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Home My WebLink AboutFood Service Establishment Inspection 24 (3) i Establishment: all Inspection Date:�yqJ � Time: RO[nsp REinsp Address/City: 4411 Health Depth 'I'" —Win�%b,�- Class: 1 2 3 4 Based on an inspection this day,the items marke NC 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 I N/A I DNC 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] 61 Designated Alternate 2 12 Personnel with infection restricted C NIO NIA 14 62 Witten documentation of training program 2 A Food workers have no exposed infected lesions/burns 1 Approved source,wholesome,nunadultertted C WO NIA 4 B Personnel with infection restricted C Communicable disease of worker reported to local he director A Approved shellfish,finflsh,meat& oult USDA a roved alth13 Handwashing facilities provided,hands washed,clean', C N/0 NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) C Wholesome/nonadulterated foods/safe A Handwash facilities in all food prep/dispensing&warewash areas — D Commercial products(no home grown/canned food) 0000 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 procedure E 3 Potntialltr hazardous food meets temperature requirements C Handwashing at appropriate times hl/0 NIA 4! 0 daring 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 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 posted 24 Sanitization rinse(hot water-fchernicai) C NIO NIA 2 0 1 A Approved sanitizeravailable/adequate concentration of sanitizer 4 Adequate facilities to maintain product C N/0 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 D Pro ers nitizing procedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 0 Clean wiping cloths C NIO N/ 1 5 ' 7 Food protected during storage,preparation, C NIO INIA 2 display,serv"rce and transportation A Cloths and/or sponges in good repair and clean 114, 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 26 Food-contact surfaces clean C WO ITA 2 A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards/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 Hot and cold water under pressure,proviArequibredIwo NIA03a, Handwashing accessories providedNIO NIA 1 9 Handling of food minimized C NIO WAI 2 A No unnecessary handling RTE and/or cooked foods with bare hands A Soap/paper towels/ drying device available B Minimize food handling,other than ready-to-eat,with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel C Adequate utensil(s)for dispensing food/ice C Handwash sink(s)clean I waste receptacle at handwash sink LL 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: -F. 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 Ryes 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: where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 Ft� #' bate O ver or(?poratOr, 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 -Stored properly,labeled properly,used properly 4 Proper type/installation/backflow prevention device/air gap for: 4 -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. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination -Water quality in compliance 35 Toilet facilities. Adequate,convenient,accessible, 4 -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 1 0 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,clean 1 5 Potentially hazardous food properly thawed 2 1 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 1 ter openings protected against entrance ofinsects/rodents Floors: Floor covering installed,constructed as required,good repair,clean located 1 16 Food-contact surfaces designed,constructed, maintained,installed, 2 5 Floors graded,drained as required 6 Floor,wall juncture covered 17 Nonfood-contactsurfacesdesigned,constructed, maintained, 1 installed,located 7 Mats removable,good repair,clean 18 Single service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean 1 19 No reuse of single service article alls,ceilings attached,equipment properly constructed,good 0 Dishwashing facilities approved design,adequately constructed, 2 repair,clean.Wall&ceiling surfaces as required maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1 Equipment&Utensils: Cleanliness 151 Adequate lighting provided as required 1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 22 Wash water clean,proper temperature 1 53 Rooms&equipment hoods,ducts,vented as required Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1 2 Nonfood-contact surfaces of utensils&equipment clean 1' Tnso tablishment and premises free of litter,no insect/rodent harborage, 1 Equipment/utensils,storage,handling 1"' 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) 36 Toilet rooms enclosed with self-closing door 1" 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Propertoilet 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 INSPECTOR: PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating si ature signature print name print name pfrone number title L �Tr DATE CORRECTIONS DUE: l W H / Page 2 of 2 plus continuation pages Focused Inspection 1/2002 av Page of'13 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION FORM# REMARKS So 2a Les 4� G ; PO P-ekl)f Y V / en% 0,00!4,-n l nEra IS ` S �►irr 1 n d co !7 INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Tstribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager r