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HomeMy WebLinkAboutFood Service Establishment Inspection 53 (5) i Establishment: ) Inspection Date: Time: ,tj,p oin RE[nsp Address/City: Health Dept: �JtK Class: 1 2� Based on an inspection this day,Mel 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 N/O N/A DNC I KEY: C[complies] N/0[not observed] N/A[not applicable] 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 1�,=Parsis�he 2 r�: __.n..t,::.{ ,.� I n ©ctu5en of ttaiMn ` ►c rim" A Food workers have no exposed infected lesions burns p 2 B Personnel with infection restricted N10 NIA 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Handwashin fact) B Food cans in good condition(not dented,rusty,bloated,leaking) 9 r 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) 0000 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 0 Good hygfieAllr= A Hot holding greater than or equal to 140 F. (canoe beerp°rRroasts iso°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 i aarli t 6,",_ 0 A Approved sanitizeravailable/adequate—concentration ofsanitizer lei 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 ❑dishwashersanitizer ❑final rinse temp B Properfood thermometerfor product D Proper sani izin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 0 xC+lean wtprn�'d .M udfrtrd t ,:,�., ol A Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Produce washed B Raw meats not stored/prepared near ready-to-eat foods k, M ood-eblttt�tttt3. C Food covered properly 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 L _pf and cltl 0 w� Hanriwashitt� "` A Soap l paper towels/ drying device available A No unnecessary handling RTE and/or cooked foods with bare hands B B Dispenser(s)working: ❑Soap ❑Papertowel 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 o •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated altemate],PHF[potentially hazardous food],FS[foodbome] PHFs are hot held at: OF. 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 in advance and cooled? Y N *Are leftovers saved? Y N Is there a language barrier between inspector&QFO? Y N Iflf-yea indicate language spoken List products cooled: by QFO/DA: *Can the CFO/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 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 a;� r n x Establishment: [ Date of Inspection: v Address: Owner or Operator, 2� 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. -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Pro er type/installation/backflow prevention device/air gap for:-San itizer concentration notto 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 -Water quality in compliance 35 Toilet facilities. Adequate,convenient,accessible, 4 -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled .1 40 Garbagelrubbish storage area/rooms,endosures-properly constructed,clean X" 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 2y 14 Food worker:Clean outer clothes,effective hair restraints uter openings protected against entrance of insects/rodents 4.4 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, installed,located 7 Mats removable,good repair,clean 18 Single service articles,storage,dispensing xterior walking,driving surfaces,good repair,clean 19 No reuse of single service article 49 oKalls,ceilings attached,equipment properly constructed,good repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils; Cleanliness 51 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 rooms adequate,clean,adequate lockers provided,facilities clean Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premisesfreeof lifter,noinsect/rodentharborage, 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) 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 aroutine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: P SCHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating sign re / /� signature _ V ( 1 �✓ print name print name phone number title �4^ DATE CORRECTIONS DUE• Page 2 of 2 plus continuation pages Focused Inspection 1/2002 Page.3 INSPECTION REPORT STATE OF CONNECTICUT A ,� FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH �/ ' Pr:klb' CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INS ECTION r � c :�)/// INSPECTION FORM# REMARKS A 4 � -evt- oa�:w V � J� I L l� - hh � l a „ � A � L4 ✓1 I fie �, LIP INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) 4 2nd-Yellow-Owner/Manager Distribution: I st-White-Health Department