HomeMy WebLinkAboutSchool Inspection 569 Griffin Road (4) f§' ��;' �TATE�OO1'�C(� 1��CT�IC�UT�`•� `=�i' D�F�,Q�OD�9'�I� �� �,� Ib � ®'R °�l�,,D;_�'P.AR'RMEN'!f�S'e[l�B1��C�I-I�AL�Ct��..�� ����,.a_ .,ram __ _._._.._._�. ..�:.�. ,..,�.+�•'�-'-- ��.: .. �r ,.?@..,.
Establishment: Inspection Date: ly Time: ROinsp E]ns
Address/City: QS:Zl o� CM12i:0 a Z L Health Dept: Lj 2 a a
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 possible debitable itemV C PIO NIA JDNC I tom: C[complies] N10[not observed] NIA[not applicable]
60 Qualified Food Operator, 773 DNC[does not comply] 0[other] RTE -to-eat]
92` .Personnel with infection restricted 'N/0 N/A. 4
tit Designated Alternate 2
A Food workers have no exposed infected lesions/burns
62 Written documentation of training program 2 B Personnel with infection restricted
1 Approved source,wholesome,nonadulterated C N10 NIA 4 C Communicable disease of worker reported to local health director
A I Approved shellfish finfish,meat&poultry USDA approved 131 Handwashing facilities provided, hands washed,clean C /0 NIA 4
B Food Cans In good condition(not dented,rusty,bloated,leaking) A I Handwash facilities in all food prep/dispensing 8 warewash areas
C Wholesomelnonadufteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms
D Commercial products(no home grown/canned food) C Handwash facilities access!blelconvenient to use
E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure
0 1 E Handwashing at appropriate times
3 Potentlally hazardous food meets4emperature requirements 0 'N1A 4 0
during s orage,preparation,display,service andjtransportation
is Good,h , [epic. ractices
Yg R C WO N/A 2
A Hot holding greater than or equal to 1400F. (wholebeeapork roasis 130e F) A ❑ No eating 0 No smoking while working
B Cold holding less than or equal to450F. B Wounds covered adequately
C Proper cooling C Proper sink used for handwashing
D Proper re-heating 0
E Proper internal cooking l consumer advisory posted 24 Sanitization rinse(hot water-chemical) C N10 NIA 2
0 A Approved sanitizer available/adequate concentration of sanitizer
4 Adequate facilities to maintain product. 0 N/A, 2. B Food-contact surfaces and utensils used for potentially
temperature,thermometers'provided° hazardous foods 'ized at least every 4 hours
A Food thermometer available and accurate C Adequate ishwashersanitizer ❑final rinse temp
L Proper sanitizing
B Proper food thermometer for product
procedure
E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in cooler units 0
0 25 Clean_wiping cloths /0 NIA 1'
7 Food protected during;storage,preparation, C N10 'NIA :2
display;service and transportation A Cloths and/orsponges in good repair and clean
B Wiping cloths kept in sanitizer between uses
A Produce washed
O
B Raw meats notstored/prepared near ready-to-eat foods 26 Food-contact surfaces clean C. N10 NIA' 2':
C Food covered properly -
A 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
S Food containers stored off the Floor 30 Hot and cold water under pressure,provided as require MW WA 2
38 Handwashing accessories,provided C- N10 NIA 1
9 Handling,of food minimized N10.NIA 2 A Soap l paper towels l drying device available
No unnecessary handling RTE and/or cooked foods with bare han 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 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 hat 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 foodslequipment? 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 6 QF0? Y N if ves indicate language spoken
List products cooled: by QFO/DA: *Can the QFOIDA read the inspection report? Y N
Describe cooling methods: Indicate who answered the above questions: Name(print):
Is cooling monitored for time&temp? Y N Is the monitoring of cooling recorded? Y N indicate the title of above person(circle all that apply):QFO DA Mgr Cook Owner FW
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 t of 2
Flu p
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E' t lis r en ��t<<_ Date of'�n'specfit n,'
A' tlF0$U, 1n _ _ Owner„or'Ope"rator:
ADDITIONAL FOUR POINT ITEMS q 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
No cross connections back siphonage,backflow
11 Toxic chemicals. 4
�4 Proper device/air gap f r:
-Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines
-San itizer concentration 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
-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 r3.` KEY: DNC [DOES NOT COMPLY]
2 Sources of food:Original container,properly labeled 40 Garbagelrubbishstoragearea/rooms,enclosures-properly constructed,clean 1
5 Potentially hazardous food properly thawed 2, 41 Garbagelrubbish disposed of in an approved manner,at approved frequency
10 Food dispensing utensils properly stored 1 42 Vermin Control: No insectsirodents present 2
14 Food worker:Clean outer clothes,effective hair restraints 43 Outer openings protected against entrance of insects/rodents 1
44 Floors:Floor covering installed,constructed as required,good repair,clean 1
16 Food-oontact surfaces designed,constructed,maintained,installed, .2: 45 Floors graded,drained as required
located
46 Floor,wall juncture covered
17 !Nonfood-contact surfaces designed,constructed, maintained, 1 47 Mats removable,good repair,clean
Installed,located 1
2
481 Exterior walking,driving surfaces,good repair,clean
18 Single service articles,storage,dispensing
19 No reuse of single service article 49 Walls,ceilings attached,equipment properly constructed,good 1
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 `l
Equipment&Utensils: Cleanliness y 1 51 Adequate lighting provided as required 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 lifternoinsectlrodentharborage, 4
28 Equipmentlutensils,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 Propertoilet 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 ORoutine Inspection ❑Reinspection E3 Preoperational Inspection
Other Inspection:
ck"IN PERSON IN CHARGE: Demerit Score: +Include demerits from page 1
u."� 4 3 2 1 Total Rating
s' ature print
si I furs `
C' Z�� M • DATE CORRECTIONS DUE: (J
phone number tit
Page 2 of 2 plus continuation pages Focused Inspection 1/2002
Page� 0f2_
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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
&A S S w�Y 2
INSPECTION REMARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARG
Distribution: I st-White-Health Department 2nd-Yellow-Owner/Manager
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