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Home My WebLink AboutFood Service Establishment Inspection 17 (25) i Establishment: > Inspection Date: a/3 Time: ?o! REinsp Address/City: />' 64 lte, Health Dent:3'D-(k Class; 1 2 34�15 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 N10 N/A JDNC I KEY: C[complies] N/O[not observed] N/A[not applicable] a k. DNC[does not comply] 0[other] RTE[ready-to-eat] ttat led pod 0peratflr ; ° 3 61 Designated Alternate 2 12 Persofine "iui#h infection restricted C NO 4 62 Written documentation of training program 2 A Food workers have no exposed infected lesions/burns -71 B Personnel with infection restricted 1 Approved Source,wholesome,nonadulterated C N10 /A 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Handwashing facttiltiles provided,hands washed,clean C N/Q 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 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 I Proper handwash procedure 0 E Handwashing at appropriate times 01 3 Potential du irtg s Dhazadous food meets t,e"efiaaature re tres llfs ty N f p prpnd srotorage, e a pattatro 15 Good c practices ' C WO; NIA 2 A Hot holding greater than or equal to 1400F. (whole beef/pork roasts 1300 F) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to450F. 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` ,inn rare( Ti— h water Chollpal� • `-"' CtYt�ihA 2 ° 0 A Approved sanitizeravailable/adequate concentration ofsanitizer 4 Adequate facilities to maintain product CIWO N/A � 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 D Proper sanitizin rocedure B Properfood thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units o 7` 'Pood prat c ed 60 'thing sAarags,pro, aiia�; display,service and transportation A Cloths and/or sponges in good repair and clean 'IT B Wiping cloths kept in sanitizer between uses A Produce washed B Raw meats not stored/prepared near ready-to-eat foods C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards I sneeze guard Single use gloves changed when soiled E No unauthorized personnel Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor Handling of food miMmized C N No unnecessary handling RTE and/or cooked foods with bare hands A Dap I per I drying device available - ; 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 1 jj 0 1 1 1 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. (JAY: QFO[qualified food operator],DA[designated altemate],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&QFO? Y N Iflf ves 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):QFO DA Mgr Cook Owner FIN Is cooling monitored for time&temp? Y N Is the monitoring of cooling recorded? Y N .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 in where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 Establishment: cO' Date of Inspection: 1 ddress: Y AL IV,, t Owner or Operator 1•z'r--t ' ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] z' 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 No cross connections,back siphonage,backflow 11 Toxic chemicals. Proper type/installation/backflow prevention device/air ga for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizes 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 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 storage area/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 Guteropenings 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 -Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing o"Walls,ceilings attached,equipment properly constructed,good 19 No reuse of single service article repair,clean.Wall&ceiling surfaces as required 0 Dishwashing facilities approved design,adequately constructed, maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored EEquipment&Utensils: Cleanliness 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 2 h water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required ccurate 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 I 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 fixturesprovided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 1 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean offiRoutine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: MPERSON IN CHARGE Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating nditure signature int name print name U~°��f,♦ DATE CORRECTIONS DUE: phone number title �i Meta - Page 2 of 2 plus continuation pages Focused Inspection 1/2002 f Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT T\OWN ((� � DATE OF INSPECTION I I t�� 2z�3� INSPECTION REMARKS FORM# f . e INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager