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Home My WebLink AboutFood Service Establishment Inspection 97 Establishment: JLQ Inspection Date: Time: G ROinsp Einsp Address/City: CI,11 So Health D pt: S WLlat�(j✓ class: 1 2 s 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 debitable items N/O NIA DNCI KEY: C[complies] N/O[not observed] NIA[not applicable] $ DNC[does not comply] 0[other] RTE[r dy-to-eat] 2 - A Food workers have no exposed infected lesions/burns *� 1f1ti 2 B Personnel with infection restricted ✓ �x1N{ OBt1 C, N/A 4 C Communicable disease of worker reported to local health director A I Approved shellfish,finfish,meat&poultry USDA approved 93: 9 � � b t.. �aailtltf� x w8shetl,cC�an" C` N/C. i�fzA ;4 B Food cans in good condition(not dented,rusty,bloated,leaking) 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 0 M <; o , e ��"fit � es � 'x ,x. _ �, NIA, A Hot holding greater than or equal to 1400F. (whole beeoporkroasts isoo F.) t/ A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450 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 0 A Approved sanitizeravailable/adequate concentration ofsanitizer B Food-contact surfaces and utensils used for potentially 1111 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 sanitizing procedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 0 A Cloths and/or sponges in good repair and clean 90 MZ"" B Wiping cloths kept in sanitizer between uses A Produce washed 0 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 B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean No pooling of eggs not cooked immediately 0 Food containers stored off the floor 0 TT A No unnecessary handling RTE and/or cooked foods with bare hands A Soap paper towels I drying device available B 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 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. M: QFO[qualfied food operator],DA[designated a@emate],PHF[potentially hazardous food],FB[foodbome] PHFs are hot held at: F. 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&CFO? Y N ttygs 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 FW 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 inspection: where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 rEstablsishent: Cl,e� � Date of Inspection: (A E� `®1'1 �1 C t�2v� Owner or Operator: t� ADDITIONAL FOUR POINT ITEMS Z" KEY: DNC [DOES NOT COMPLY' z4 6 Foods not re-served. 4 31 Sewage disposal approved. -Unwrapped foods not re-served -Operating as required -Potentially hazardous foods not re-served 11 Toxic chemicals. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Pro per type/installation/backflow prevention device/air gap for: -Sanitizer concentration not to exceed maximum -Food-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 35 Toilet facilities. Adequate,convenient,accessible, -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storagearea/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 property stored 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings 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 ated 6 Floor,wall juncture covered 17 No ood-contact surfaces designed,constructed,maintained, 7 Mats removable,good repair,clean installed,located - —_( ) 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 property constructed,good 20 Dishwashing facilities approved design,adequately constructed, repair,clean.Wall&ceiling surfaces as required maintained installed located i 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 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 23 Accurate 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 lifter,no insect/rodent harborage, 8 Equipment/utensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance 571 Clean/soiled linens stored properly 36 Toilet rooms enclosed with self-closing door 581 No live birds,turtles,or other animals(except guide dogs) 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Propertoiletfixturesyrovided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean [311outine Inspection inspection ❑ Preoperational Inspection Other Inspection: IN PE T R: PERSON �INpCHARGE: Demerit Score: *Include demerits from page 1 QQfA ()&-V( 4 3 2 1 Total Rating st ture signature ,9/, n `� PV t print name ( print namet_J t Phone num er title DATE CORRECTIONS DUE: X �� ( � �`-2y Page 2 of 2 plus I continuation pages Focused Inspection1/2002 Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION FORM# REMARKS (�� vks � c 4 LLi k S INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager