HomeMy WebLinkAboutFood Service Establishment Inspection 17 (31) EHS-166•Rev.11105 INSPECTION REPORT STATE OF CONNECTICUT ❑ ROUTINE INSPECTION REIN�SPECTII
FOOD SERVICE ESTABbISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ PREOPERATIONAL ❑o —�---,
410 Capitol Avenue,MS#11 FDP,Hartford,CT 06134
N�IM�OF ESTABLISHMENT
ESTABLISHMENT � �r� �i 'T '-� CLASS
STREET TOWN
ADDRESS ��'
OWNER or j � INSPECTION
OPERATOR f�/! <a DATE and TIME Ile)116-
Based on an inspection this day,the items marked below identify the violations in operation or facilities which must be corrected by the date specified below.
SOURCES OF FOOD EQUIPMENT&UTENSILS:CLEANLINESS VERMIN CONTROL
1 Approved source,wholesome, 4 21 Preflushed,scraped,soaked and racked 42 Presence of insectsirodents 2
nonadulterated 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of 1
2 Original container,properly labeled 1 curate thermometers provided,dish basket,if used nsectslrodents
2 anitization rinse(hot water-chemical)
FOOD PROTECTION 5 Clean wiping cloths FLOORS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 26 Food-contact surfaces of utensils& 2 44 Floors:Floor covering installed,
temperature requirements during storage, equipment clean constructed as required,good repair,clean
preparation,display,service,and
transportation 27 Nonfood-contact surfaces of utensils& 1 45 Floors,graded,drained as required 1
41 equipment clean 46 Floor,wall juncture covered
4 Adequate facilities to maintain product 2 28 Equipmenuutensils,storage,handling 1 47 Mats removable,good repair,clean
temperature,thermometers provided
5 Potentially hazardous food properly thawed 2 48 Exterior walking,driving surfaces, 1
6 Unwrapped or potentially hazardous food 4 WATER SUPPLY good repair,clean
not re-served 29 Water source adequate,safe 4 49 Walls,ceilings attached,equipment properly 1
7 Food protected during storage,preparation, 30 Hot and cold water under pressure, 2 constructed,good repair,clean. Wall&ceiling
display,service&transportation 2 provided as required surfaces as required.
8 Food containers stored off floor 50 Dustless cleaning methods used, 1
SEWAGE DISPOSAL cleaning equipment properly stored
9 Handling of food minimized 2 31 Sewage disposal approved 4
10 Food dispensing utensils properly stored 1 32 1 Proper disposal of waste water 1 LIGHTING&VENTILATION
11 Toxic items properly stored,labeled,used 4 51 Adequate lighting provided as required 1
PLUMBING 52 Room free of steam,smoke odors 1
i
PERSONNEL 33 Location,installation,maintenance 1 53 Room&equipment hoods,ducts,vented as required
12 1 Personnel with infection restricted 4 34 No cross connection,back sip honage,backflow 4
DRESSING ROOMS&LOCKERS
CLEANLINESS OF PERSONNEL TOILET FACILITIES 54 Rooms adequate,clean,adequate lockers 1
13 Handwashing facilities provided, 4 35 Adequate,convenient,accessible,designed, 4 provided,facilities clean
personnel hands washed,clean installed
14 Clean outer clothes,effective hair restraints 1 36 Toilet rooms enclosed with self-closing door 1
15 Good hygienic practices,smoking restricted 2 37 Proper fixtures provided,good repair,clean HOUSEKEEPING
55 Establishment and premises free of litter,no 1
EQUIPMENT&UTENSILS: DESIGN, HANDWASHING FACILITIES insect/rodenthatorage,no unnecessary articles
R CT10N & INSTALLATION 8 Sultable hand cleaner and sanitary towels or 1 56 Complete separation from livinglsleeping quarters 1
16 Food- ontact surfaces designed,cons uct T2 approved hand drying devices provided, and laundry
intained,installed,located tissue waste receptacles provided
57 Cleanlsoiled linens stored properly 1
17 Nonfood-contact surfaces designed, 1 58 No live birds,turtles,or other animals 1
constructed,maintained,installed,located GARBAGEIRUBBISH STORAGE&DISPOS I(except guide dogs)
18 Single service articles,storage,dispensing 2 39 1 Approved containers,adequate number, 1
19 No reuse of single service article covered,rodent proof,clean SMOKING PROHIBITED
20 Dishwashing facilities approved design,adequately J
40 Storage area/rooms,enclosures- 59 Smoking prohibited,signs posted at each 3
constructed,maintained,installed,located properly constructed,clean entrance
1
41 Garbage disposed of in an approved manner,
at approved frequency QUALIFIED FOOD OPERATOR
DEMERIT SCORE 60 Qualified Food Operator 3
3 2• 1. F RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2
62 Written documentation of training program 2
(� Signature of erson in charge
TOTAL RATING Date Corrections Due
C 04 spector)
ESCRIR CIENCIE N CONTINUATION SHEETS
n tars IOIN: 0 -'Arhite-Health Department 2°d-Yellow-Owner/Operator
Page / of a-
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
INSPECTION REMARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager
Page,Of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME F ESTABLISHMENT TOWN DATE OF INSPECTION
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INSPECTION FORM# REMARKS
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st- ite-Health Department 2nd-Yellow-Owner/Manager