HomeMy WebLinkAboutFood Service Establishment Inspection 98 i
Establishment: GgAAo, Wz" Inspection Date: _ ; Time: / -/..S- oinsp REinsp
Address/City: cix2 yV(;t^ yd„.Q Health Dept: So,. 1 W t Class: 1 2 3
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 JXO I N/A DNC I KEY: C[complies] NIO[not observed] N/A[not applicable]
�� QfiQd tsafor r 3 DNC[does not comply] 0[other] RTE[ready-to-eat]
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12 Personnel wit infection s#Flcted B1 t�esigsatsd i4ttentate 2 C A .
n docureronaf trahr p 2 A Food workers have no exposed infected lesions/burns
1 Appcovetf source,wholesome;"noeadultetstetl C 0 NIA 4, B Personnel with infection restricted
C Communicable disease of worker reported to local health director
A Approved shellfish,finfish,meat& oult USDA a roved 13 Handwashin facilities
B Food cans in good condition(not dented,rusty,bloated,leaking) g N{A
A Handwash facilities in all food prep/dispensing&warewash areas
C Wholesome/nonadulterated foods/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/Proper handwash procedure
0
E Handwashing at appropriate times
3 PoteatiaH hazardous food meets temperature requirements C N/0 N/A 4 0
dpling s1raue,preparation,display,service and transportation
15 Good hygienic practices
A Hot holding greater than or equal to 1400F. (whole beef/porkroasts 1300 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 2 Sanitization rinse(hot water chemjcal) C NI0 [
0 A Approved sanitizer available/adequate concentration ofsanitizer A
4 Adequate facilities to maintain product C N/0 NIA 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 Proper sanitizin rocedure
C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food
0 0
5 Glean wiping Cloths
x Foam Pry 4oted'tltlring'stotage,"preparation, C NIO d.UA 2 C
m y A Cloths and/or c)�s a ,spir dee and transportatron 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 026 Food-contact surfaces zslei
C Food covered properly =-. � .�� ` RI
AMIXES
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 38. Mot and cold water under ensure,�lro
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3.8 Handwashing accessories provi
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Hail of: r stiifnized> C 1,WO'NIA €
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 ❑Papertowel
C Adequate utensil(s)for dispensing food/ice
C Handwash sink(s)clean/waste receptacle at handwash sink
0
"ME '4�4 1 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: 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 temper re do you cook:
Poultry Ground Beef ork What diseases related to FB illness are required to report to the local health department?
Roasts Other
Describe re-heating procedures: Is there a written illness policy! requires the food worker to report specific illness conditions
Are temperatures recorded/logged for cold holding fo equipment? Y N and diseases to the QFO?YN *Do you have a paid sick leave policy? Y N
Are foods cooked in advance and cooled? Y *Are leftovers saved? Y N Is there a language bar' between inspector&QFO? Y N If yes indicate language spoken
List products cooled: by QFO/DA: *Can the CFO/DA read the inspection report? Y N
Describe cooling methods: Indicate who wswered the above questions:Name(print):
Is cooling monitore 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
Establishment: Date of taspection: 3 ►'(
ddress: 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. 4
-Potentially hazardous foods not re-served -Operating as required
34 No cross connections back si hona e,backflow 4
11 Toxic chemicals. � p g
-Stored properly,labeled properly,used properly
4 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 machinesProper drain for:
29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines
-Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4
-Water quality in compliance-Monitoring in compliance designed,properly installed
OTHER ITEMS ca
KEY: DNC [DOES NOT COMPLY]
0
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 ` 41 Garbage/rubbish disposed of in an approved manner,at approved frequency
10 Food dispensing utensils properly stored 1 42 Vermin Control: No insects/rodents present 2
14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outeropenings protected against entrance of insects/rodents 1
4 Floors: Floor covering installed,constructed as required,good repair,clean 1
16 Food-contact surfaces designed,constructed, maintained,installed, 2 45 Floors graded,drained as required
located
6 Floor,wall juncture covered
17 Nonfood-contactsurfaces designed,constructed, maintained, 1 47 Mats removable,good repair,clean
installed,located
8 Single service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean 1
19 No reuse of single service article 49, Walls,ceilings attached,equipment properly constructed,good QV
repair,clean.Wall&ceiling surfaces as required
20 Dishwashing facilities approved design,adequately constructed, 2
maintained installed,located 50 Dustless cleaning methods used,cleaning equipment properly stored 1
Equipment&Utensils• Cleanliness 1 1 Adequate lighting provided as required
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1
22 Wash water clean,proper temperature 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
27 Nonfood-contact surfaces of utensils&equipment clean 1
55 Establishment and premises free of litter,no insect/rodent harborage, i
Equipment/utensils,storage,handling 1 no unnecessary articles
32 Proper disposal of wastewater 1 56 Complete separation from living/sleeping quarters and laundry 1
33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1
36 Toilet rooms enclosed with self-closing door
58 No live birds,turtles,or other animals(except guide dogs) 1
1
i r area
59 Seats 75 or more:Nonsmoking provided,sign(s)posted at
37 Propertoiletfixturesprovided,good repair,clean 3
entrance(s),smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered, 1
rodent proof,clean EXbutine Inspection ❑Reinspection ❑ Preoperational Inspection
INSPECTOR: PERSON IN CHARGE:
Other Inspection:
Demerit Score: *Include demerits from page 1
C%t 4 3 2 1 1 Total Rating
signature signature
--J Q " (A 5 W k ° o print name print name ® DY10
DATE CORRECTIONS DUE:
phone number Ile title 'n _
Ow ctie,,r Page 2 of 2 plus continuation pages Focused Inspection 1/2002
Page of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
1�A1�
INSPECTION
FORM# REMARKS
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager