HomeMy WebLinkAboutFood Service Establishment Inspection 85 (20) s
Establishment: , 0-6-Z> 6,ue.,,j `7sTM Ian Date: Time: U a insp insp
Address/City: _S-7;—
�.6e uLje Health beV , Class: t 2
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 items C NIO N/A DNC KEY: C[complies] NIO[not observed] NIA[not applicable]
!QuallfledfFood Operator 3 DNC[does not comply] 0[other] RTE[ready-to-eat]
` ° ' 12:'. Personnel with tafeeti'' restricted
lgnatetl Alternate ; 2 C Nl , Nlq, 4
x Food workers have no exposed infected lesions!burns
itten docymentafion of traiding program
B Personnel with infection restricted
Approved source,wholesome„nonsduiterated A ;N7,0 jV1A ; munlcable disease of worker reported to local Health director
A Approved shellfish,finfish meat&poultry USDA approved 13: andwashrngyfaciiities provided,handswashad,,clean ,C °N10 4
B Food cans in good condition(not dented,rusty,bloated,leaking) 4-1 Handwash facilities in all food prep/dispensing&warewash areas
C Wholesomelnonadulteratedfoodslsafe B Handwash facilities in or immediately adjacent to toilet rooms
D Commercial products(no home grown/canned food) C Handwash facilities access iblelconven lent to use
E Potentially hazardous foods received at proper temperature 41
D Personnel hands washed,clean 1 Proper handwash procedure
.... :: ;:. .., .. . ,:.�:......x::.r .......... .. Handwashing at!appropriate times
3 x, tenttally-hazardouefatrtl'rtfeets temperature requirements= = C' NIO 4'.
during Rstot2'g'e,preparatlorr,dt''sptay;service and tranaportatron^
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W Go �ienfcf5r�ctic:es V TUb' !A,
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A Hot holding greater than or equal to f 40°F. (whde baeflpwk masts 130°F.) ❑ No eating ❑No smoking while working
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
E Proper internal cooking l consumer advisory posted r24 Sanitization4ririlse(h`�fwatet;-chemical}* C !WO`.RNIA '2`
0 A Approved sonitizerevailableladequate concentration ofsanitizer
4;i AgNa e;faci[Itlesta:malntairr pfiuef �, ;;;x a;C ;Nlp NlA ;.Z. B Food-contact surfaces and utensils used for potentially
-4 r" m ;tti�tofnetesproiflded fi '• N r " " r" ' hazardous food sanitized at least every 4 hours
4. .. ...,.................. ... frs..L..SG..fc�"..# N.,:�.XT'.�'.':. 1 F {+,'.f i�.:2'.'y.!4� ai:•.....r
A Food thermometeravailableandaccurate C Adequate ❑dishwashersanitizer ❑final rinse temp
L 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
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.7 Food protec'�ed during storageprepa.11,1 in, a`C�NI0�,N1A r ^`a ` "' ' �.."
display, service and trollyl r#att pr •W V.5 + x n ?• '4" ly;.y Cloths and/or sponges in good repair and clean
.a l ��I }I B Wiping clofhs kept in sanitizer between uses
A Produce washed
0
B Raw meats notstoredlprepared near ready-to-eat foods r2t3r,FodtlIC
rc5.u`rfscg ,x
C Food covered properly dC A Food equipment clean,utensils clean,equipment interiors clean
D Adequate splash guards/sneeze guard K B Single use gloves changed when soiled
E No unauthorized personnel C Food--contact surfaces clean
F No pooling of eggs not cooked immediately k 0
a'
8 Food containers stored off the floor
-3U= Hot andreold wa4erundarprreseure,prp�rld s equtie - N/A 2
_ ,.._.; e: ided HI:
0 IC IN10i40; H00w04066es
9 H . 8 #�fpo nmimi ed u0 NA
A Soap/papertowels/ drying device available
A No unnecessary handling RTE andlorcooked 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)clean/waste receptacle at handwash sink
C Adequate utensil(s)for dispensing foodlice 0 N
O 1 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The following information is not debitable and does not affect your score. KEY: OFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food], FB[foodborna)
PHFs are hot held at: F. 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 tempera
]ure do you cook:
Poultry Ground Beef ork 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 req ires the food worker to report specific illness conditions
Are temperatures recorded/logged for cold holding foodslequipm t? 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 I overs saved? Y N Is there a language barrier between nspector&QFO? Y N,4Lyes indicate language spoken
List products cooled: by QFOIDA: ♦Can th F01D read the inspection report? Y N
Describe cooling methods: Indicate who answered the above quest! Na rinQ:
Indicate the title of above person(ct all th ply):QFO DA Mgr Cook Owner FW
Is cooling monitored for time&temp? Y N Is the itoring of cooling recorded? Y N .Obtain signature of the person tf ecei t QFO responsibilities information at the time of the
m
Is there a produce washing policy? Y N ♦Descrbe what is washed and Is
where: Note: Thi report t two p form( tal of 62 debitable items) Page t of 2
S �1TErOF COIVNI CTICU7` t) PARTMENT F PVBL1C,i HEALTH 410 GAPITOL"ENUE=MS#51FDP-.HARTFORD,CT 0 '�
F(1CUSEA FbOD S t',i[GE t1�1SPECTION REPORT
,iI�M1r,4LTHb�PT �L% aG`fy?� ae2 .ADDRESS/CITY."
Establishments Date-of Inspection: " f
Owner,or>Operator: L
ADDITIONAL FOUR POINT ITEMS 'z KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served.
4 31 Sewage disposal approved.
-Unwrapped foods not re-served rating as required 4.
-Potentially hazardous foods not re-served
No cross connections,bac backflow
11 Toxic chemicals, ' 4
-Stored properly,labeled properly,used properly — o er t e ins fla ckflow r v n i for:
-Food equipment -Hose connections -Dish machines
-Sanitizer concentration not to exceed maximum permitted -Soda system carbonator -Beverage tlispe'm nsers -Toilet tanks
-No unnecessary toxics on the premises -Chemical dispensers -Ice machines
-Pesticidesfrodenticides properly dispensed Proper drain for:
29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines
4
-Well/well head protected from contamination 35 Toilet facilities, Adequate,convenient,accessible,
-Water quality in compliance-Monitoring in compliance designed,properly installed
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
2 Sur of food: Original container,properly labeled i 0 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,clean 1 F
5 otentially hazardous food properly thawed 1 Garbageirubbish disposed of in an approved manner,at approved frequency
10 Food'dispensing utensils properly stored 1 ermi Control: No insects/rodents present
4 Food worker,Clean outer clothes,effective hair restraints 1; 43 uteropenings protected against ofinsectslrodenis
4 Floors: Floor covering installed,constructed as required,good repair,clean 1
16 Food-contact surfaces designed,constructed,maintained,installed, 45 Floors graded,drained as required
located
6 Floor,wall juncture covered
17 Nonfood-contact surfaces designed,constructed, maintained, 1 7 Mats removable,good repair,clean
installed,located
2
8 Exterior walking,driving surfaces,good repair,clean
18 Single service articles,storage,dispensing
19 No reuse of single service article 9 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 1"
Equipment&Utensils• Cleanliness 1 51 Adequate lighting provided as required '
l Preflushed,scraped,soaked and racked p 52 Room free of steam,smoke odors
22 Wash water clean,proper temperature 53 Rooms&equipmenthoods,ducts,vented as required
23 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean r 1
27 Nonfood-contact surfaces of utensils&equipment clean 1'
55 Establishment and premisesfree of litter,no insectlrodent harborage, 1
8 Equipmentlutensils,storage,handling 1 no unnecessary articles d^(
32 Properdisposal ofwaste water 1 56 Complete separation from living/sleeping quarters and laundry 1;
33 Plumbing location,installation,maintenance w 57 Clean/soiled linens stored proper 1
58 No live birds,turtles,or other animals(except guide dogs) ;1 Y
36 Toilet rooms enclosed with self-closing door ..
1 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at t 3
37 Proper toilet fixtures provided,good repair,clean enirance(s),smoking area indicated by signs)
39 Approved garbagelrubbish containers,adequate nu mbe overed,r 1
rodent proof,clean ❑Routine Inspection ❑Reinspection 13 Preoperational Inspection Other Inspection:
T PERSO I Demerit Score: •Include demerits from page 1
12,11 �:, ;h 4 3 2 1 Total Rating
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prin name print name fZC/���VL
a _�t��- J5-/{ DATE CORRECTIONS DUE:
phone number
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Page 2 of 2 plus continuation pages Focused lnspecd I/2002
Page of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TO DATE OF IN PECTIO N
INSPECTION REMARKS
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
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Page Of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET .
NAME,OF ES� TABL ISHr W T TON DATE OF YJSPE TION
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INSPECTION FORM# REMARKS
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INITIAL(INSPECTOR) ,>/� INITIAL(PERSON IN CHARGE)
Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager
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INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TO DATE INSPECTION
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INSPECTION RENLARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager