HomeMy WebLinkAboutFood Service Establishment Inspection 10 (29) /
.. � '.`...: 97505•:
Establishment: 1 L'A_70,,"= S. Inspection Date: j _ Time: // . 110[nsp )RE[nsp
ddresslCity:� l �' a _Lc +4� Healfh Dept; �6,�/f P.�.1�'•��r C rs��_ cuss: 2 3
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 NIA IIINC I KEY: C[complies] N10[not observed] NIA[not applicable]
BQ i Qualified Food Operator ti DNC[does not comply] 0[other] RTE[ready-to-eat]
3
32 ::Personnel with infection restricted CN!0
63 IDesignatedAlternate' 2
Ni'
A Food workers have no exposed infected lesions 1 burns
62 Written documentation oftraming program 2
B Personnel with infection restricted
3 roved source wholesome nonadulterated C N10 NIA .a:
rP ! C Communicable disease of worker reported to local health director
A Approved shellfish finfish,meat&poultry USDA approved
33:: Handwashing#actltties prowded;,hands washed clean:= C NI0 N1A 4 '
B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepldispen &war wash areas
C Wholesomelnonadulteratedfeodslsafe B Handwash facilities' or immediate) jacent toilet rooms
D Commercialproducts{nohomegrownlcannedfood) C Handwash faciliti s b o lent use P
E Potentially hazardous foods received at proper temperature D Personnel hand w 1 Prop andwash procedure
a '
E Handwashing at propriate times >11
3 'PgteMtallyy hazardous food meets temperature requireni s; C N10 'NIA x4
during sfarage,preps lbn,dlsplay*,;srervlcerand transportation..
r 5 '.Good;H.Y9ienidrpra tires C ;N10 `NI
A Hot holding greater than or equal to f 44°F. (whore beef/porkioasts 1300 F.) J.
❑ No eating ❑L 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 /w
advisory �24 San izationir(hs ;(�qt, er.'=chemical C INTO NMI
E Proper internal cooking/consumer adviso }
0 A Approved sanitizeravailableJadequateconcentrationofsanitizer
4i i, Adequate facititres to mrganp�Qdus� G tN10 WA' 2.' B Food-contact surfaces and utensils used for potentially ,f
° tetii perature,t. ennometers�provided a r k I hazardous food sanitized of least every 4 hours f�
w t.,,:
A Food thermometeravailableandaccurate C Adequate ishwashersanitizer inalrinsetemp �[
D Proper sanitizin rocedure
B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in coolerunits
O 2 ieanw to cloths t
n t i. , .,• t r, P 9a N!QNI, r1
NcFrpr�0 R1dted dFIr or iUage, p* partition; ;'. €C NIO INIA r 2 = fr
u display,:servtce,a~nx¢ rartsperatro[t R * t I A Clothsand/or sponges in good repair and clean
n
Wiping cloths kept in sarntizer between uses
A Produce washed
0
B Raw meats notstoredlprepared near ready-te-eat foods 26 ;Food-cantaahsri0faces'cle fG i 10,,N1A';2
C Food covered properly � � t. �: � � ��
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
8 Food containers stored offthe Floor 30 ;Flot aH]��gtyiiteG tindrp�ossurw.
e,provided as required jG rNlO `N!A >2•,
0 88 .HiMdwashfnglecessorfes provided< C Nl0 `NIA [3`
t9, `Handling=.ofif'd tiff imizer "
"..:.. I
c..v� ...<� _ �.::_: � N10 tNlA ;'3 A Soap 1 paper towels! drying device available
A No unnecessary handling RTE and/or cooked foods with bare hands B
he
Dispenser( )working: ❑Soap ❑Paper#owe)
B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean 1 waste receptacle at handwash sink
C Adequate utensil(s)for dispensing food/ice 0
0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The following information is not debitable and does not affect your scare. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodborne)
PHFs are hot held at: OF. Ii 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 Park What diseases related to FB illness re you required to report to the local health department?
Roasts Other
Describe re-heating procedures: Is there a written illness policy th requires the food worker to report specific illness conditions
Are temperatures recorded/logged for cold holding foodslequipme ? Y N and diseases to the QFO? Y ♦Do you have a paid sick leave policy? Y N
Are Dods cooked in advance and cooled? Y N *Are left ers saved? Y N Is(here a language barrier be en inspector&QFO? Y N If vas indicate language spoken
List products cooled: by QFOIDA: *Can the OFOIDA read the inspection report? Y N
Describe cooling methods: Indicate who answered the above questions: A (print): f
Is cooling monitored for time&temp? Y N Is the monito ng of cooling recorded? Y N Indicate the title of abov or on(cir II a �DA Mgr Cook Owner FW
Obtain signature pf e p n" r 0 responsibilities information at the time of the
Is there a produce washing policy? Y N ♦Describe hat is washed and Inspection:
where: Note: This repo two page farm{total of 62 debitable[terns) Page 1 of 2
5 x rn9�� tga -r�„rr A b:.
+ EC7l-U , D PARTIIIi�1+ET®1=pIJBLIC`.liEALTM 4 f O'CAPIT%AVENUE M5#51PDP-HARTFORD,
FEI�IJSED FfiOD 5ERVI TI11r ', T
AbC'RIESSlC[TY 5 .�
Estat lishmerli � T�rfr rS' l's iC L_ date of Inspection:
R
¢ , �,v Owner or~Operator,
.--ADDITIONAL FOUR POINT ITEMS v
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
11 Toxic chemicals, No cross connections,back siphonage,backflow
4. Eger typelinst l tbi backflow prevention device/air gap for:
-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
-Pesticideslrodenticides 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, 4
-Water quality in compliance
-Monitoring in compliance designed,properly installed
OTHER ITEMS
��KEY: DNC [DOES NOT COMPLY]
2 Sources of food:Original container,properly labeled 0 Garbage/rubbish storagearealrooms,enclosures-properly constructed,clean 1
tially hazardous food properly thawed I 1 Garbage/rubbish disposed of in an approved manner,at approved frequency
to y
0 Fp6d dispensing utensils property stored 1 42 Vermin Control: No insectslrodents present r2.
Food worker:Clean outer clothes,effective hair restraints 43 Outer openings protected against entrance of insects/rodents 1
4 Floors: Floor covering installed,constructed as required,good repair,clean 1
1 ood-contact surfaces designed,constructed,maintained,installed, S Floors graded,drained as required
Gated
6 Floor,wall juncture covered
17 'Nonfood-contact surfaces designed,constructed, maintained, 47 Mats removable,good repair,clean
installed,located
18 Single service articles,storage,dispensing 1 481 Exterior walking,driving surfaces,good repair,clean 1
19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good 1'
repair,clean.Wall&ceiling surfaces as required
0 Dishwashing facilities approved design,adequately constructed, 2
maintained installed located 50 Dustless cleaning methods used,cleaning equipment properlystored
Equipment&/Utensils: Cleanliness 51 Adequate lighting provided as required �1�
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1"
22 Wash waterclean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required
rate thermometers provided,dish basket,if used 4 Rooms adequate,clean,adequate lockers provided,facilities clean 1
nfood-contact surfaces of utensils&equipment clean
5 Establishment and premisesfreeof litter,noinsectlrodentharborage, 1
quiprnenYutensils,storage,handling no unnecessary articles
2 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,or other animals(exceptguide dogs)
36 Toilet rooms enclosed with self-cl os i ng d oor 1,
59 Seats 75or more:Nonsmoking area provided,signs)posted at
37 Proper toilet fixtures provided,good repair,clean 3
enirance(s),smoking area indicated by sign(s)
39 Approved garbagelrubbish containers,adequate number,covered, 1I It
rodent proof,clean PRoutine Inspection ❑Reinspection 0 Preoperational Inspection
therInspection:
I CT , C,dA� : Demerit Score: *Include demerits from page 1
r 4 3 2 1 Total Rating
signature sign�ure
print name print me
�rrlof _ DATE CORRECTIONS DUE:
phone number title
-- Page 2 of 2 plus continuation pages Focused Inspection C002
Page of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF IN PECTION
INSPECTION REMARKS
FORM#
el
lvt��A
A/0
8
lG � C
rt` 4 ° t
INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGEr4V
Distribution: 1 st-White-Health Department 2nd-Yellow- Owner/Manager
Pag�e.
of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
..
INSPECTION REMARKS
FORM#
.ry
Dates
F.h.
Emp:
EmpIHEo
PASS WHEN BLUE
BAR TURNS ORANGE
'01
UACErtIRENIMpuWA
ES CEMUMCala0.a4.411A
JQC
r--
�- y3LL6Ld 10 — �
JA
V
Azeel
INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager
5
st s:
h
i e T
1 ,
S
f
M'-15'•Yf 4��X� t ,`4 ` \ ; t ' 1 4 i .I � ' y
1` Flr [1in
VMI
om
Mir'
-
x
< :.�c"'k'-w"1 E",��'u--'1 er w�P eey�`�y�•"�,�� �`�� :� Ky�x°F�' s P �£ '"
i.
' sn.. OF :
. .. \ . axeax�.�. = . �. .
2 � - A/
.. . .
«« _
� . . .
. . _, �
-
. . . .4& -
.
. e . . e�. ,
- � - - : -
� ,
� . . • .> . . ,: : �/» «� .\ � . < : . < . :. ,.�. ,_ � - , -
�
. ... �
. . .. � : . . . .
. .z=.. : . . _ .