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Home My WebLink AboutFood Service Establishment Inspection 19 (4) Establishment: 3 Inspection Date: / Time: 5 r oins REins Address/City: ,tj)ltjJ,y-- Health D pt: � S.e�, class: 1 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 debitable items C N/O WA DNC KEY: C[complies] N/O[not observed] NIA[not applicable] fi ( $ toad 1. CF �� ' a g DNC[does not comply] 0[other] RTE[ready-to-eat] Designated Alternate z '112 —ftireoi el tiai "tnfection restricted C NlA 4 fit Written docutnentation of trairring program z q Food workers have no exposed infected lesions/burns _ B Personnel with infection restricted 1 Approved source,wholesome,nonadtdterated C N10 N)A 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Handwashing facilities provided,itandswashiA clean; C. NO NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonaduIterated foods/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 I Potentially hazardous foods received at p ro per tem pe ratu re 0 D Personnel hands washed,clean/Proper handwash procedure pot�Fa# E Handwashing at appropriate times �(hazardot�s.!,Md 0 t�"sEae,preparation dispst#r,seruic o r o �.. �5 -066d by ienfc`prat#ices C NIO NIA A Hot holding greater than or equal to 140oF. (whole beef/pork roasts 1300 e) 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 0 E Pro er internal cookin /consumer advisory p p 9 osted ., n _ J #�} e ft #edr� �tsat ).. ;NtO, ip. Y" 0 A Approved sanitizeravailableladequateconcentrationofsanitizer 4 Ad `f�ces 1 4 B Food contact surfaces and utensils used for potentially ter peratO►e totftet °'peC(F ,� hazardous food sanitized at least every 4 hours -' A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper sanitizin B Properfood thermometerfor product procedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 Ila d1splay,service and transportation A Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Produce washed 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 Adequate splash guards I sneeze guard B Single use gloves changed when soiled /01 E No unauthorized personnel C Food--contact surfaces clean 000, F No pooling of eggs not cooked immediately 0 8itood containers stored off the floor owi 0i 031 9 Handiirtg b. of fciod treir�ttaiz" paper I A No unnecessary handling RTE and/or cooked foods with bare hands towels drying device available B ispenser(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 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 aRemate),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&CFO? Y N byes 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):CFO 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 CFO 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 Establishment: 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. 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Proper type/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 40 Garbage/rubbish storagearea/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 214 loors: Floor covering installed,constructed as required,good repair,clean located Food-contact 16 Food- designed,constructed,maintained,installed, 5 Floors graded,drained as required 6 Floor,walijuncture 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 hValls,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 5 11 Adequate lighting provided as required 1 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,stnrage,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 Proper toilet 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: INSPECTOR: PERSON IN CHARGE: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating si ture signature Za�� print n*Aa JV_)X W_ vwat_� 1:�to DATE CORRECTIONS DUE: phone number 29 title q `U �.e_ Page 2 of 2 plus continuation pages Focused Inspects 1 2002 Page Of---' INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION �, ► S tj1 3j"- l� INSPECTION REMARKS FORM# 1.) ( s d c/� vl yh S► c 0 nq s yd '� CU f / 1 �'�►-�, _ �L�`�/1 Cal�u-t 1 INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager