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Home My WebLink AboutFood Service Establishment Inspection 10 (26) i r Establishment: 0 P 0k,40 Inspection Date: Ti e: 0]nsp REinsp Address/City: ('6 Health Dept: 5 Imo, /'�, (t j/ Class: 1 2 30 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. RISK FACTOR ITEMS:Listing is not inclusive of all possible debita3item 0 WA DNC KEY; C[complies] N10[not observed] NIA[not applicable) p611 allfied Fad Ope� tdr 3 DNC[does not comply] 0[other] RTE dy to-eatj 2 12 :Pe�rstiIGi#Fnctton r� trCfecJEg A Food workers have no exposed infected lesions A burns en documentatild of tr injh a r'R B Personnel with infection restricted t1 A`t 4 � t j;' C Communicable disease of worker reported to local health director or A I Approved shellfish,finfish,meat&poultry USDA approved 13];;F{agdwslaimgafacDttiesprQ�id`ed;;handswashed,cteari;' C, .10aNIP 4 B I Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grownlcanned food) C Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature JJ D Personnel hands washed,clean/Proper handwash procedure E Handwashing at appropriate times PoWrtttailyy hazardousifood me®tAtemperatureirequtrgments N!a NAA '4 0 d n g sEbta 4p epa atiolr,dis lay se Ia 4 d ° p t m f5i C�oizd`N rehic�F�ctrce`sl �- q'' Y C, . 1,.�2 A Hot holding greater than or equal to 140°F. (whole beef/pork roasts1300P) A CI No eating ❑No smoking while working V. B Cold holding less than or equal to45°F. B Wounds covered adequately C Proper Cooling C Proper sink used for handwashing D Proper re-heating 0 � . i..aoniinse� .�w, ahemlc 0 NIA TE Proper internal cookin l consumer adviso ry posted * z'}L"'k'"V'` t Ar pApproved sanitizeravailable/adequate concentration of sanitizer ��aa of c lit! s tom aal d�tt (p 'NI, 2 g Food-contact surfaces and utensils used for potentially ' p _ hazardous food sanitized at least eve 4 hours peratu[e,#herrnometersprovtdad is every A Food thermometer available and accurate C Adequate 49 ishwashersanitizer ❑final rinse temp L Proper ani zin rocedure B Proper food ttlermometerforproduct E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 41, 0 p e ` ' rn9 ww:4 +tr�d�proteot@d�durin$StO�ge, 3 � tl� 2 N/0 � '- - � > '� ��, '� � :s. � _s � .e'y"k.-a .,� s» •� s,a� .�� selvtcearrid4F�n tpr A Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Prodduceuce washed O B Raw meats not stored/prepared near ready-to-eat foods r2s ', pd Gontac;swrtfaces eiear .4 +' 0{{ NAA :1'- � C Food covered properly a� N t ;9 A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards!sneeze guard 4.11 g Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean F No pooling of eggs not cooked immediately 40U p 8 Food containers stored off the Floor Pooxk r s pro C) A3d p t tmg �3a andw"ashrf"acedrieskpfoViddd� / 2l of food mtnr ` N/Oj NAA� 1 A Soap/paper towels/drying device available A No unnecessary handling RTE and/orcooked foods with bare hands B .Dispenser(s)working: ❑Soap ❑Papertowel B Minimize food handling,other than ready-to-eat,with bare hands L. C Handwash sink(s)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice p 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[quelfied food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodbcme] 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 1t_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): 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 r1s there a produce washing policy? Y N *Describe what is washed and inspection: here: Note; This report is a two page form(total of 62 debitable items) Page.1 of 2 .r w'M stailishmet Dte � � 1 Address: {w A ner� ti .. . ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. 4' 31 Sewage disposal approved. -Unwrapped foods not re-served4a -Operating as required -Potentially hazardous foods not re-served 34 No cross connections,back siphonage,backflow 11 Toxic chemicals. 4' 4 Proper typelinstallation/backflowprevention device/air gapfor: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration not to exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pest icides/rodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination Ldes acilities. Adequate,convenient,accessible, 4 -Water quality in compliance d,properly installed -Monitoring in compliance OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Jourcesoffood: Original properly labeled #' g p P Y 40 Garbagelrubbishstoragearealrooms,enclosures-propedyconstructed,clean E �< 5 Potentially hazardous food properlythawed 2 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 1 a 3 Outer openings protected against entrance of insectsfrcdents 1 4 Floors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, ,s 4 located 5 Floors graded,drained as required 46 Floor,wall juncture covered 7 0 od-wntactsurfacesdesigned,constructed,maintained, 47 Mats removable,good repair,clean _iRs4led,located 8 Exteriorwa€king,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing a2r 9 Walls,ceilingsattached,equipment prop arlyconstructed,good 19 No reuse of single service article repair,clean.Wall&ceiling surfaces as required � 0 Dishwashing facilities approved design,adequately constructed, :2' 1 maintained installed located 0. 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 51 Adequate lighting provided as required a 1_ � 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 premises free of litter,no insect/rodent harborage, 1 r 28 Equipment/utensils,storage,handling 1 no unnecessary articles 32 Proper disposal 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 I 39 Approved garbagelrubbish containers,adequate number,covered, 1 — rodent proof,clean Woutine Inspection ❑Reinspection ❑ Preoperational Inspection PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 �J4�. 4 3 2 1 Total Rating si ature signature 271> k Z_ pin na print name phone number title � DATE CORRECTIIC ONS DUE: Page 2 of 2 plus continuation pages Foe d 1nsPed io Ez Page3 of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION k -, UZI/, INSPECTION REMARKS FORM# aC l � c' ' s� N --i n - INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) C2ZD Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager