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HomeMy WebLinkAboutFood Service Establishment Inspection 83 (7) A4 A-e—­,J 51-1 Establishment: Inspection Date: Time: i� nsp ' sp ddresslCity: 3 � �,y Health Dept: ass 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 N10 NIA DNC KEY: C[complies] N10[not observed] NIA[not applicable] 6U I QrialrfietlfoaaQpera#or s _ 3 DNC[does not comply] 0 jother] RTE[ready-to-eat] =12 Person.nef with infection restricted k.., C HO NIA 4' fs ;Ribstgnated Alternate A Food workers have no exposed infected lesions 16urns ritten ddcumentation of training program ` " ` B Personnel with infection restricted -11(Approved SGurCe,wholesome,;rlonadultgratetl C ;NIO N C Communicable disease of worker reported to local health director _. .. A Approved shellfish,finfish,meal&poultry USDA approved 13 h:Handwashm %e lfitles rovtdetl:hands washed clean_ B Food cans in good condition(not dented,rusty,bloated,leaking) s ti.. p C :N10 N/A k4•. A Handwash facilities in all food prepldispensing&warewash areas C Wholesome/nonadulteratedfoodstsafe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products[no home grownlcanned food) C Handwash facilities access!blelconvenlent to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean 1 Proper handwash procedure E Handwashing at appropriate times 3 ,Potentfallyahazardbiis."food meets temperature requirbmen Is C Kb NlA 14' O during storage,preparation dtaple servrce4anld transportation; 1 5 °G ract hC 7 ood<hygtenrcp fees F NIA 2 A Hot holding greater than or equal to 1&F. (whole beef/parkroasrs Mo F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to45'F. B Wounds covered adequately C Proper cooling V C Proper sink used for handwashing D Proper re-heating C E Proper Iconsumeradviso posted 24 "8anitrzattonrrfrise' hbtw44er-trht7iCtf) C Id10 NIA 2 A 9 ry .,; :..x 0 A Approved sanitizeravailableladequate concentration ofsanitizer �4 Xlddqu t fPcilftfes to malntarn pFd;duet Y p ;« r C WO 'NSA ' q Food-contact surfaces and utensils used for potentially r 6 tenpgratur {the]rrno�ngters provt eds m hazardous food sanitized at least every 4 hours l l A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper sanitizin B Proper food thermometer for product procedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 < s , F 25 I Clean awipIIN'1cloths 7 r oald pretect6t �li�rtng,storage,fprepar�tion G�N/0 I�JIA ti Y 1. drspfOa ��4� 17fFGe and trerfsp SrCaf;o K F .,z ti e !< Cloths and/or sponges in good repair and clean E m K :�,�`.s.na ec� SE+S.�;T •g+f Pi.•�+ 3��...�: u .s. �:>,rt A .c m9'' �c 9 i4.:: at rg A r:•. A Produce washed . B Wiping cloths kept in sanitizer between uses 0 B Rawmeats not stored/prepared near ready-to-eat foods 14 h26'Tood-BdInt"act#surtace clean C Nl0 C Food covered properly A Food equipmentclean,utensils clean,equipment interiors clean D Adequate splash guards/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 ;3`A 1.Hrit and cold wafer undh A oYfdCd.6s urged 'ANIA•'2� 0 !3 _ d % Y qt 7n S Y+ ?k#P'tQ3' }.H y'C>e a"N;'`!% k �y 1 r +.'+Y ... 8 Handwd'sfti" "'oriessprovide r 9�.. I r .. ..•. : t ��Handl�n" 'of f oQd m[nimfztl, C NIO IA F 2 A No unnecessary handling RTE aridlorcookedfoodswith bare hands A SDa /pa er towels tying device available B Dispensers 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 1 1 F-H 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodborne] 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 temperature do you cook: Poultry Ground Beef Pork 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 tpdt requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foodsleq ment? Y N and diseases to the QFC Y N ♦Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N ♦ e leftovers saved? Y N Is there a language bards stween inspector 1f yes indicate language spoken List products cooled: by QFOIDA: *Can the OFOIDA read the inspection report? Y N Describe cooling methods: Indicate who ans Fed-th above questions:Name print): Is coding monitored for time&temp? Y N Is a monitoring of cooling recorded? Y N :ndicate the) a of above erson(circle all that a ):QFO Mgr Cook Owner FWObtain si azure of the erso who rgcei �h respoAD�es; nformation at the time of the Is there a produce washing policy? Y N escribe what is washed and inspecti O where: Note: This rep is a two page form(t a of 62 debitable items) Paget of 2 C,ONNECT�CUT ©:PA OWEN -�i=PUBLIC HEALTH 41 D CAPiTOE AVENUE-MS#,51 FC1P-HARTFORD,CT 06134' fQCttJSED_FOOD SERVICE INSl'ECTIflN REPO12r i' t-? H E ; '� 3d�✓"�'"' a `' � � ��'�,Ca/_'�—. .:.ADDRfrSSICtTY.. �: a Estat}lishment ' 'T -" �J Date of inspection: / `ddress :- '--; 3 ;. --G .