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Home My WebLink AboutFood Service Establishment Inspection 94 (2) /)J Cad�i M PaS- � Establishment: v� Inspection Date: Time: o� of REinsp ddress/City: Olill Q\t6Vr l U"LL.L, (Ls� . Health Dept: inn s: 12 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 N/O N/A NCI KEY: C[complies] NIO[not observed] NIA[not applicable] 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 2 Emil f2 f-Pefsoir�;("with rrection restr`iG C 40', t�iA 4 A Food workers have no exposed infected lesions I burns t 0"60""a"oftil 019,programi Ae 2 B Personnel with infection restricted R r#ar@t1 satrrcc�, vhctla'sd�1e,°nerta�utt�rated C WO NIA 4 C Communicable disease of worker reported to local health director AI Approved shellfish,finfish,meat&ppoultry USDA approved 13" Fteridwashing facifill provided,hallwasiclean` N/0] NtA 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 I Proper handwash procedure 1. 0 E Handwashing at appropriate times 0 A Hot holding greater than or equal to 1400F. (whole beef/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 C E Proper internal cooking I 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 ' washersanitizer ❑final rinse temp B Proper food thermometer for product L Proper sani izin rocedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 sp V I F A Cloths and/or sponges in good repair and clean N _M t A Produce washed B Wiping cloths kept in sanitizer between uses 0 B Raw meats not stored/prepared near ready-to-eat foods C Food covered properly _j I IA_ Food equipment clean,utensils_clean,_equipmentinteriors clean.. . D Adequate splash guards/sneeze guard Al B Single use gloves changed when soiled E No unauthorized personnel A, C Food contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor 0 ` rt ,.a . .R a.,: �`� . £g A Soap/paper towels/drying device available A No unnecessary handling RTE and/or cooked foods with bare hands B Dispensers)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 1 # •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. _M: QFO[qualfied food operator],DA[designated atemate],PHF[potentially hazardous food],FB[foodbome] Pl are hot held at: OF. Pl 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 tLy_es indicate language spoken List products cooled: by QFOIDA: *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 ki rs o received the QFO res onsibilities 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 debitable items) Page 1 of 2 1 JGI VK �A- Establishment: E�C n Date of Inspection: d �� I ddress:ga1 Owner or Operator: a., Svil h ADDITIONAL FOUR POINT ITEMS za " 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. No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly Propertype/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. -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 0 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properly thawed 1 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 uteropenings protected against entrance of insects/rodents 4 oors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, 5 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed, maintained, 7 Mats removable,good repair,clean installed,located 8 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good 20 Dishwashing facilities approved design,adequately constructed, repair,clean.Wall&ceiling surfaces as required - ---.- maintained installed located-- m---- 50 Dustless cleaning methods used,cleaning_aquipmentproRer lystored___ E uipment&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 2 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 7 onfood contact surfaces of utensils&equipmentclean 55 Establishment and premises free of litter,noinsect/rodentharborage, Equipment/utensils,storage,handling no unnecessary articles 32 Yroper disposal of waste water 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) 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Propertoiletfixturesprpvided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean Nkoutine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: IN E T R: PERSON[ CHARGE: Demerit Score: *Include demerits from page 1 0'114k&q n9l, t%kW,& 4 3 2 1 Total Rating i Mau—re st nature i s sq)?d6vc, t print na a print name "4x3 `M o mcf hcp Cy DATE CORRECTIONS DUE: p one number title Page 2 of 2 plus continuation pages Focused Iuspecdou 1/2002 Page 3 of t,av INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION FORM# REMARKS 2 /- �- v\ ca DEC �k C��" 2.� C) DAL jr �d W�- I JJ0111 Ll �� 4, �ei2 ((Ak-kL&A INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager