HomeMy WebLinkAboutFood Service Establishment Inspection 28 (8) EHS-106-Rev.11105 INSPECTION REPORT STATE OF CONNECTICUT ❑ ROUTINE INSPECTI ❑ REINSPECTION
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ PREOPERATIONAL ❑ 0
410 Capitol Avenue,MS#11FDP,Hartford,CT 06134
NAME OF ESTABLISHMENT
ESTABLISHMENT I fit/ r� CLASS
STREET TOWN
ADDRESS y /�
OWNER or INSPECTION
OPERATOR � DATE and TIME
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 [43
Presence of insectslrodents 2
nonadulterated 22 Wash water clean,proper temperature 1 Outer openings protected against entrance of 1
2 Original container,properly labeled 1 23 Accurate thermometers provided,dish basket fused insectslrodents
24 Sanifization rinse(hot water-chemical) 2
FOOD PROTECTION 25 Clean wiping cloths 1 F RS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 , 26 od-contact surfaces of utensils& 4 'FI rs:floor covering inst ,
temperature requirements during storage, -E�uipment clean constructed as requir d,good repair,clean
preparation,display,service,and
transportation
7 Noo�food-contact surfaces of utensils& 1 45 Floors,graded,drained as-required ment dui clean
q p 46 Floor,wall juncture covered
4 Adequate facilities to maintain product 2 28 1 Equipmentlutensils,storage,handling 1 47 Mats removable,good repair,clean
tem erature,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 2 311 Sewage disposal approved 4
10 Food dispensing utensils properly stored 1 32 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
PERSONNEL 33 1 Location,installation,maintenance 1 53 Room&equipment hoods,ducts,vented as required
12 1 Personnel with infection restricted 14 34 1 No cross connection,back siphonage,backflow 14
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, HANIDWASHINGFACILITIES insectlrodent harborage,no unnecessary articles
CONSTRUCTION &INSTALLATION 38 Suitable hand cleaner and sanitary towels or 1 56 Complete separation from livingisleeping quarters 1
16 Food-contact surfaces designed,constructed, 2 approved hand drying devices provided, and laundry
maintained,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 GARBAGE(RUBBISH STORAGE&DISPOSAL (except guide dogs)
1 B Single service articles,storage,dispensing 2 39 Approved containers,adequate number, 1
19 No reuse of single service article covered,rodent proof,clean SMOKING PROHIBITED
20 Dishwashing facilities approved design,adequately 2 40 Storage arealrooms,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
4 3 2 1 RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2
A� [ ri##en tlocumenta#ion of training program 2,
Signature of Per on in char%
TOTAL RAT'ING Date Corrections Due
SIGN pector)
,;
a7_ c� DESCIU DEFICIENCIES ON CONTINUA ION SHEETS
ISTRIBIITION:1"-White—Health Department 2"a—Yellow—Owner/Operator
Page_ of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF SPECTION
INSPECTION REMARKS
FORM#E
✓� 12� 24Z �f
C�&IVY `�c-l�- ^
0
t�r1 _.
ell
' G -
INITIAL(INSPECTOR) INITIAL,(PERSON IN CHARGE)
Distribution- 1st-White-Health Department 2nd-Yellow- Owner/Manager
- 7a
NAME OF • • t • '
i
' KIM�, .-J
p IF
WE —,
m/wdAl
ma115225111
MOW
mus,
wjllo�4 -,a
INITIAL •R r •N IN CHARGE)
t= ��