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HomeMy WebLinkAboutSchool Inspection 949 Avery Street i Establishment: Inspection Date: Vk -Lq t Time: Kinsp REinsp Address/City: OV Health Dept: S . Wo &vr' class; 1 z PDa 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 W N/A DNC I KEY; C[complies] NIO[not observed] NIA[not applicable] '4 V 3 DNC[does not comply] 0[other] RTE[ready-to-eat] tom ' ` in in res#acted' 61 ©esitignated Alternate 2 ! 4 62 Written documentation of training program Y A Food workers have no exposed infected lesions/burns B Personnel with infection restricted 1 Approved Source,wholesome,rts3rradttftgreted C NIA 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA app roved V Z 1 1 13 Han ing faeilit es p�ded,hands �led,c ,� C N/A 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 V 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 0 E E Handwashing at appropriate times 3 Potetiatlif hazardous fir®d otfs ts )N t "44Ow �[r o datyt�s rye pahota dt�ptay,se a ��a ;� �; � - 'i 5 ''Loci gpi�r����acttce� C W9, '' NIA 2 A Hot holding greater than or equal to 140°F. (whole beef/pork roasts 130°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 0 E Proper internal cooking/consumer advisory posted4OF '19 1xn rset�rafier .ispt C p t 0 A Approved sanitizeravailable/adequate concentration ofsanitizer 4 A@te facilities to maintain preifuGt '` � f B Food-contact surfaces and utensils used for potentially pe pro�tid�d � tent ratttre dwrrttotneters hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp L Proper sanitizin B Proper food thermometer for product procedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 7 o d'pr`citicted dirt 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 0 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 C Food—contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor 0 9 Handling of food rein ed :C. :. � .�. fi pwtriF 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 C I 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. M: 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 re o"report to the local health department? Roasts Other 4900-1 Describe re-heating procedures: Is there a written illness polic requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holdi di1 equipment? Y N and diseases to the N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and co . Y N *Are leftovers saved? Y N Is there a uage barrier between inspector&QFO? Y N if-yea indicate language spoken List products cooled: by Q�/DA: *Can the QFO/DA read the inspection report? Y N Describe cooling me s: 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 moni ored 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 [where: there 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 J lishment: Qrti1;, Date of Inspectioss: 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. i -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow Propertype/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -San itizer concentration not to exceed maximum permitted -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 Ldes aclities. Adequate,convenient,accessible, -Water quality in compliance-Monitoring in compliance d,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 Garbagelrubbish 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 loors: Floor covering installed,constructed as require ,good repai,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 property 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 571 Clean/soiled linens stored properly 58 No live birds,turtles,or other animals(except guide dogs) 36 Toiletroomsenclosedwithself-closin door 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 ropertoiletfixturesprovlde good rep ',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 INSPECTOR: PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signature signature o� en ! �print name L print nam 0 0 �z DATE CNS DUE: 0 Z(2 7� phone number � title ORRECTIO Page 2 of 2 plus continuation pages VFocused Inspection 1/2002 Page- INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION IPV4119 11, S-1.�� — — �i I i INSPECTION REMARKS FORM# 2®0 Y—N 1 `seX. s� o rCIA, I'an + INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager 111