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HomeMy WebLinkAboutFood Service Establishment Inspection 17 (33) _sTA'I'k'Oupri1V tC 'j "pQCC1S 1OOD S R4Vd� .10 Establishment: bin Inspection Date: 7vil, Time: i",�,� R tnsp E[ns ddress/City: j S Lrj� rJc Health Dept: ;, �� G+�iAln.5 c class: 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 JONC I KEY: C[complies] MID[not observed] NIA[not applicable] 60 Quatlftetl Fgod 6p b.W N 3 DNC[does not comply] 0[other] RTE[ready-to-eat] F 12 Person`nelwlth infection restricted, C.:;NIO N1A. 4:: Al rDesignated Alternate 2e. A Food workers have no exposed infected lesions I burns 162 Written documentation of trainigprogram 2 B Personnel with infection restricted 1 A roved souce,wholesome nonadutterated NLO NIA i4 :pp r . '< r C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 Hand►nmsh1ngsbdIl1ttes provided, hands washed,clean C: NI0 NIA 4 B Food cans in good condition(not denied,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas 91 C Wholesomelnonadulteratedfoods/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 propertempereture D Personnel hands washed,clean I Proper handwash procedure 0 E Handwashing at appropriate times ' 3 'Paffentially hazardol add meets temperature requirements C Nl0 NIA 4 0 ti during s orage,.preparation,display,service and transportation „ , its Gooditgfenlle4practices �C°;NlO NIA :2.; A Hot holding greater than or equal to 140 F. (whale beef/pork roasts 1300F.) A ❑ No eating ❑No smoking while working B Cold holding less than or equal to 45°F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking/consumer advisory posted 124 Sari;It ization rinse(hot water=chemical} i G_ td1O NIA;2 0 A Approve dsanitizeravallableladequate concentration ofsanitizer 4* , >/!Cequate facilitieszt9 main#arn pro > ct a 6 N1O [NIA 2 B Food contact surfaces and utensils used for potentially ternPe[rature,therrrtometerspravltled hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwasher sanitizer Arinal rinse temp B i'roperfoodlhermometerforproduct L Proper sanitizing procedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 C !25 1 C1 '"lptng cloths r C iN1O :NIA I 7 Food rotected;dtarin storage, re arafion I P 9 9 P p •� �VIO.INlA 2 ... .. . . .:: . 'display,service and transpartatian +..r �~ k r [y i A Cloths and/or sponges in good repair and clean .., t [ k. B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats notstoredlprepared near ready-to-eat foods Fogcs otatact€st rteGes clean C 'NTO )aJIA r,2 C Food covered properly A Food equipmentclean,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 notcooked immediately 0 8 Food containers stored off the floor r 0Flot and doltl vrgfer`;undjar pre'saure,praviddd as require ;C'; 3 'Ila P2 0 ' B't�Handwashin accessories= iovided - r •1NO 'NIA• 1 ..n tin :,offood.mintmised w _ �C IVIO NI `2 w ,.. A Soap!paper towels I drying device available f!s g . . .,.. ,. B unnecessary handling RTE aridlor cooked foods with bare hands Dispenser(s)working: ❑Soap ❑Paper towel Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean Iwaste receptacle at handwash sink C Adequate utensil(s)for dispensing foodlice 0 0 1 H •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated altematel,PHF[poten&ally hazardous food],FB[foodborne] PHFs are hot held at: F. PHFs are cold held at: F. 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 re you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness polic at requires the food worker to report speck Ilness conditions Are temperatures recordedilogged for cold holding foods/equipment? Y N and diseases to the QF0? N *Do you have a paid sick leave policy? Y N alaaalifeAre foods cooked in advance and cooled? Y N +Are leftovers ved? Y N is there a language bar' r between inspector&QFO? Y N €f vas indicate language spoken List products cooled: by QFOIDA:_ +Cart the Qli read the inspection report? Y N Describe cooling methods: Indicate who a e*theoveestions: Nam print): Indicate the tee f ale all that ply):QFO DA Mgr Cook Owner FW Is coding monitored for time&temp? Y N Is the monitorin of cooling recorded? Y N Obtain s€g lure of d QFO resp n ibiti'es-iw or n at the time of the Is there a produce washing policy? Y N ♦Describe w at is washed and inspecti where: Note: This report i a o page form(total of 62 debitable items) Page 1 of 2 .' X,1, n, s STi4TE f CONINECTiICUT DEPARTMENT OF 1?iIJBLIC HEAL.TM 411)CAPIT,©L AUENUE.,MS#51FDP-HARTF,ORD,CT•06134 CIC[JSE FpOA SEEj'1E E.T1NSI EGTION ItEPQRT LO A H AL f DEPT1, Atil]RESSICtTY: Establishment: � v rS T &I �1 Date of Inspection:7 i,�/ " ddress 1 J / r Owner or Operator:. ADDITIONAL FOUR POINT ITEMS Q KEY: DNC [DOES NOT COMPLY] Iv 6 Foods not re-served. t -Unwrapped foods not re served 4 31 Sewage disposal approved. q` -Potentially hazardous foods not re-served 74 -Operating as required I 1 Toxic chemicals. No cross connections,back siphonage,backflow 4 Pry e(ertype/installation/backfiow prevention devicel air gap for: 4` -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines .San itizerconcentration notto exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticides/rodenticides 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 designed,properly installed -Monitoring in compliance OTHER ITEMS zKEY: DNC [DOES NOT COMPLY] tz 2 Sources of food: Original container,properly labeled 40 Garbageiubbishstoragearea/rooms,enclosures-properly constructed,clean 1 5 Po_tentialIy hazardous food properly thawed 2 1 Garbage/rubbish disposed of in an approved manner,at approved frequency t0 od dispensing utensils properly stored 42 Vermin Control: No insectslrodents present =� 14 Food worker:Clean outer clothes,effective hair restraints 43 Outer openings protected against entrance of insectslrodents 1`' 4 Floors: Floor covering installed,constructed as required,good repair,clean 1 16 Food-contactsurfaces designed,constructed, maintained,installed, ;:2w 5 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 47 Mats removable,good repair,clean in tailed,located 18 An service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean 44 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 1_ maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils& Cleanliness 1: 51 Adequate lighting provided as required 1; 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1 2 Wash water clean,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 27 An food-contact surfaces of utensils&equipment clean 1 ls� 55 Establishment and premises free of titter,no insect/rodent harborage, 1 28 Equipmentlutensils,storage,handling .1<" no unnecessary articles 32 Proper disposal of waste water `; .; 56 Complete separation from living/sleeping quarters and laundry 1 57 Clean/soiled linens stored properly 33 Plumbing location,installation,maintenance 1 . 58 No live birds,turtles,or other animals(except guide dogs) 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,clean3 s 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 TOR: E N E: Other inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating gneture f sl ature ? print name pnnt name ph' ne number tl DATE CORRECTIONS DUE: 4217 Page 2 of 2 plus continuation pages Focused Inspection�;zaoa Page of 44 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION .`�/a"- yr �(Y>�L CJ L�✓l/G/ Sex' INSPECTION REMARKS FORM# �j 40 04 r .7 J 3c�v ._. n a c. INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow- Owner/Man Page "-;),of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN 3 DATE OF IN PECTION INSPECTION REMARKS FORM# .� IN f >+� Vdt V I . C I C ' INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager