HomeMy WebLinkAboutSchool Inspection 949 Avery Street (6) l
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Establishment: i i!O f� SAe R�1 Inspection Date: " ZV Time: [ RE[nsp
Address/City: �, / ,ST�iP� Health Dept: 6� G�i� Sd class: 1 2:�rj
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 N10 NIA JONC I KEY; C[compiles] N10[not observed] NIA[not applicable]
Qualified Food OpQr$tOr 3 DNC[does not comply] 0[other] RTE[ready-to-eat]
61 1pesignated Alternate 2
12 Persor>nel with infection restricted C::N10.;:M1UA'.4
A Food workers have no exposed infected lesions I burns
62 r Written docurn'entatlon oftraining p gramv 14 2 B Personnel with infection restricted
t Rprovad source,wholesome,nonadultt rated C NIQ N!A '4' C Communicable disease of worker reported to local health director
A Approved shellfish,finfrsh,meat&poult ry USDA approved 13 Handvifashtng facilities prov[ded, hands washed,clean C, N1O NlA: 4
B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food preprdispensing&warewash areas
C Wholesome/nonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms
D Commercial products(no home grown/canned food) C Handwash facilities accessiblelconvenient to use
E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure
0 E andwashing at appropriate times
3 ;Potentlplly" hazardi�us'foocCmeets'ternperatare&iliufiemenfs C �Vb N!A [4;
during s,Eorage,:preparatron display,seniice and iraitisporfahon r.
,. :;...4 . ..; 15, od hygrern6,pit ices C N/0 2 t
e :: si . ..
A Hot holding greater than or equal to 140 F. (whole beeflpAtomb 1300 F) A ❑ No eating ❑ No smoking while working
B Cold holding less than orequal to 45'F. k, B Wounds covered adequately
C Proper cooling i C Proper sink used for handwashing
D Proper re-heating <
E Properinternal cooking l consumer advisory posted $
Nat h . 10:NIX 2:;
0 A Approvedsanitizeravailableladequateconoentrationofsanitizer
4 A1dequate faailltiesufoxmaintkin prod.uct,�k w•a ;: •2. ;.+ ;[yip tNIA g Food-contact surfaces and utensils used for potentially
`�terrr��fYera ur®,therm v e#'e prov c ei ' ` ' ' '�' n 1, t; ' hazardous food sanitized at least every 4 hours
�:. r,.1,. W ti aY r: • : ,,::rk •.; ,F a,.
A Food thermometer available and accurate C Adequate 0dishwashersanitizer Ofinal rinse temp
L Proper sanitizin rocedure
B Proper food thermometer for prod uct E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in cooler units C
0
0 25 Glean wi In cloths 6 F 3 tx } P
rr � a �r V.
4 I tsPx.. r C iN10 NIA `1
7 04°toted+slorfrtg storage,ppr�air,�� JVIO'NIA 2
`"' r A Cloths and/or sponges in good repair and clean
�r a Wei servtc�and transpoTtatl.'on +� tt
° { "°''" ' °' '" ' k` ' "' B Wiping cloths kept in sanitizer between uses
A Produce washed O
B Raw meats not storedlprepared near ready-to-eatfoods 1&1foode'cbhtdct*UVaces'61ea11`s w**'° �� � t C-IWO N/A 44
!C*?fit'. ^ya'3::.a.'4^`.'r,'x:$'M skl' ,'�r f-5 :? 'E f• 6 �. ..` X':'.�3`1
C Food covered properly A Food equipmentclean,utensilsclean,equipment interiors dean
D Adequate splash guards 1 sneeze guard B Single use gloves changed when soiled
E No unauthorized personnel C Food--contact surfaces clean
F No pooling of eggs not cooked immediately 0
8 Food containers stored off the floor " a ° ""S'"" °
K30 i, t.and.cold water'Mn provided as requir ,2
h
0 `3$"klandWat'stiiri a cessorres fyroyrded,
C E fr. . f. x . , � :
t9Handhngrofood mrnrmized _ Y # rx rk.NrO'NIA k2- A Soap 1 paper towels 1 drying device available
A No unnecessary handling RTE and/or cooked foods with bare hands B
Dispenser(s)working: ❑Soap ❑Paper towel AIC
B Minimize food handling,other than ready-to-eat,with bare hands r C Handwash sink(s)clean Iwaste receptacle at handwash sink
W
C Adequate utensil(s)for dispensing food/ice oe 0
0 zr DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The fallowing information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB Ifoodborne]
Pli 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 FI3 illness are you required to report to the local health department?
