-eat] v � praf 3 � ;1. �#� sat � �' Miami restr9td�t ;,` I � E�t� N1A 4' g1 Designated Alternate _ 2 62 Written documentation of training program 2 A Food workers have no exposed infected lesions/burns B Personnel with infection restricted 1 Approved source,wholesome,nonadulterated C N10 NIA 4C Communicable disease of worker reported to local health director A I Approved shellfish,flnfish,meat&poultry USDA approved 13 Mandwastrirtg facilities pr ilded,hands washed,clean C N/0 NIA 4''i 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 room 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 J. 3 Potential # 0oloo dudng s orage preparation,display,;xe 100, d tr .� i5 '(obigterr�c'pr€tties C` NIO WA 2 A Hot holding greater than or equal to 1400F. (whole beef/pork roasts 130e F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450 F. B Wounds covered adequately C Proper cooling 60000, C Proper sink used for handwashing 74 D Proper re-heating 0 E Proper internal cooking/consumer advisory posted t � tlr ihe )_ C Nd0 Nit. 0 A Approved sanitizer available/adequate concen tration of sanitizer 4 Adequate factittles to maiotaia product B Food-contact surfaces and utensils used for potentially test perature,ttentnameters'Oro ld �� s hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate dishwashersanitizer ❑final rinse temp L Pro er sanitizin roce ure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units100, A" TWO,7 "I?tSodptot �teidr�trg' a ,K ., k t display,service and transportation 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 01 ti C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards I sneeze guard B Single use gloves changed when soiled E No unauthorized personnel L C Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor .00 3 } 0"101 Handling of food minknized A No unnecessary handling RTE and/or cooked foods with bare hands A Soap/paper towels/ drying device available B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean I waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 O *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 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 report specific illness conditions Are temperatures recorded/logged for cold holding foods/equipment? Y N and diseases to the QFO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are leftovers saved? Y N Is there a language barrier between inspector&QFO? Y N Iflf ves 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): 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 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 d . Establishment: /' t Date of Inspection: 1 Address: %1' J-1_ 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 No cross connections,back siphonage,backflow 11 Toxic chemicals. 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 +G -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. -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 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 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 481 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing n 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 1 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 2 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 271 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 571 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(s),smoking area indicated by sign(s) 39 1 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean I WRftllne Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTOR: IN �►R E: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating si ture J / signature 3-5F �X�/ X. I �'1 pri t name pant name phone number title - DATE CORRECTIONS DUE: Page 2 of 2 plus continuation pages Focused Inspecdou 1/2002 t?b ��r� • Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH - CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION �� s 1 . INSPECTION REMARKS FORM# CM2 do✓% INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager