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HomeMy WebLinkAboutFood Service Establishment Inspection 10 (25) (.. 1 n 01 Establishment: 's Inspection Date: Time: U.Zcs� RO[nsp RE[nsp Address/City: ,6j, l vi Health Dept: S . I.j 2 3 Based on an inspection this dby,the items marked D C 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 0 NIA DNCI KEY: C[complies] NIO[not observed] NIA[not applicable) DNC[does not comply] 0[other] RTE[ready-to-eatj 60 tatltd Fb�O0iert�ir 3 � 1} � "12 -Personnel with infection,restricted ^ ��� . ��,� � � � �� ,�,� ��� ,�� �, . �.� � .f :��,� �.. �_,:.: 2N10; NIA� 4�j b�1 estgna ed,Alterna,, 2 , q Food workers have no exposed infected lesions 1 burns �Wrtten documentation n traing p?�bgrm y' x 2 B Personnel with infection restricted ✓ 1 ,4pproved=squrce,w�gJesome, or�au#eiaite"�I, C;NIC'NIA! 4 C Communicable disease of worker reported to local health director A I Approved shellfish,finfish,meat&poultry USDA approved L 131 Hainduvashmgfagilitie&provided,hands;"she&clean I C MNj NIA, A B Food cans in good condition(not dented,rusty,bloated,leaking) LA Handwash facilities in all food prepldispensing&warewash areas C Wholesomelnonadulteratedfoods!safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grownlcannadfood) C Handwash facilities accessiblelconvenlent to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure E Handwashing at appropriate limes RoCentt ll hazittdoits+foodmeetstemperatu�eerequirementsf C,N10 N/A.;4, 0 ] 1d n g o ge�,f troh tlis la"I sertritie and=trahsportation 1 �� 9 a 15 Goodhygrenicapracicos rtr 'N10 NIA! ` 2, A Hot holding greater than or equal to 140 F. (whole beeflpark roasts 130'F) A ❑ No eating ❑yNo 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 cookinglconsumeradvisoryposled 24 °Sanit[ atlonxc nse(riot watei chemical) C',, 0 NIA 2 0 A Approved sanitizeravailableladequate concentration ofsanitizer f�� a lst �lt h .u t >� C N/0 N1A' 2+ g Food-contact surfaces and utensils used for potentially 9�" ate:ti w ra %*t Cehi ratdr ,thertnometars provided i7 ,' i"; hazardous food sanitized at least every 4 h rs A Food thermometer available and accurate C Adequate [3dishwashersanitizer TIfinal rinse temp B Properfood thermometerfor product L Proper sanitizing procedure Ag C Thermometers appropriately placed in rooter units E Sanitizing between raw animal origin&ready-to-eat food 0 0 25 "'Clears,Wr rtlg dloths C N/Oi N(Aj f x o !*ootocte l°during torag�;preparaton, C N10l ILIA 2` A R, xx A Cloths and/or sponges in good repair and clean aYser��tge..�r�dtranprt B Wiping cloths kept in sanitizes between uses A Produce washed 0 B Rawmeats notstored/prepared near ready-to-eat foods &ol2G 1A 2 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 11 00, 0 elk.d 8 Food containers stored offthef[oor 30, ;Hot and ccild�lrater,undernpmssurei.provide&asyrequire � NIO NIA II I 0 i8 Handwashing accessorse§provided C' N10i NIAI 1 ; Handling offood►nmimEzed *r 1; a;_ C] N10�N1A:'2, A Soap!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)clears/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: IF. 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 Fla 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 recordedllogged 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 9-M 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), 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 page form(total of 62 debitable items) Page 1 of 2 1 �. :' �^ 1?" '�§s.az 3� g���s.,�.a' � �..z +� 3i e Mr w w, .. �a e,,.�� •e s '�,, Establishment: r '��`a ' Ditty olrspectiOn � — , ddress: fie n gOwner ors operator . > _ :i ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 101 6 Foods not re-served. 4', 31 Sewage disposal approved. -Unwrapped foods not re-served -Operating as required 4 -Potentially hazardous foods not re-served 34 No cross connections,back siphonage,backflow 11 Toxic chemicals. 4' 4 Stored properly,labeled properly,used properly Proper typelinstallationl backflow prevention device/air tar: -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 -Pesticideslrodenticides properly dispensed I-Chemical dispensers -Ice machines Proper drain for: 29 Water source adequate,safe. 4 1 -Food equipment -Dish machines -Ice machines -Well I well head protected from contamination 35 Toilet facilities, Adequate,convenient,accessible, 4= -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 0 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,clean Potentially hazardous food properly thawed 2 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 42 Vermin Control: No insectslrodenis present 2' 14 1 Food worker,Clean outer clothes,effective hair restraints 1 43 Outer openings protected against entrance of insects/rodents 1 4 Floors: Floorcovering installed,constructed as required,good repair,clean 1 16 Food-contact surfaces designed,constructed,maintained,installed, 2 " 45 Floors graded,drained as required located 46 Floor,wall juncture covered 17 Nonfood-contactsurfacesdesigned,constructed, maintained, 4, 7 Mats removable,good repair,clean installed,located 8 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing T 19 No reuse of single service article ;p 49 Walls,ceilings attached,equipment properly constructed,good repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2 Z maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Ulensits- Cleanliness 1 ` 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 2 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 23 Accurate thermometers provided,dish basket,if used 541 Rooms adequate,clean,adequate lockers provided,facilities clean °1 27 Nonfood-contact surfaces of utensils&equipment clean 1 f ' 55 Establishment and premises free of litter,no insect/rodent harborage, 28 Equipmentlutensils,storage,handling 1= no unnecessary articles 32 Proper disposal of wastewater 1; 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly i a1 58 No live birds,turtles,orother animals(except guide dogs) t 36 Toilet rooms enclosed with self-closing door t 1 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toiletfixtures provided,good repair,clean ' entrance(s),smoking area indicated by sign(s) r , 39 Approved garbage/rubbish containers,adequate number,covered, l rodent proof,clean EgRoutine Inspection ❑Reinspection ❑ Preoperational Inspection I PE PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating allure signature l f prihf na4XX m print name Goa �4 � DATE ORRECTIONS DUE: phone number � title Page 2 of 2 plus_�_ continuation pages Focused 1.sp Wi..112002 Page.3 of "av INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN ( DATE OF INSPECTION ^ \ INSPECTION REMARKS FORM# 0� I U� U (---)�7 �f E Z2 v vLo (rD� ✓ INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager