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HomeMy WebLinkAboutFood Service Establishment Inspection 10 (23) AddresEstabls/City: f -,�� z71 /M-1dnspection Date: Z Time: 4,. U oinsp Einsp ddresslCity: „ d � � Health Dept: �,r i 2i- _c ass: 2 3 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 passi6el�tebT6le]items C Igo NIA DNC KEY: C[complies] N10[not observed] NIA[not applicable] 60 dlGalifled FpOd©peraipt g DNC[does not comply] 0[other] RTE[ready-to•eat] 6t pesignated'A.Itetnate 2 � :; .. fed; ° A Food workers have no exposed infected lesions 1 burns `fit Written dbc'umentotion of tra[ning program 2 B Personnel with infection restricted �} rE1p1GY�d SpUrCR,+NhDleso€ne;ftOnadUltifated ,C ,NIO NIA 4 C Communicable disease of worker reported to local health director A Approved shellfish finfish,meat&poultry USDA approved �R .t�aip wasihtng fa ill es ptovti ed;hands rasi ecl;:clean C NIO;rN1A= 4 B Food cans in goad condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepldispensing&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 accessibletconvenient to use E Potentially hazardous foods received at proper temperature 0 D Personnel hands washed,clean!Proper handwash procedure t E Handwashing at appropriate times ' tall hazartlatas food meets tam e't tiixe +� t .5�' 0 prsparatton�dfspiay, c � t ce*. ,. '. fapreC}I@,S t€t� =k Wi r S � C, f/Q i i�t1�1 2 0 A Hot holding greater thanorequal10140°F. (Whole heeeperka,aarss9o°F.) l.» . � A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 45°F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating_ 0 E Proper internal cooking I consumer advisory posted to}Io s( chemicl Cry WQ i IVlA,12 , Approved sanitizer availableladequate concentration of sanitizes d r Ac�q+ te,aei 1tted rttafntaf pwaduot Ct ip tN/ t Food contact surfaces and utensils used for potentially �r �+ F erp¢� # ,vheron� rc�u41 t r 'F < E f �• hazardous food sanitized at least eve hours A Food thermometer available and accurate C Adequate ❑dishwashersanilizer inal rinse temp 4. B Proper food thermometer for product D Proper sanitizin rocedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units y 0 0 i r.tean<Wt'I"g Cloths C g� " [ NJO `iWA �9 �r B�} s+Pr�I ��' [ 'r 44 < 'k �' A Cloths andlor sponges in cod repair and clean 3 � 9 P ping cloths kept in sanitizer between uses A Produce washed B IlRawmealsnotstoredlprepared near ready-#o-eat foods I" ��Cr .400§tu �Saf�� [ ,0 C Food covered properly " Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards 1 sneeze guard a Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 11 8 Food containers stored off the floor f � If`i/ �lt ` sstt tas fe u ;NIO)'N1A 2 0 �. l �dt.: , tJIA 2< ME ° � r CVl flllA. '1 A Soap paper towels 1 drying device available A No unnecessary handling RTE and/or cooked foods with bare hands B Dispenser(s)working: OSOap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sinks)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing foodlice J±L 0 O 1 *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(foodborne] 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 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 thh od worker to report specific illness conditions Are temperatures recordedllogged for cold holding food quipment? Y N and diseases to the QF0? Y N b you have a paid sick leave policy? Y N Are foods cooked in advance and coaled Y N *Are leftovers saved? N Is there a language barrier betweep i spector&QFO Y N It yes indicate language spoken List products cooled: by QFOIDA: 7 *Can the QFOIDA 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&to ? Y N Is the monitoring of cooling recorded? Y N •Obtain signature of t arson whe-receive the QFO responsibilities information at the time of the r'sthere a produce washing Iicy? Y N ♦Describe what is washed and inspection:_ � ��gf Jere: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 TE'OF C_ONNECTIC!~iT' DEP�LCTIh(IrNT OF RUI3LIC�HEATH 41 Q CAPIT I-p11ENUE MS#51 FI]P HpiRRT 06153 CU�uFiD)H'0 31),6+RVIC- - ,DEPORT b r',?fib 'rmt '` a �:qAL HEALTH DEFT` /� "11�.1 jltl J :- , . Gk ADDRESStCITI Establishment Date of,lns�ection: Z� vaa �ss ��� v "" /j,� a _ ,Owner.or,Operator: GU KEY: DNC [DOES NOT COMPLY] , 6 Foods not re-served. 4 31 Sewage disposal approved. -Unwrapped foods not re-served 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections, back siphonage,backflow Proper type/installation/backflow prevention device/air gap for: 4' -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines - Sanitizerconcentration not to 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 Toilet facilities, Adequate,convenient,accessible, 4 -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS c; KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 1 0 Garbagehubbishstoragearea/rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properly thawed 41 Garbage/rubbish disposed of in an approved manner,atapproved frequency 10 Food dispensing utensils properly stored 42 Vermin Control:No insects/rodents present 2: _ 14 Food worker:Clean outer clothes,effective hairrestraints 1 3 Outer openings protected against entrance of insects/rodents 4 Floors: Floor covering installed,constructed as required,good repair,clean 1„ 6 Food-contact surfacesdesigned,constructed,maintained,installed, (41 45 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed, maintained, 47 Mats removable,good repair,clean installed,located 18 Single service articles,storage,dispensing 2 ` priorwalking,driving surfaces,good repair,clean 19 No reuse of single service article 9 Is,ceilings attached,equipment properly constructed,good 1 repair,clean.Wall&ceiling surfaces as required 0 Dishwashing facilities approved design,adequately constructed, e2` maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1 Equipment&Utensils' Cleanliness 1 51 Adequate lighting provided as required 1' 1 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 Gc ate thermometers provided,dish basket,if used Rooms adequate,clean,adequate lockers provided,facilities clean 1 7 � food-contact surfaces of utensils&equipment clean 55 Establishment and premisesfreeof litter,no insect/rodent harborage, c!• Fquipmentlutensils,storage,handling 1 no unnecessary articles 32 Proper disposat of waste water 56 Complete separation from livinglsleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 57 Clean/soiled linens stored properly ) 58 No live birds,turtles,or other animals(except guide dogs) 1, 36 Toilet rooms enclosed with self-closing door 1 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toile#fixturesprovided,good repair,clean entrance(s),smoking area indicated by sign(s) 3 39 Approved garbage/rubbish containers,adequate number,covered, 1 rodent proof,clean ❑Routine Inspection ❑Reinspection 0 Preoperational Inspection INSPECTOR: PER N IN CHARGE: Other Inspection: � Demerit-Score: •Include demerits from page 1 4 3 2 1 Total Rating sign ture d' ; signaTure 41 � . r-phone name � print e — number _ title DATE CORRECTIONS DUE: 2,p/g 71- � fj Page 2 of 2 plus continuation pages Focused Inspection— �2 Page t 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 r An v, 4ac,&� 4` W � -'� •plc.` � � o f � INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Pa - of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC NEAT TH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF IN ECTIO INSPECTION FORM# REMARKS T L Date:�r fxFa EroD:f fmp�eado PASS WHEN RLUE 6AR TURNS ORANGE. AlUlEVM1UAC�elO�ANPNJaA bav 114 4a jQ e INITIAL(INSPECTOR) 1NITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager