HomeMy WebLinkAboutFood Service Establishment Inspection 75 (5) ENS-106-Rev.06/01 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ ROUTINE INSPECTION OTHER ECTION
❑ PREOPERATIONAL ❑ OTHER
410 Capitol Avenue,MS451 FDP,Hartford,CT 06134 NAME OF
ESTABLISHMENT °�W ESTABLISHMENT
STREET � CLASS
ADDRESS I // / j( �j TOWN y
OWNER or
OPERATOR q
�p� INSPECTION l
DATE d TIME
Based on an inspection this day,the items marked below identify the violations in operation or facilities which must a e
SOURCES OF FOOD be corrected by the date specified below.
EQUIPMENT&UTENSILS:CLEANLINESS
1 Approved source,wholesome, 4 21 Preflushed,scraped,soaked and racked IN CONTROL
nonadulterated 4 resence of insects/rodents
22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of
2 Original container,properly labeled 1 23 Accurate thermometers provided,dish basket if used insects/rodents 1
FOOD PROTECTION 24 Sanitization rinse(hot water-chemical) 2
25 Clean wiping cloths 1 FLOORS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 26 Food-contact surfaces of utensils&
temperature requirements during storage, 2 44 Floors:floor covering installed,
preparation,display,service,and equipment clean constructed as required,good repair,clean
transportation 27 Nonfood-contact surfaces of utensils&
equipment clean 1 45 Floors,graded,drained as required
product 46 Floor,wall juncture covered
4 Adequate facilities to maintain 1
P 2 28 Equipment/utensils,storage,handling 1
tem eralure thermometers rovided 47 Mats removable,good repair,clean 5 Potentially hazardous food properly thawed 2
6 Unwrapped or potentially hazardous food 4 48 Exterior walking,driving surfaces,
not reserved WATER SUPPLY good repair,clean 1
erly
7 Food protected during storage,preparation, 29 Water source adequate,safe
30 Hot and cold water under pressure, 2 49 onstructed 9go da pair,cle nm Wall pro
ceiling 1
display,service&transportation
8 Food containers stored off floor
2 provided as required surfaces as required.
SEWAGE DISPOSAL 50 Dustless cleaning methods used, 1
Handling of food minimized cleaning equipment properly stored
10 Food dispensing utensils properly stored 31 Sewage disposal approved cleaning
4
11 Toxic items properly stored,labeled,used Proper disposal of waste water 1 LIGHTING&VENTILATION
4 51 Adequate lighting provided as required 1
PERSONNEL PLUMBING 52 Room free ofsteam,smoke odors
12 4 Personnel with infection restricted 33 Location,installation,maintenance 1 53 Rom&equipment hoods,ducts,vented as required 1
34 No cross connection,back siphonage,backflow 4
LEANLINESS OF PERSONNEL TOILET FACILITIES DRESSING ROOMS&LOCKERS
1 Handwashing facilities provided, 35 Adequate,convenient,accessible,designed, 4 provided,Room facilities clean adequate lockers
ersonne1
l hands washed clean installed
14 Clean outer clothes,effective hair restraints 1 36 Toilet rooms enclosed with self-closing door
15 Good hygienic practices,smoking restricted 2 37 Proper fixtures provided,good repair,clean 1
HOUSEKEEPING
EQUIPMENT&UTENSILS: DESIGN, 55 Establishment and pemisesfree of lifter,no
CONSTRUCTION&INSTALLATION HANDWASHING FACILITIES insect/rdent harborage,no unnecessary articles 1
38 Suitable hand, and sanitary towels or 1 56 Complete separation from livin /slee in
16 Food-contact surfaces designed,.constructed, 2 approved hand drying devices provided, 9 p g quarters 1 maintained,installed,located tissue waste receptacles provided and laundry
17 Nonfood-contact surfaces designed, 1 57 Clean/soiled linens stored properly 1
constructed,maintained,installed,located GARBAGE/RUBBISH STORAGE&DISPOSAL 58 No live birds,turtles,or other animals 18 Single service articles,storage,dispensing (except guide dogs) 1
19 No reuse of single service article p 9 2 39 covered,rtlodent'p proof,clean ate number,
1
20 Dishwashing facilities approved design,adequately 2 40 Storage area/rooms,enclosures— NONSMOKING AREAS
constructed,maintained,installed,located properly constructed,clean 59 Seats 75 or more:Nonsmoking area provided, 3
sign(s)posted at entrance(s),smoking area
41 Garbage disposed of in an approved manner, 1 indicated b sin s
at approved frequency
DEMERIT SCORE QUALIFIED FOOD OPERATOR
4 3 2 60 Qualified Food Operator 3
1 RISK FACTOR VIOLATIONS IN RED 61 Designated alternate
2
62 Written documentation of training program 2
TOTAL RATING Date Corrections Due Signature rson' Marge
C
tSIGNE (Inspe
DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
Pag� of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN
DATE OF SPECTION
INSPECTION v1 �
FORM# REMARKS
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NITIAL(INSPECTOR)
INITIAL(PERSON IN CHARGE)
Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager