HomeMy WebLinkAboutFood Service Establishment Inspection 98 (7) 1
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Establishment: L- it 7— 5— �, Inspection Date: Time: Rolnsp Einsp ..
Address/City: < / e Health Depf: Class; 1 2 3
Based on an inspection this day,the I ems 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 NIO NIA DNC I KEY: C[complies] NIO[not observed] NIA[not applicable]
'60 ,Qualthed=Food Operator ri 3 DNC[does not comply] 0[other) RTE[ready-to-eat]
12 , Parso.nnel with rnfecton r.,esfricted
S.
ignatedAlternate 2 C, NlQ';N1A
4
Y Y Food workers have no exposed infected lesions I burns
R.62 piton doRumentahon of training program
Approvetl source,wholesome,nonadulterated C N/0 N Personnel with infection restricted
s. ,:;n , . F ,:: C Communicable disease of worker reported to local health director
A Approved shellfish,finfish,meat&poult USDA approved
11' Haridwashtng«faarirtids provrded,:hantlswashetl;clean.. E C :NtO` NIA: 4
B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas
C Wholesomelnonadulteratedfoods/safe B Handwash facilities' or immediately adjacent to toilet rooms
D Commercial products(no home grownlcanned food) C Handwash faci t eessiblelconvenient to use
E Potentially hazardous foods received at proper temperature D Personnel hart as can!Proper handwash procedure
E HandwashW appropriate times
3 Pofefitialiy hazardotrss NOW—.ets Tempera u`re requirements EC NIO'NIA i 4
J. durmg storage,prepara#(bn,displays servicetand transportation "
s •� " f .. z i15 Good gi�ei�i �iractices
A Hot holding greaterthan or equal to 140 F. (whole beerlporkroasls1300F) o 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 i2 c{ anttizabon ri tse;tF ct wa v rNl0' :2
0 Approved sal availablelade ateooncenfratlonofsanitlzer <
�4 "ZPdequate fecrlt}e =to�maintainvPlAoduct h =" ' B y
i r iC iNl0 �N)A 2u Food-contact surfaces and ut s used for eettiai
l t mpprafure,thermometers:pr'o�ri�l ,x n •r i A� t ' hazardous food sanitized at least every ours
A Food thermometer available and accurate C Adequate ❑dishwashersanilizer ❑final rinse temp
B Proper food thermometer for product L Proper sanitizin rocedure
E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in cooler units
s Clt:an wiptng�ClQt is a h U; `C N10 6WA 1"
o* F 4od rotected�dt.frtn�,�t�r�i�ery'�r��raat�'or+s f4 b lG ! ��;' , _ � ...z,.y ..Y .. >
r iK Cloths and/or sponges in good repair and clean
-S A ��. _ ,nF.�.�..�:.'91::$�}�lp!.,',���k A?hn..lt-.it t$•'R` .�rwa:aY:.ti..d: E:b.
Produce washed B Wiping cloths kept in sanitizer between uses •
0
B Raw meats not stored/prepared near ready-to-eat foods i213 F o o rtaet su'rfaaes'clearr
k f •.-.. .. �av,as r;xa,. ,: e. kk*�}:'tggR:�y •"ii 6 r. m:,w ,-f at riw
C Food covered properlyI IA Food equipment clean,utensils clean equipment interiors clean
D Adequate splash guards I 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.eontainers stored off the floor Hot andcoltlrwdterfu der pressure,providedas,requ Ire"; ! :N(A .2
0 04".Handwash ng accessoriesiprovided; ', -, NIO N/A IiE1
{�nF,�and]f1 of foVdir�rrirmrfzed 4N10 JA 1,,2 a
A No unnecessary handling RTE and/or cooked foods with bare hands A Soap!paper towels 1 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 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 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 ill ess are you required to report to the local health department?
Roasts Other
Describe reheating procedures: I Is there a written illness p icy that requires the food worker to report specific illness conditions
1 Are temperatures recorded/logged for cold holding foods/equipment? N and diseases to the QF Y N *Do you have a paid sick leav policy? Y N
Are foods cooked in advance and cooled? Y N Are lekove saved? Y N Is there a language artier between inspector&QFO? Y N If es ndicate language spoken
List products cooled: by QFOIDA: 4 *Can the QFOIDA read t e inspection report? Y N
Describe cooling methods: Indicate who nswer d the ab a questions:Name(print):
Is coolingmonitored far time&tam 7 Y N Is the monit Y N Indicate th title of a e perso (ac
t �eres
DA Mgr Cook Owner FW
p ng of cooling recorded. .Obtain sgnature person hosibilities information at the time of the
Is there a produce washing policy? Y N ♦Describ what is washed and inspection:
whore: Note: This report' a two pa a form(total of 62 debi ab items) Page 1 of 2
QM, . CT Q6134
S1' TEC)FCONNECTXfrtl I�E�'AtTMEMTUFPl1RLIC HEALTH 4EO, APiT�t. VEiVLIE MS#59FDRIdRTFORD,
a,_ FOGCfSED F'OOD:iSEIiVFC INSF'ECIOTtREIPOR '.'
LOCALHEALTH pEPTi' ,
RE
-
Establishment /-11/t_C Date of Inspection:
ddress: J/i l Owner orr b erattir: A.,
ADDITIONAL FOUR POINT ITEMS {
KEY: DNC [DOES NOT COMPLY]
F
6 Foods not reserved. 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 4
4. Em e�rtype/installation/backflow prevention deyicelairga -for:
-Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines
-Sanitizerconcentration notto exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilettanks
-No unnecessary toxics on the premises -Chemical dispensers -Ice machines
-Pestfcideslrodenticides properly dispensed Proper drsig 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 o, KEY: DNC [DOES NOT COMPLY]
2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storage area/rooms,enclosures-properly constructed,clean
1�
5 Potentially h aza rd o u s foo d properly thawed ; 41 Garbagelrubbish disposed of in an approved manner,at approved frequency
10 Food dispensing utensils properly stored w1. 2 Vermin Control: No insectsirodents present 2:.
14 Food worker:Clean outer clothes,effective hair restraints 1„ 43 Outeropenings protected againstentranceofinsects/rodents 1;
4 Floors: Floor covering installed,constructed as required,good repair,clean
16 Food-contact surfaces designed,constructed, maintained,installed, 45 Floors graded,drained as required
o ted
Floor,wall juncture covered
1-7food-contactsurfacesdesigned,constructed,maintained, lE,
installed,located Mats removable,good repair,clean
8 Exterior walking,driving surfaces,good repair,clean .1.
18 Single service articles,storage,dispensing Z
19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good 1;
repair,clean.Wall&ceiling surfaces as required
0 Dishwashing facilities approved design,adequately constructed, 2
maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored w .
Equipment&Utensils; Cleanliness 1' 51 Adequate lighting provided as required 1
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors ;1
22 Wash water clean,proper temperature 53 Rooms&equipmenthoods,ducts,vented as required
urate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean
nfoo ontact surfaces of utensils&equipment clean
55 Establishment and premises freeof litter,no insect/rodent harborage, ra
28 -Equipme utensils,storage,handling 1 no unnecessary articles r
F5roperdisposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry
33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1
36 Toilet rooms enclosed with self-closing door
58 No live birds,turtles,or other animals(except guide dogs) 1
1
59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at
37 Proper toilet fixtures provided,good repair,clean 3'
entrance{s},smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered, 1
rodent proof,clean Routine Inspection ❑Reinspection ❑ Preoperational Inspection
7TOR: RGE:
Other Inspection:
Demerit_Score: *Include demerits from page 1
4 3 2 1 Total Rating
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TT)honember {Itle 0cONS DUE: �r`r! r, ,f`
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INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
INSPECTION FORM# REMARKS
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INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT,, TOWN DATE OF INSPE TION
INSPECTION FORM# REMARKS
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Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager