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Home My WebLink AboutFood Service Establishment Inspection 52 (3) Establishment: eckkt-1JjAyyAn Inspection Date: Time: Roinsp Einsp Address/City: C QII Rj W Health Dept: 1, 2 4 Based on an inspection this day, a items marked DNC ide tify t e 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 WA NCI KEY; C[complies] N/O[not observed] N/A[not applicable] 3 DNC[does not comply] 0[other] RTE[ready-to-eat] M" C Q m _ 2 r :a' A Food workers have no exposed infected lesions I burns �) B Personnel with infection restricted " �� ef1tt8� C /0 N/A. 4 C Communicable disease of worker reported to local health director A Approved shellfish,flnflsh,meat&poultry USDA approved "*0 Jg1W]HIPS PO deed bands *CJW_ .O _IW Wk'"4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulteratedfoods/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 .s I �r� RMe �. A Hot holding greater than or equal to 140 F. (whole beer/pork roasts 130e F.) 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 hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate lirdishwashersanitizer ❑final rinse temp 71 1 B Properfood thermometer for product L Proper sani izin rocedure 1-1 E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 � F o `� � A 3 Cloths and/or sponges in good repair and clean 9WRYMEw ' �'� B Wiping cloths kept in sanitizer between uses A Produce washed B Raw meats not stored/prepared near ready-to-eat foods 0 E�� 1:EEN 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 0 I I m A No unnecessary handling RTE and/or cooked foods with bare hands A Soap paper towels 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. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodbome] 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 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 ff-M 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): 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 rs there a produce washing policy? Y N *Describe what is washed and inspection: where: I : Note: This report is a two page form(total of 62 debitable items) Page t of 2 - Establishment: d i A Date of Inspection: Ok\S_ ddress: u 2 Owner or Operator: h/A \c 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. 34 No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Proper type/installation/backflow prevention device/air gapf o -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 machines Proper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35rdesigtnfed, ilities. Adequate,convenient,accessible, -Water quality in compliance-Monitoring in compliance properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources offood: Original container,properly labeled 40 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,dean 5 Potentially hazardous food properly thawed 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 43 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, 5 Floors graded,drained as required located 17 Nonfood-contact surfaces designed,constructed, maintained, 6 Floor,wall juncture covered installed,located 147 Mats removable,good repair,clean 18 Single service articles,storage,dispensing 8 Exterior walking,driving surfaces,good repair,clean 19 No reuse of single service article 49 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 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 54 Rooms adequate,clean,adequate lockers provided,facilities clean 27 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,no insect/rodent harborage, 8 Equipment/utensils,stprage,handling no unnecessary articles 32 Proper disposal of waste water 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance 57 Clean/soiled linens stored properly 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 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 50outine Inspection OReinspection 0 Preoperational Inspection INSPECTOR: PERSON IN CHA E: Other Inspection: Demerit Score: *Include demerits from page 1 l.J 4 3 2 1 Total Rating i ature ,akfnature rip 1CIV Z S� pint namee print name I S� C�um er —Zs- ,` r phone number title DATE CORRECTIONS DUE: XZn Page 2 of 2 plus continuation pages Focused Inspectlon ll. Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION -IMI/6-A 'W �0 6,1 - - %s- N INSPECTION REMARKS FORM# At j►� s �<< h or i S s f vnjru {-e✓1 1LL Ln c, v W INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager