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HomeMy WebLinkAboutFood Service Establishment Inspection 50 (8) l II e Establishment: ]`�rb 15 Aj,0A,• , 11�14,e Inspection Date: ; Time: >'4 ; Roinsp insp ddresslCity: .0 R Health Dept: ass: 1 2 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 WA NCI KEY: C[complies] NIO[not observed] NIA[not applicable] i 0 Quelled Fdb Qp000.1 _ ;:; 3 DNC[does not comply] 0[other] RTE[ready-to-eat] t 4 12 Personnel with rnfeiction restr]cted Bt Designated Alternate ` 2 q Food workers have no exposed infected lesions 1 burns C N10 NIA 4 TT Written documentation of trairnng program 2 B Personnel with infection restricted 1 Approved source,'whgfesoroe,':.'nonadulferated ' C VlO N(A 4 C Communicable disease of worker reported to local health director ;..:. A Approved shellfish,finfish,meal&poultry USDA a roved 1.3 ..Handwashrng facilities provided;hands we h6cl Mean. C N10; NIA: 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grownlcanned food) C Handwash facilities access lblelconvenient to use E Potentially hazardousfoods received at proper temperature kA ID Personnel hands washed,clean/Proper handwash procedure 0 E Handwashing at appropriate times 3 Rotentratly'ha ardausfoadfnreeWtemperature�requi ements lic Njb wA 4 0 fl durm; sttorage+preparatl' display,servica affd transportatior! t �-Good h,ygierlic`;praqt yes C N10'°WA :2 A Hot holding greater than or equal to 140 F. (whole beeflpork roasts 1300 F.) A ❑No eating 0 No smoking while working B Cold holding less than or equal to 457 B wounds covered adequately C Proper cooling AL C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking/consumer advisory posted 124«Sant ti atlortkrtnse ( ,t.'water=trherriiaal) C k!(p NIA: 2;:. t •s x f 0 A Approved sanitizeravailable/adequate concentration ofsanitizer , 14 A lequate faciillkts;o,m alndtain plRoduc) " 'Ok 161N104 NIA M2. g Food contact surfaces and utensils used for potentially l tetin .Qre,�themi'y;�y.iy•�ters,,ptovId.e I hazardous food sanitized at least every4 hours A Food thermometer available and accurate 1� C Adequate ishwashersanitizer ❑final rinse temp �+ D Proper sanitizin rocedure B Properfood lhermometerfor product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in coolerunits ' N a � , �6,;C:leanritif' ,� t N p ,t I F[ rotercte'tl�durr fora e� e� aratron� ' � � e.} f I ; w r ; �,�R[ g'• y *� , N1A 1 splfe at>~d�t otitlrr> s t s t N10 �N�A A Cloths and/or sponges in good repairand clean .;r �?!�F r B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meals not storediprepared near ready-to-eat foods 2g T_681'c1 tact}s r"e' " lean C Food covered properly r A Food equipment clean,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 30a, ot ofcQld NQ water under d AAe daaei t2=yl [%�r�Hanoiii3ga A foddr in t'^itede "'.�t w.�:r n s Wifftlwashi cceAsones.pTr,gd, n+ t:.l;G !NIO A Soap 1 paper towels I drying device available A No unnecessary handling RTE andlorcooked foods with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready to eat,with bare hands J Handwash sink(&)clean 1 waste receptacle at handwash sink Adequate utensils)for dispensing foodlice 0 1 *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],FS[foodhorne] PHFs 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 FB illness are you required to report to the local health department? Roasts Other Describe re-heating procedures: is there a written illne policy that requires the food worker to report specific!lines&conditions Are temperatures recorded/logged for cold holding foods/equipment? Y and diseases to the F0? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are leftovers s ed7 Y N Is there a fang d1ge barrier between inspector&QFO? Y N If ves indicate language spoken List products cooled: by QFO1D — *Can the QFOIDA read the inspection report? Y N Describe cooling methods: Indicat who answered the above questions:Name(print): Indicate the title of b ve pp rson(circle all that p �y):QF DA Mgr Pock Owner FW Is cooling monitored for time&temp? Y N Is the monit�t g of coaling recorded? Y N .Obtain signature f he fs n who received 0 reb"ies infor 9b n at the ime of the Is there a produce washing policy? Y N ♦Descd what is washed and inspection: where: Note: This report' wo page form(total of 62 debitable"ems) Page 1 of 2 STATE OF CONNECTLCIJ�t-! DEPART>MEN.T OF�IJBLIC HEALTH 47©'CAPITOL AWENUE-MS#Jr1 FDP-HARTFORD,CT QG134 j< �{'' ,� - y;,� F,OC14C7SED FOOD.`S�R!?LCE IlVSPEC'�IO1�T TiEPQRT AI F�tEALTHADQRES,SICITY Establishment: " .- x�� .�_ `.:lth�ri Date,of Inspection: duress �' l/ Owner or Operator, ADDITIONAL FOUR POINT ITEMS ?. c 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 7oxicchemicals. No cross connections,back siphonage,backflow 4 Proper typelinstallation/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 -Pesticides/rodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well Iwell head protected from contamination-Water quality in compliance 35 Toilet facilities. Adequate,convenient,accessible, 4 -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] my 2 Sources of food: Original container,properly labeled 1 0 Garbage/rubbish storage area/rooms,enclosures-properly constructed,dean 1 5 Potentially hazardous food properly thawed 2 ` 1 Garbagelrubbish disposed of in an approved manner,at approved frequency i 10 Food dispensing utensils prope rl y stored >lr= 2 Vermin Control: No insectslrodents present 2'` 14 Food worker:Clean outer clothes,effective hair restraints k1'' 3 Outer openings protected against entrance of insects/rodents 1 4 Floors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, 2 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 installed,located 2 f $ Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 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) ,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 Roomfree of steam,smoke odors 22 Wash water clean,proper temperature 53 Rooms&equipmenthoods,ducts,vented as required , 23 curate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean i<1< b r xt �7 Nonfood-contact surfaces of utensils&equipment clean t 55 Establishment and premises free of litter,noinsectlrodent harborage, l.a 28 E ui mentlutensils,storage,handling 1 q p g g no unnecessary articles 32 Proper disposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry 33 Plumbing location,installation,maintenance ; 57 Clean/soiled linens stored properly i l 581 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 1 r 59 Seats 75or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) ,N 39 Approved garbagelrubbish containers,adequate number,covered, .1;. rodent proof,clean outine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: PERSON IN CHARGE: or Inspection: Demerit Score: *Include demerits from page 1 - L 4 3 2 1 Total Rating i nature signaf re pr t name nt name7 �� 1 I phone number floe DATE CORRECTIONS DUE: yPta Page 2 of 2 plus__L_continuation pages Y F.—ea I.spe�fl n Inooz Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH � �� CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION �_s ,- INSPECTION REMARKS FORM# 'le�- T-0 c J G G a 6 1 , —61 s INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager ��e,�' -- �� '