Roasts Other
Describe re-heating procedures: i' Is there a written illness policy that requires the food worker to report specific illness conditions
Are temperatures recorded/logged for cold holding foot/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 If yes 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):
Indicate the title/of above person(circle all that apply[:QFO DA Mgr wok Owner FW
Is cooling monitored for tme&temp? Y N Is a monitoring of cooling recorded? Y N .Obtain sig4repf th arso who eceived th r ponsibilitie information at the time of the
Is there a produce washing policy? Y N ♦ escribe what is washed and inspector*l
where: Note: This report is a two page form total of 62 debitable items) Page f of 2
ONNECYIGUT L31wPARTINENT QF P..11BLIC'HEALTH .�4'10"C [TQL AVENUE-MS#5TFI3N'-HAR7FORC �G �b 4
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A `sI�EP .ti ESSICITY
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Establishmen /Lim �, Z�3:'�. Date of Inspection: I
Owner yor Operator
ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served.
-Unwrapped foods not re-served 4 31 Sewage disposal approved. 4
-Potentially hazardous foods not re-served -Operating as required
No cross connections,back siphonage,backflow
11 Toxic chemicals. 4
4- Proper typehnstallationl backflow prevention device/air gap for:
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
-Pesticideslrodenticides 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
-Monitoring in compliance designed,properly installed
U
OTHER ITEMS c�ia KEY: DNC [DOES NOT COMPLY] ja
Sourcesoffood: Original container,properly labeled 40 Garbage/rubbish storage arealrooms,enclosures-propedyoonstructed,clean --�
5 Potentially hazardous food properly thawed 41 Garbagelrubbish disposed of in an approved manner,at approved frequency #
10 Food dispensing utensils properly stored T. 2 Vermin Control: No insects/rodents present 2
14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected againstentrance of insects/rodents 1
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 '
18 Single service articles,storage,dispensing 2
8 Exterior walking,driving surfaces,good repair,clean r= ;
�
19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good °
repair,clean.Wall&ceiling surfaces as required
0 Dishwashing facilities approved design,adequately constructed, 2, 1
maintained installed located 50 Dustless cleaning methodsused,cleaning equipment properly stored
1 51 Adequate lighting provided as required
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors
22 Washwaterclean,proper temperature v
53 Rooms&equipmenthoods,duas,vented as required
23 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1
7 Nonfood contact surfaces of utensils&equipment clean ` 'y 55 Establishment and premisesfreeof litter,no insect/rodent harborage.
8 Equipmentlutensils,storage,handling I ' no unnecessary articles
32 Proper disposal of wastewater 1 56 Complete separation from living/sleeping quarters and laundry ,
33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly
58 No live birds,turtles,orother animals(except guide dogs) 1
36 Toilet rooms enclosed with self-closing door 1
59 Seats 75or more:Nonsmoking area provided,sign(s)pasted at 3
37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered, 1
rodent proof,clean ❑Routine Inspection ❑Reinspection ❑ Preoperational Inspection
—WSRECTOR: '011PERSON IN CHARGE: Other Inspection:
'e emerit Score: *Include demerits from page 1
4 3 2 1 Total Rating
nature signature _
` -
riot name _ print name
r f DATE CORRECTIONS DUE: s
,'phone number title
`� Page 2 of 2 plus continuation pages Focused Mspe'fl n 112002
Pagel OfL—
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTIOiN
INSPECTION REMARKS
FORM#
6
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: I st-White-Health Department 2nd-Yellow-Owner/Manager