� ^� Owner or Operator:. ADDITIONAL FOUR POINT ITEMS Kn= 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 -Stored properly,labeled properly,used properly PP�opQrtyp�dillstalfafieaL�ackflow prevention device/ -Sanitizer concentration not to exceed maximum permitted -Food equipment -Hose connections -Dish machines -No unnecessary taxies on the premises -Soda system carbonator -Beverage dispensers -Toilet tanks -Chemical dispensers -Ice machines -Pesticides/rodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines 4 -Well l well head protected from contamination 35 Toilet facilities, Adequate,convenient,accessible, 41 -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS m KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storage area/rooms,enclosures-properlyconstructed,clean 5 Potentially hazardous food property thawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils property stored 1:' 2 Vermin Control: No insects/rodents present 2 _ 14 Food worker:Clean outer clothes,effective hair restraints 43 ter openings protected against entrance ofinsects/rodants t414 Floor's; Floor covering installed,constructed as required,good repair,clean 1; 16 Food-contact surfaces designed,constructed,maintained,installed, 2: Floors graded,drained as required located 6 Floor,wall juncturecovered 17 Nonfood-contact surfaces designed,constructed,maintained, 47 Mats removable,good repair,clean ins`t led,located 8 Exterior walking,driving surfaces,good repair,clean 1. �(1 gle service articles,storage,dispensing 2 19 Noreuse of single service article 9 Walls,ceilings attached,equipment property constructed,goad 1 repair,clean.Wall&ceiling surfaces as required ; O 6.Ili shwashing facilities approved design,adequately constructed, 2 ` maintained installed located /50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1. 22 Wash water clean,pro pe r tem p eratu re ; 53 Rooms&equipment hoods,ducts,vented as required 2 urate thermometers provided,dish basket,if used 4 Rooms adequate,clean,adequate lockers provided,facilities clean 1. 7 - nfood-contact surfaces of utensils&equipment clean i 55 Establishment and premises free of litter,noinsecllrodentharborage, , Equipment/utensils,storage,handling no unnecessary articles 32 Pro per disposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly a 1. 58 No live birds,turtles,orother animals(except guide dogs) 1: 36 Toilet rooms enclosed with self-closing door 1 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet fixtures provided,good repair,clean 3 entrance(s),smoking area indicated bysign(s) 39 Approved garbagelrubbish containers,adequate number,covered, 1 ': rodent proof,clean g3ftutine Inspection OReinspection ❑ Preoperational Inspection INSPEC OR: R CHARGE; Other Inspection: Demerit Score: *Include demerits from page 1 17 LQ � 4 3 2 1 Total Rating nature s natu e print me / print name f_ /0 - CPS !� DATE CORRECTIONS DUE: phone numbe'rrT � title -�=� , Page 2 of 2 plus continuation pages Fnc dl.spectio 112001 Page / 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# r� - X-/ye- LLZ 0 - INITIAL(INSPECTOR) /� INITIAL(PERSON IN CHARGE} Distribution: 1st-White-Health Department 2nd-Yellow-Owner ager Page of f� ,I a�v INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION REMARKS FORM# Lasso— Date: fecha Emp: £mpleado PASS WHEN BLUE BAR TURNS ORANG£ r� RAiUI uAC0u 0RNalaR64, «�6a4017,-C; Ld r B INITIAL(INSPECT ) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow--Owner/Manager