Loading...
HomeMy WebLinkAboutFood Service Establishment Inspection 57 (11) i V ............ ................ Establishment; inspection Date: i / Time: Rojnsp R nsp Address/City: — c� / Health Dept: �.� ,Li �� ass: 2 3 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 N10 NIA DNC KEY: C[complfes] NIO[not observed] NIA[not applicable] 60 Qya[ified FQO t3perafor, 3 DNC[does not comply] 0[other] RTE[ready-to-eat] r tl<2 'EPe soppe!tntilth r e 'on rest Ic E Ptf,, atetl"liteirta _ ti... 4 ;, I 52 WdEten tlocyeratttton ofitrairling program 2 A Food workers have no exposed infected lesions!burns B Personnel with infection restricted �f A�pror�etlaQurce,suholesomg;,npn;tdult$ated, C ,NIOt Nli `4', a! municable disease of worker reported to local health director A Approved shellfish fnfish,meat&poultryUSDA approved B Food cans in good condition(not dented,rusty,bloated,leaking) i ! �tn9 i�EUttE&�pD�►ided'httndsw�s�ieiF'tleaff' hC:j�t0 r `4` Handwash facilities in all food prep/dispensing&Warewash areas C Wholesomelnonadu Iterated foods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities accessiblelconvenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean 1 Proper handwash procedure 0 E H _ashing at appropriate times 3 iPotierttia[t hazardogs fio4d meets tehlpe�ature requirements ;C N10 NIA t4 ditrjng sgrae,preparatrp� gtsplaYrserrrcentl tranepottatron r�H i �rti practt�es c 0 A 2„ . € + t g A Hot holding greater than or equal to 140 F. (whola Naflpork roasts 1300 el A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450 F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking 1 consumer advisory posted C EAII®- . m.. 0 A Approved sanitzeravailablefadequate concentratlon of sanitizer p4 A+e�i�aerilrtre> ttr main#airtr tf�cf B Food-contact surfaces and utensils used for potentially }} erTf rB U ,#hetmgm�ker.tir vis$ 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 L Proper sanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food O 0s the r 1 c.,►v!b' N7a A Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not storedlprepared near ready-to-eat foods t2t3+�Frrd �ihsul�d �f�ar�� C N!0 NA 2; C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean` D Adequate splashguardslsneeze guard B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfacesclean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor r ntiod ep > ivera'sr � 'NIA '2 0 rg ^ 9 a} NowR � d c A Soap I paper towels 1 drying device available A No unnecessary handling RTE and/or cooked foods with bare hands 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 foodlice 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 allemate],PHF[potentially hazardous food],FB[foodborrej 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 F8 illness are u required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy that r quires 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 bamer be n inspector&QFO? Y N ff yes indicate language spoken List products cooled: by QFOIDA: +Can the QFOIDA 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 Wolin recorded? Y N Indicate the ti of above person( e all that apply]:QFO DA Mgr Cook Owner FW Obtain signature f e er_ ho receive�a the QFO responsibilities information at the time of the Is there a produce washing policy? Y N ♦Describe what is washe, and inspection: / where: Note: T4 report is a two)age fdmn(total of 62 debltable items) Page 1 of 2 G�NNECTiGU "W-I PAfi ME=NT tSF Pllt3LIC H LTH 41�CAPt'�'OL A1/ENUI= 1ViS#51 FOP=HARTFORD,CT 06134 r �L�AL HIf W bPT. of!C " DDRESS/CITY Establishment �1 �. - ✓I Date of Inspection - �h�c.d— f5wner orOperator. . ADDITIONAL FOUR TEMF� KEY,. rGisR 6 Foods not re-served. 4 31 Sewage disposal approved. -Unwrapped foods not re-served 4 -Operating as required -Potentially hazardous foods not re-served No cross connections, back siphonage,backflow ll 4' Toxic chemicals. 4 Pro eerrtype/Installation/backflow prevention devicelairgaofio -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines - Sanitizerconcentrationnot#p exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticides/rodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines 4 -Well/well head protected from contamination 35 Toiletfacilities. Adequate,convenient,accessible, -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS z ou: KEY: DNC [DOES NOT COMPLY] c 2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storagearealrooms,enclosures-properly constructed,clean 1. 5 Potentially hazardous food properly thawed 2.: 1 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 42 Vermin Control: No insecWrodents present 2 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected against entrance of insectsfrodents 4 Floors:Floor covering installed,constructed as required,good repair,clean , 16 Food-contact surfaces designed,constructed,maintained,installed, ?,= 5 Floors graded,drained as requiredeo ed 6 Floor,wall juncture covered 17 N od-contact surfaces designed,constructed, maintained, 1 7 Mats removable,good repair,clean s --installed,located l Single service articles,storage,dispensing 2; 8 Exteriorwalking,driving surfaces,good repair,clean 18 19 No reuse of single service article al ,ceilings attached,equipment properly constructed,good f g 20 Dishwashing facilities approved design,adequately constructed, 2 repair,clean.Wall&ceiling surfaces as required maintained installed located 501 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness � ' 51 Adequate lighting provided as required 21 Preftushed,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 Arc4,rate thermometers provided,dish basket,if used 5 Rooms adequate,clean,adequate lockers provided,facilities clean l> N ood-contact surfaces of utensils&equipment clean 55 Establishmentandpremisesfreeof litter,no insect/rodent harborage,29 1- Equipmentlutensils,storage,handling ;1 no unnecessary articles nl5ropro� erdisposalofwastewater 6 Complete separation from living/sleepingquartersandlaundry 1, 33 Plumbing location,installation,maintenances 1 57 Cleanlsoiled linens stored properly 58 No live birds,turtles,or other animals(except guide dogs) ,1 t rooms enclosed with self-closing door 1 � 59 Seats75 or more:Nonsmoking area provided,sign(s)posted at r 7 ro er toilet fixtures provide,good re air, can r3, entrance(s),smoking area indicated by sign(s) 39 Approved garbagelrubbish containers,adequate number,covered, 1 ` rodent proof,clean outine Inspection ❑Reinspection 0 Preoperational Inspection TOR: PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signature signetu t ' print name print Ume-^ I l phone number title DATE CORRECTIONS DUE: 3� C)U3 Page 2 of 2 plus c continuation pages ro�� e��ro4r o Page of _ -INSPECTION-REPORT ___ _ ___ ___ _ _ STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH NAME OF ESTABLISHMENT TOWN DATE OF INSPEC ION INSPECTION FORM REMARKS # w oel ZZ4L4 �d ZZI - a INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager Pageof - -INSPECTION-REPORT STATE OF CONNECTICUT-.- - FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH NAME OF ESTABLISHMENT TOWN DATE OF SPECTION INSPECTION FORM# REMARKS ( ; e ,t t >� .3 � �. . . —<.vcte, j AW 4-1 INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE}\ Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager