The URL can be used to link to this page

Home My WebLink AboutFood Service Establishment Inspection 69 (3) Establishment: P., Inspection Date: o?� Timer ;off ins REinsp Address/City: fN Health Dept: J,ilItc%I Class: t 2 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 debatable items C N/A DNC t�Ey; C[complies] N/O[not observed] NIA[not applicable] 60 Quell�yttl bper f g DNC[does not comply] 0[other] RTE[ready-to-eat] 61 60e819nalledAlternate000, 2 12 i-With infect on restr%cted N/tk N6A 4`" 62 Wriften documentation of training program A Food workers have no exposed infected lesions/burns 2 B Personnel with infection restricted t Approved source,whatesome,nonadulterated C N/0.N/A, 4 A Approved shellfish,finfish,meat&poultry USDA approved C Communicable disease of worker reported to local health director B Food cans in good condition(not dented,rusty,bloated,leaking) 13 Wandwa&Fttng Witttes provided,hands Washed,Clean C WO WA 14- C Wholesome/nonadulterated foods/Safe A Handwash facilities in all food prep/dispensing&warewash areas D Commercial products(no home grown/canned food) B Handwash facilities in or immediately adjacent to toilet rooms E Potentially hazardous foods received at proper temperature C Handwash facilities accessible/convenient to use 0 D Personnel hands washed,clean/Proper handwash procdure Asas E Handwashing at appropriate times t1otert#isi haiar us foci Meefs fjnip � k o da ittg orage prlparation d� iay seevtpe � p° , i5 'Gooc�'hgi�'prac�ices C N/O' 2, A Hot holding greater than or equal to o140oF. (whole beef/pork roasts 130e F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 45 F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating e E Proper internal cooking/consumer advisory posted 0.;, aitiot�j �x t�et�ical 4 .� Approved sanitizeravailable/adequateconcentrationofsanitizer Adequate faeihhes °malint, 4� # hf? a g Food-contact surfaces and utensils used for potentially tperature,thermotseters provided' -' hazardous food sanitized at le 4 hours A Food thermometer available and accurate C Adequate ishwashersan' ❑final rinse temp B Proper food thermometer for product D Proper sanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 ' Fo(ci protected duriirg sorajs;pr'ppr sort, ' ` `fiprr + 2 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 O C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards/sneeze guard Looe E No unauthorized personnel B Single use gloves changed when soiled F No pooling of eggs not cooked immediately C Food--contact surfaces clean 0 8 Food containers stored off the floorIT i 9 " Handling of lbod milhimized' / / A No unnecessary handling RTE and/or cooked foods with bare hands Soap paper towels drying device available g B Dispenser(s)working: ❑Soap ❑Paper towel 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. K 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 food worker from working:Are internal cooking temperatures taken? Y N *To what temperature do YOU cook: Poultry Ground Beef Pork Roasts Other What diseases related to FB illness are you required to report to the local health department? 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 CFO? 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 lf-M 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: 7where: Note: This report is a; o page form(total of 62 debitable items) Page 1 of 2 WE Establishment: Date of Inspection: 1�0� ddress.60 1 `fin ` .L-L `&S , S' L'_kjj%oL� Owner or Operator: I/l� ADDITIONAL FOUR POINT ITEMS ; KEY: DNC [DOES NOT COMPLY] z 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 Proper type/installation/backflow prevention device/air gaper: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration not to exceed maximum permitted -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 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 Food dispensing utensils properly stored ermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints Outer openings protected against entrance ofinsects/rodents loors: Floor covering installed,constructed as required,good repair,clean 16 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 ig 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 Nonfood-contact surfaces of utensils&equipment clean 5 Establishment and premises free of litter,no insect/rodent harborage, 28 Equipment/utensils,storage,handling no unnecessary articles 32 Proper disposal of wastewater 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 Propertoiletfixturespvovided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean woutine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTOR: PERSON IN Demerit Score: *Include demerits from page 1 45;�40A 4�� 4 3 2 1 Total Rating sign ure signature r' t name print name ply i �J VAJL6,r� L" r phone number title DATE CORRECTIONS DUE: Page 2 of 2 plus continuation pages Focused Inspection 1/2002 Pagc�Z of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION CJ4)t S ��-Vjsu-- INSPECTION FORM# REMARKS U if Vt( re<Z�—yL,), r 40 INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distn ution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Page of `7 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF PE TION ��4I 3 � INSPECTION FORM# REMARKS ly- I f INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) L Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager