The URL can be used to link to this page

Home My WebLink AboutFood Service Establishment Inspection 64 (4) i Egttablishtent: GUY, .� Inspection Date: Time: ROin REinsp Address/City: / ( .-i /h Jc� Health Dept: ��-u•'t WN&- Class: 1 2 33) 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/O WA DNC KEY: C[complies] NIO[not observed] NIA[not applicable] �peftor 3 DNC[does not comply] 0[other] RTE[ready-to-eat] ` feslOrl Atnt61 2 e "ch resfricfed2 C LO N/A 4 62 Written documentation of training program 2 A Food workers have no exposed infected lesions/burns 9 Approved source,wholesome,noB Personnel with infection restricted nadufterated C N/0 IA 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved B Food cans in good condition(not dented,rusty,bloated,leaking) 13 Hantlwashfng facitgres pr©vtded,bands yv shet},c an' C (7 NA 4 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 C Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature 0 D Personnel hands washed,clean/Proper handwash procedure Ile P rdou hod E Handwashing at appropriate times during some,preparation,dIserl # �, 0 'fir"'>st C 0' WA' 2 A Hot holding greater than or equal to 1400F. (whole beeflpork roasts tsoo F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450F. 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 i]fL# 0 0 U` A Approved sanitizeravailable/adequate concentration ofsanitizer 4Ad6ate fclfltfes ' pr�scirpt t` B Food-contact surfaces and utensils used for potentiallyOF © +> Titled hazardous food sanitized at least every 4 hours - : A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinseItemp B Proper food thermometer for product D Proper sanitizin procedure OF C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat fo 0 oisii prstectei>)d;tt'ring 'toF a Nf0 N/A` 9 display,service and transportation A Cloths and/or sponges in good repair and clean L00000 A Produce washed B Wiping cloths kept in sanitizer between uses Raw meats not stored/prepared near ready-to-eat foods 0 C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean E No unauthorized personnel D Adequate splash guards I sneeze guard g Single use gloves changed when soiled F No pooling of eggs not cooked immediately C Food--contact surfaces clean 8 Food containers stored off the floor 0 m. ,� � ,�_ 0 v 14anA4n4 of iod'rnln 12 dad . . , �N e A No unnecessary handling RTE and/or cooked foods with bare hands A Soap/paper towels I drying device available B B Minimize food handling,other than ready-to-eat,with bare hands Dispenser(s)working: ❑Soap ❑Paper towel C Handwash sink(s)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 0 I �L •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 If 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):QFO DA Mgr Cook Owner FW 4-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 Establishment!" f Date of Inspection:ddress: ! llu�l W I � 1i��yv ��-�} �t� 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. -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 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-Monitoring in compliance designed,properly installed 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 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 4 Floors: Floor covering installed,constructed as required,good repair,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 501 Dustless cleaning methods used,cleaning equipment properlystored Equipment&Utensils: Cleanliness 5 11 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 -541 Rooms adequate,clean,adequate lockers provided,facilities clean 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 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 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 Mikoutine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating ig re / / sign p print name v print name y phone number ti le DATE CORRECTIONS DUE: Page 2 of 2 plus continuation pages Focused Inspection 1/2002 Page Zd INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSP�CCTION .J:2 60-� C44A A INSPECTION FORM# REMARKS na C At INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Istribution: I st-White-Health Department 2nd-Yellow-Owner/Manager