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Home My WebLink AboutEli Terry School i Establishment: ' C Inspection Date: tSd t Time: ':16_AM(R0lnsD RElnsp Address/City: I �, Healt Dep: S , gay" Class: 1 2 ®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 C 10 WA DNCJ KEY: C[complies] NIO[not observed] NIA[not applicable] 3 DNC[does not comply] 0[other] RTE[ready-to-eat] T �1 �?esg�a#e�A�I#eriiate 2 b t3 $1W ;, tit Written documentation of training program 2 A Food workers have no exposed infected lesions/burns B Personnel with infection restricted 1 Approved sotfrce,wholesome,nonadulterated C 0 N/A 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Han�h f cii B Food cans in good condition(not dented,rusty,bloated,leaking) im C Wholesome/nonadulterated foods/safe A Handwash facilities in all food prep/dispensing&warewash areas 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 ing E andwash at appropriate times } cfugr spbrafot'rispy .r 4e� ` .`i3 O A Hot holding greater than or equal to 140 F. (whole beef/pork roasts 1300 F.) LIVIA ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450 F. A IB 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 sanitizeravailableladequate concentration ofsanitizer 51t �aitfs�tt►naagttn pwu B Food contact surfaces and utensils used for potentially 01 i thenotrteters pro+ ded rq p 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 Pro ersanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 0 s o age, ay "prep r ":_ ., yr. display,service and transportation A Cloths and/or sponges in good repair and clean 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 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 V0 8 Food containers stored off the floor Ell 0 r g tfarttlling bSoiidir€iinirnizet!` F., 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 I Handwash sink(s)clean I waste receptacle at handwash sink 01Z 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 aftemate],PHF[potentially hazardous food],FB[foodbome] PHFs are hot held at: F. 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 yo o report to the local health department? Roasts Other_ Describe re-heating procedures: Is there a written illness y that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holdi ods/equipment? Y N and diseases tot O? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cool . Y N Are leftovers saved? Y N Is there/DA:nguage barrier between inspector&QFO? Y N !-yes indicate language spoken List products cooled: by Q *Can the QFO/DA read the inspection report? Y N Describe cooling method 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 monito for time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain signature of the person who received the CFO responsibilities information at the time of the Is there roduce 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 s Establishment: Date of Inspection: f Address: Owner or Operator: ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] z 6 Foods not re-served. -Unwrapped foods not re-served 4u 31 Sewage disposal approved. 4++ -Potentially hazardous foods not re-served -Operating as required 11 o cross connections,back siphonage,backflow Toxic chemicals. N � � � -Stored properly,labeled properly,used properly ` Wiper 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 machines f� Proper drain for: 29 Water source adequate,safe. MZ11,; -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination +': -Water quality in compliance x 35 Toilet facilities. Adequate,convenient,accessible, 4, -Monitoring in compliance 3 designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 40 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,clean Al 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 , 14 Food worker:Clean outer clothes,effective hair restraints 1' 3 Outer openings protected against entrance of insects/rodents 1, 4 Floors: Floor covering installed,constructed as required,good repair,clean 41 16 Food-contact surfaces designed,constructed,maintained,installed, located 5 Floors graded,drained as required 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 2, 8 Exterior walking,driving surfaces,good repair,clean 1 19 No reuse of single service article 49 Walls,ceilings attached,equipment properly constructed,,ggo r=epair, lean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, ' maintained installed located J 50 Dustless cleaning methods used,cleaning equipment properly stored ,i1 EEquipment&Utensils; Cleanliness51 Adequate lighting provided as required 1 21 Preflushed,scraped,soaked and racked I 52 Room free of steam,smoke odors , 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 7 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,no insect/rodent harborage, � 28 Equipmentlutensils,storage,handling no unnecessary articles 32 Proper disposal of waste water FSeats eparation from living/sleeping quarters and laundry ` 33 Plumbing location,installation,maintenance ed linens stored properly s,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door r r more:Nonsmoking area provided,signs)posted at 37 Proper toilet fixtures provided,good repair,clean ),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean outine Inspection ❑Reinspection 0 Preoperational Inspection INSPECTOR: PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 AZ � 4 3 2 1 Total Rating signs u e ignaturele print print me (� yoZ"4qa� I Ot55 ;-6'1 Jwa R yer- phone number ew-k title DATE CORRECTIONS DUE: Page 2 of 2 plus continuation pag s Focused Inspection 1/2002 _ Page 3 of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF IN 0,^ S. t/,,7ECTION � INSPECTION FORM REMARKS # (. S U i 3a i� re� o n S► � S y o CAo _ o S foci, �¢ o INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Z� Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager