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Home My WebLink AboutFood Service Establishment Inspection 70 (7) Establishment: — Inspection Date: 1 Time. '��sn-1 REinsp Address/City: ,' �, }Ll Wi�� Health Dept: +-/!0 1-,�;t��(t�- Class: z Q� 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 DNC I KEY: C[complies] N/0[not observed] N/A[not applicable] 60 Qualified food Operator 3 DNC[does not comply] 0[other] RTE[ready-to-eat] Designated Alternate 12 Personnel with infection restricted r, N/0 I NIA 14 62 Written documentation of training program 2 q Food workers have no exposed infected lesions/burns B Personnel with infection restricted 1 Approved source,wholesome,nortadulterated C N/0f/A 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved ol 13 Handwwastung facilities provided,hands washed,clean C N/0 NfA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulterated foods/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 E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean/Proper handwash procedure 0 E Handwashing at appropriate times 3 Potentially hazardous food meets temperature requirements C NIO N/A 4; 0 during storage,preparation,display,service and transportation 15 Good hygienic practices C WO NIA 2 A Hot holding greater than or equal to 140°F. (whole beef/pork roasts too°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 posted ajUnitization rinse(hot'water-chemical) C N/O' NIfilo 0 Approved sanitizeravailable/adequate concentration of sanitizer 4 Adequate facilities to maintain product C I NIO NIA 2 B Food-contact surfaces and utensils used for potentially temperature,thermometers provided hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp B Proper food thermometer for product L Proper sani izin rocedure All C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 25 Glean wiping cloths C NIO NIA' 1 Food protected during storage,preparation, C NIO NIA display,service and transportation A Cloths and/orsponges in good repairand clean B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods 26 Food-contact:surfaces clean C NO NIA 2 C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards I sneeze guard 01 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 Food containers stored off the floor 30 Hot and cold water under pressure,provided as required e N10 N/A 2 0 38 Handwashing accessories provided C NIO NIA 1 9 Handling of food minimized C N/0 NIA 2 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/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: 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 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 lf-yes 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):CFO DA Mgr Cook Owner FW •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 Qate 1ns{pctton 1rs ;�' ` + t lwn a r tpera or,. 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. 34 No cross connections,back siphonage,backflow 4 4 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 -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. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35Fdesnfed,properly lities. Adequate,convenient,accessible, 4 -Water quality in compliance inMonitoring in compliance stalled OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 1 0 Garbage/rubbish storage area/rooms,enclosures-properly constructed,clean ` 1 5 Potentially hazardous food properly thawed 2 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 ermin Control: No insects/rodents present 2 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outer openings protected against entrance of insects/rodents 1 4 Floors: Floor covering installed,constructed as required,good repair,clean 1 16 Food-contact surfaces designed,constructed, maintained,installed, 2 45 Floors graded,drained as required located 6 Floor,walljuncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 1 47 Mats removable,good repair,clean installed,located 18 Single service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean 1 19 No reuse of single service article 49 Walls,ceilings attached,equipment properly constructed,good 1 repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1 Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required 1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1 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 1 27 Nonfood-contact surfaces of utensils&equipment clean 1 55 Establishment and premises free of litter,no insect/rodent harborage, 1 28 Equipment/utensils,storage,handling 1 no unnecessary articles 32 Proper disposal of waste water 1 ; 56 Complete separation from living/sleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 57 Clean/soiled linens stored properly 1 58 No live birds,turtles,or other animals(except guide dogs) 1 36 Toilet rooms enclosed with self-closing door 37 Proper toilet fixtures provided,good repair,clean 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 3 entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean outine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTOR: PERSON IN CHARGE: D Demerit Score: *Include demerits from page 1 z� 4 3 2 1 Total Rating s' re signaturd— Ito yj 0Z_ '?0 print name print name V pie oui r title DATE CORRECTIONS DUE: �''7 O Page 2 of 2 plus continuation pages Focused Inspection 1/2002 ' I Page2 of am INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION FORM# REMARKS Ll N�lo Yma .e 152 "AIL c 14d- Z_>,�A7e-Z o.-o,4 �74b(--( d4IL� L -t�,Qt 1Wk, �C� 4 ,V ,� L�C bo � e 4� c/ 3rj (� INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Dis 1 ution: Ist-White-Health Department 2nd-Yellow-Owner/Manager