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HomeMy WebLinkAboutFood Service Establishment Inspection 76 (4) ' �I m 'ion o fu cmc m fi Ta anFes- _..,_, Establishment: ]�,� � , Inspection Date: r " Time:�� pins Einsp Address/City: - `jj ,4M-, f tjLVt> Health Dept: 5,, Class: 1 04 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 JDNC I KEY: C[complies] N10[not observed] N/A[not applicable] k60 }4Utalifted Faod Operators r - g DNC[does not comply] 0[other] ready to-eat] Personnel wrthi infection resfr[cted.> TE[C 40 81 De91 rioted Alternate : 4 2 �2 ' A Food workers have no exposed infected lesions!burns 82 Written documentation of trarnmg program 2 B Personnel with infection restricted 1 Approved source,wholesome,'nonatlulterated 0 10 NIA 4; C rn unicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultryUSDA approved 13 Ha dwatahtng facthties provided;:hands washed,clean' C ;Nf_ 4 B Food cans in good condition(not dented,rusty,bloated,leaking) p andwash facilities in all food prepldispensing warewash areas C Wholesomelnonadulteratedfoodslsafe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities access iblelconvenient to use E Potentially hazardous foods received atproper temperature D Personnel hands washed,clean I Proper handwash procedure t;:�g Handwashing at appropriate times i ... r. ....:::::..,::.:, 3 Poterttfallyrhaardepasrattcn d$eja<te attf '.ig slFojnon C :NIO 4 0 f drrrrpg`istoragie P P. p; qa. p . a r r. R 18 :Good hY9ienic practices C. NJQ.. NIA .,, A Hot holding greater than or equal to 140°F. (whole beeUporkroasls 1300F.) I,JLA ❑No eating ❑No smoking while working B Cold holding less than or equal to 45e 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 FIR, .:Santttzetton rinse shot . W.=p Wnical)r lC !N10; NIA 2 0 A Approved sanitizeravailableladequate concentration ofsanitizer 4, ` ,4tl®gruatedfaarre�somatnt am product-A -wr },,Y h y, [�. . [IO (N!A',�2: B Food contact surfaces and utensils used far potentially * w tei�riperature;thermbi�neters'�Tb�►te x „x. , ; r hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate WIshwashersanitizer ❑final rinse temp D Pro er sanitizin rocedure B Properfoodthermometerforproduct E Sanitizing between raw animal origin 8ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 '25 'Clears Wipgtcl6ihi IFr t� mood protect �l'li [itg.storage,preparation En ' r�{lyl .`NjA 2 C 1N10 'NlA 1" i : A Clothsandlors on es in hoodFre airandclean 0t `display,service and transportation P 9 9 p i:. B Wiping cloths kept in sanitizer between uses A Produce washed LZ 0 13 Raw meats not stored/prepared near ready-to-eat foods 26a=5oad=conCect� iiifa�`skott: '- ` Qi �` 2'' C Food covered properly y .1,;;* � p *" � 4 . .' 1 r 11 A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards I sneeze guard V 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 $0(Hof andical�water�und ier p xi ressure,prl5vid€1'as°requi�e` r & 0 r36!'Hantiv]ra hm`lg accessortes provided 'rg? i :ndimg�ofYotsti:rnin(rnlze�, C:'NlOiNlA;,2 1A Soaplpapertowelsl'dryingdeviceavai�able A No unnecessary handling RTE and/or cooked foods with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel 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 score. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodborne] PHFs are trot held at: IF. 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 ork 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 that requi s the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foodslequipme . 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 left ers saved? Y N Is there a language barrier betwee inspector&QFO? Y N If ves indicate language spoken List products cooled: by QF01DA: ♦Can the QF01DA read the inspection report? Y N Describe cooling methods: Indicate who answered the a ve questions:Name(print): Indicate the title of above pe o (circle all that apply]:QFO DA Mgr Cook Owner FW Is cooling monitored for time&temp? Y N Is the monitori g of cooling recorded? Y N .Obtain sign u e of erg ho received the QFO responsibilities information at the time of the /� " Is There—a produce washing policy? Y N *Describe what is washed and nspection: where: Note: This report is a two ge form(total of 62 debitable items) Page 1 of 2 �..,. -,� E " r CUT D_PA NT OF PUBLI.G tHEALTH 41 Q°CApll OL AVENUE-'MS#51 FDP=FAA t FdF21],CT 06134 CONNECTI RIME FOC�Is FOOD S)CRtrICE YNSPECTT0N REEURT «LtAL HEAL1'W DEFT; Yf1.. ADDRESSICITeY � --�r za Es#ablllshment C D®vrt� '".S. '' Date of Inspection: t Address. /7r ! L'7 Owner or:Operatdr:. ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. -Unwrapped foods not reserved 4 31 Sewage disposal approved. 4 -Potentially hazardous foods not re-served -Operating as required 74 No cross connections,back siphonage,backflow 11 Toxic chemicals. 4 4 Proper tvoelinstallationlbackflowpreventiondevice/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -San itizerconcentration 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 Prover 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 t AM ` KEY: DNC [DOES NOT COMPLY] z 2 Sources of food: Original container,properly labeled 1 0 Garbage/rubbish storage area/rooms,enclosures-properlyoonstructed,clean 1 5 Potentially hazardous food property thawed 2'; 41 Garbagelrubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 2 Vermin Control: No insects/rodents present z 14 Food worker:Clean outer clothes,effective hair restraints 1" 3 Outer openings protected against entrance of insectslrodents 1 -loors: Floorcovering installed,constructed as required,good repair,clean 1 -� 16 Food-contact surfaces designed,constructed,maintained,installed, Floors graded,drained as required located 6 too n ure covered _ 17 Nonfood-contact surfaces designed,constructed, maintained, 7 Mats remove e,goad repair,glean installed,located 8 Exterior walking,driving surfaces,good repair,clean 1 18 Single service articles,storage,dispensing 2 19 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, 50 Dustless cleaning methods used,cleaning equipment properly stored 1 maintained installed located Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required 1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors F 2 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required " 231 Accurate the rmometersprgvided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1 27 Nonfood-contact surfaces of utensils&equipment clean 1 55 EstabIishment and premises free ofIifter,noinsectlrodenlharborage, r•;1 28 Equipment/utensils,storage,handling 1 no unnecessary articles x 32 Proper disposal of waste water 1 5 61 Complete separation from living/sleeping quarters and laundry �1 33 Plumbing location,installation,maintenance 1 57 Cieanlsoiled linens stored properly 58 No live birds,turtles,or other animals(except guide dogs) 1 36 Toilet rooms enclosed with self-closing door 1.6 59 Seats 75 ormore:Nonsmoking area provided,sign(s)posted at 37 Proper toilet fixtures provided,good repair,clean enirance(s),smoking area indicated by sign(s) 3 39 Approved garbagelrubbish containers,adequate number,covered, 1 rodent proof,clean outine inspection ©Reinspection ❑ Preoperational Inspection F=ARGE: Other Inspection: Demerit Score: •Include demerits from page 1 4 3 2 1 Total Rating 1 nature signature L 4tLlA ) prin name print name I �� V � / tltiec DATE CORRECTIO S DUE: / L phone number ��, Sat Page 2 of 2 plus continuation pages Focusedrnspece inooz Page—/—of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION Alc INSPECTION REMARKS FORM# r Q. t dl .- 446 -77 INITIAL(INSPECTOR) d� INITIAL(PERSON IN CHARGE) . Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Pagq=,)_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# b 4v(r - INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager