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HomeMy WebLinkAboutFood Service Establishment Inspection 85 (16) i Esta ddres blishment: Inspection Date: as Time: v,' O5 RQinsp REinsp s/City: Health Depth Class: 1 2U/�' 4 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 WO N/A DNC KEY C[complies] N/O[not observed] NIA[not applicable] ' g DNC[does not com I 61 a o ,_, g py] 0[other] E[ready-to-eat] RT d A erfi�#e" 2 '1 a f;'Pews, _ ° ii#t�i�I rn`re�tricti C N1b'N/A 4' 62 Written documentation of training p o ra►n A Food workers have no exposed infected lesions/burns 2 B Personnel with infection restricted 1 Approved source,wholesome,conadokterated C N/A N/A 4 A A roved shellfish finfish poultry USDA a roved C Communicable disease of worker reported to local health director , ,meat& B Food cans in good condition(not dented,rusty,bloated,leaking) 13 'Han thw�shirtg facilities provided,hands"had,clean C WO N/A � 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 E Potentiallyhazardousfcods-received at proper temperature C Handwash facilities accessible/convenient to use 0 D Personnel hands washed,clean/Proper handwash procedure 3 E Handwashing at appropriate times potehttal! bazar darin `s©ra a do4+ fo�jr+tQets tetlre rtlretntlts 'A' 0 g pRaraEr display,sertr attd ttaaspof#an. ` ces C 10 N/A 2'0000 hygierric practi .A Hot holding greater than or equal to 140°F. (Whole beef/pork roasts iao°F.) 15' B Cold holding less than or equal to 45°F. A ❑ No eating ❑ No smoking while working 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 , tiza -fir gs 1� p _. , ( QZ.w�ter-chernrr. ) C N10'.t/A 2 A Approved Is itizeravailable/adequate concentration ofsanitizer 4 Adequate faciifties to reafntalin produlat tam, �_ftftnrinetirs© providedY WO�� NIA 2 B Food-contact surfaces and utensils used for potentially hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate Odishwashersanitizer ❑final rinse temp B Properfood thermometer for product D Pro ersanitizin roce lure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 0 i i�tt$r!ph0t ofett"dt ,stOYat�e;"piepara�tioh, 2S ` tea0'irii sing it the C WO IA 1 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 D Adequate splash guards/sneeze guard A Food equipment clean,utensils clean,equipment interiors clean E No unauthorized personnel B 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 • iinacce $511&ttdad N/0 9 Handling 0#food trrirtimi1ed C ht/A Z C 1 A No unnecessary handling RTE and/or cooked foods with bare hands A Soap/paper towels/ Irving device available B M B inimize food handling,other than ready-to-eat,with bare hands amps s)working: ❑Soap ❑Paper towel C Handwash sinks)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 000 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated allemate],PHF[potentially hazardous food],FB[foodborne] PHFs are hot held at: °F. 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 On advance and cooled? Y N *Are leftovers saved? Y N Is there a language barrier between inspector&QFO? Y N ifs 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 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 L�men#:sss: Date of Inspection: Owner or;Operator: 14)9- 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. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Proper type/installation/b ckflow prevention devic /air gap for: -Sanitizer concentration not to exceed maximum permitted -Food equipment -Hose connections -Dish machines -No unnecessary toxics on the premises �P -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 -Water quality in compliance 35 Toilet facilities. Adequate,convenient,accessible, -Monitoring Jr compliance designed,properly installed OTHER ITEMS 2 Sources of food: Original container,properly labeled Ill DNC [DOES NOT COMPLY] arbage/rubbish storage area/rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properly thawed ean 1 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 2 Vermin Control:No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 2 3 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, located 5 Floors graded,drained as required 17 Nonfood-contact surfaces designed,constructed,maintained, 6 Floor,wall juncture covered ¢V installed,located 7 Mats removable,good repair,clean r,. 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 properly stored Equi ent&Utensils' Cleanliness 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked 22 Wash water clean,proper temperature 52 Room free of steam,smoke odors 23 Accurate thermometers provided,dish basket,if used 53 Rooms&equipment hoods,ducts,vented as required 54 Rooms adequate,clean,adequate lockers provided,facilities clean 27 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free oflitter,no insect/rodent harborage, 28 Equipment/utensils,storage,handling no unnecessary articles 3 roper disposal of waste water 56 Complete separation from living/sleeping quarters and laundry 3 lumbing location,installation,maintenance 57 Clean/soiled linens stored properly 36 Toilet rooms enclosed with self-closing door 1581No live birds,turtles,or other animals(except guide dogs) 37 Proper toilet fixtures provided,good repair,clean 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean MfFoutine Inspection ❑Reinspectio 1 ❑ Preoperational Inspection INSPECTOR: P ON IN CHARGE Other Inspection: Demerit core: *Include demerits from page 1 Si ature s nature 4 � 3 2 1 Total Rating print name C ri name one number title DATE CORR DUE: Page 2 of 2 us continuation pages Focused Inspectlon I/2002 Paged of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION �-Jkl INSPECTION FORM# REMARKS a r a _ a r INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager