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Home My WebLink AboutFood Service Establishment Inspection 96 (9) Establishment: s Inspection Date: Time: a =R2 RE[nsp Address/City: OttoS � �,1>�}�. 1Pw . Health Dept: 3� Based on an inspection this day,the items marked DNC identify a violations in operation or facilities which must be corrected by the date specified on page 2. JR1,1!K FACTOR ITEMS:Listing is not inclusive of all possible debitable item C N10 NIA DNC EEY: C[complies] N10[not observed] NIA[not applicable] 3DNC[does not comply] 0[other] RTE[ready to-eat] edC2 -fed' terrtate� A Food workers have no exposed infected lesions/burns W documentatto rd ":"' � 2 B Personnel with infection restricted tlisdurer Whq 301; 6 ] la NTH ¢ C Communicable disease of worker reported to local health director A 1 Approved shellfish,finftsh,meat&poultry USDA approved 1A s i zfatciIII' ip o [ Ifi daviiashed cleeri C 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 accessiblelconvenient to use E Potentially hazardousfoods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure 0 E Handwashing at appropriate times 'Po idll aS�Yrdausfdnditn t r urine Nl4 0 �' � a`�att�ir d�s Icy t` n t ►1 o a off: � r'� � -• ,o, �;�.,r,, , iffi tea.: A Hot holding greater than or equal to 140°F. (wholebeaupork roasts 1300F.) 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 a4 a 1 'r s of n►atp > �J r �l a1 r ' ICI 0 AN� E Proper internal cooking l consumer advisory posted ., .. 0 A Approved sanifter available/adequate concentration of sanitizer I eorAa r g Food-contact surfaces and utensils used for potentially hazardous food nitized at least eve 4 hours ttNe ' every Mms 1 A Food thermometer available and accurate C Adequate dishwashersanitizer ❑final rinse temp D Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units O r2 l!fGI Vwi in cl b a A Cloths.and/or sponges in good repair and clean . B Wiping cloths kept in sanit'izer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods o tsMAJARt )4C ! IA A A :> �� F 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 0 8 Food containers stored off the floor D (Rod-wa t; s rovtdedrAs reZZ qu]r ARa V/AA f 0 ABr gd r( [gyp M,N t r — Soap/paper towels 1 drying device available A No unnecessary handling RTE andlor cooked foods with bare handsLoo B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean 1 waste receptacle at handwash sink C Adequate utensil(s)for dispensing foodlice 0 -_ - I I EH 0 I •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. _M: QFO[qualified food operator],DA[designated alternate),PHF[potentially hazardous food], FB[foodbornel PHFs are hot held at: OF. PHFs 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&QFO? Y N ff-M 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 the person who received the QFO responsibilities 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 a farm(total of 62 debitable items) Page 1 of 2 9t blishment. s � - s's.4 . #A _ Da te�of n peg on . ddress: b 2. Owner or Operator!.. ADDITIONAL FOUR POINT ITEMS 29'-a KEY: DNC [DOES NOT COMPLY] o: 6 Foods not re-served. -Unwrapped foods not re served 4 31 Sewage disposal approved. 4 -Potentially hazardous foods not re-served -Operating as required No cross connections,back siphonage,backflow 11 Toxic chemicals. 4 4 -Stored properly,labeled properly,used properly ProAe.�typ�talfationl backflow prevention devicel airgap for: -Food equipment -Hose connections -Dish machines -Sanitizerconcentration notto exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticideslrodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -ice machines . -Well f 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 Sourcesoffood: Original container,properly labeled 1" 40 Garbagelrubbishstoragearea/rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properlythawed 2 1 Garbagelrubbish disposed of in an approved manner,at approved frequency tF 10 Food dispensing utensils properly stored 1 42 Vermin Control: No insectsirodents present J-1 14 Food worker:Clean outer clothes.effective hair restraints 1 43 Outeropenings protected againstentrance of insects/rodents 44 Floors: Floor covering installed,constructed as required,good repair,clean 1 16 Food-contact surfaces designed,constructed,maintained,installed, 2 45 Floors graded,drained as required 14�catecl 6 Floor,wall juncture covered � 17 No food-contact surfaces designed, constructed, maintained, 4 47 Mats removable,good repair,clean nstalled,located 18 Single service articles,storage,dispensing 2; 48 Exteriorwa[king,driving surfaces,good repair,clean 19 No reuse of single service article 49 Walls,ceilings attached,equipment properly constructed,good repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1 Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required �r 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 23 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1 27 Nonfood-contact surfaces of utensils&equipment clean 1 55 Establishment and premisesfreeoflitler,no insect/rodent harborage, 28 Equipment/utensils,storage,handling 1" no unnecessary articles 32 Properdisposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1` 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 toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) 3 39 Approved garbagelrubbish containers,adequate number,covered, 1; rodent proof,clean 2koutine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: PERSON IN CHARGE- Other Inspection: Demerit Score: •Include demerits from page 1 05- 4 3 2 1 Total Rating s' ature sigTre 1+� t p int na a ? rint na e l l/ </ d ` , U Acne number ties DATE CORRECTIONS DUE: �' Page 2 of 2 plus continuation pages Focused Inspection 112002 Page� of ,ary INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME,OF ESTABLISHMENT TOWN y DATE OF INSPECTION t 5 1 S - W\ 1z INSPECTION REMARKS FORM# C Cd R cll:� c= h s b lc- 01 k d G2 Lf 3' I v ve✓ —�—D -Le 10 6 v P M r'y EA 61:�)- bCtA-4 0�c - h R4 c INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager