Loading...
HomeMy WebLinkAboutFood Service Establishment Inspection 12 (15) Establishment: Lv_;�j,�pr_� 6 :�. � r-lnspecti0n Date: 5 / / Time: It 'nsp insp Address/City: / /mil; mil ([ SrHealth apt: TL � �� class: 1 2 Based on an inspection this day,the items marked DNC identify the violations in operation orfacilities 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 N/A JDNC I KEY: C[complies] N10[not observed] NIA[not applicable] 60 Qualified"FogtlOpe�dtor g ` DNC[does not comply] 0[other] RTE[ready-to-eat] "� ` '12 Persopnef with infection,restricted C NIP, NIA., 4 B1 ;DestgnatedAltematt#• 2 A Food workers have no exposed infected lesions 1 burns 62 Written documerffatioh oftraming program 2 ` B Personnel with infection restricted 1 IApprpved source,wholesome,eonaduiferated C ;N/0 NIA i4 C Communicable disease of worker reported to local health director A I Approved shellfish,finfish meat& oult USDA approved 113 Handwashtng factltttes ptbv(ded,.,harids washe'd,clean i C NIO ;NIA'i4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepfdispensing&warewash areas C Wholesomelnonadulteratedfoodslsafe B Handwash facilities in or immediately adjacent to toilet rooms Q Commercial products(no home grown/canned food) C Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature k D Personnel hands washed,clean I Proper handwash procedure 0 _ Handwashing at appropriate times P` ,ntlal[y hazardous food meets t_zlefrn erafure re uirements T f Nl0 ,4 k tlurupg storage,pre�raratton;;diaplay=semicezand tra aportabon_ ; = G rid hY9 �ernc practices 'w01 2 A Hot holding greater than or equal to 140 F. (whole beerrnor&,onts130P F) A' ❑ No eating nµ ❑ 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 A Proper re-heating E Proper internal cooking/consumer advisory posted 124 itiz tr0iln,se (hot water, '1 m4-al) C N10 !A 2 .x ,.. he Approved saniUzeravailableladequate concentration ofsenitizer iE6A a uate a 1I(]es3to'kmalnta=rt rotluc ' �q �, 4 � r � �e�.�.�� �� � �: �= C h!!0 I =2 Food-contact surfaces and utensils used for potentially pera ure etsnpgmeters;ptaavtt d hazardous food sanitized at least ever ,4 hours :"....�L. _....:..i.. v.. ..4.::k' -P`-#.,u. :. ""'"" kz. Food thermometer available and accurate C Adequate ❑dlshwashersanitizer final rinse temp B Properfood thermometer for product D Proper sanitizin procedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0-1 n=ufrprn cloth k prod prote �rdurtng�storage; ;rap 'Fatii3n t '� G INTO N! Y s" x gr Y _ �s d�s: i�ttf�strnvtc�a�a�i�lrertsporf4atls�nw� �• �� r. � ` "'` `` A loths andlorsponges in good repair and clean A Produce washed B Wiping cloths kept in sanitizer between uses B Raw meats not stored/prepared near ready-to-eat foods �!contacts nfa es dear „"p; c F : 'I INIG 2 C Food covered properly od 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 cleanIlk F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor 30f•' At and col water:under pressure[�rOYJ�d d as r qurr d EN[0-NIA 'l l 0 38; andwashmg accessorte§grovtded h C aIW N/ i _ . (9'" S t'ndhn ti apdimtntmtzeot C kNIO INIA t g`" ' " '" """Y r" " ' M X Soap pa r towels!drying device available A No unnecessary handling RTEalor cooked foods with bare hands enser(s)working: ❑Soap ❑Paper towel B Minimize food hand I!ngoulier than ready-to-eat,with bare hands C Handwash sink(s)clean/waste receptacle at handwash sink C Adequate utensil(s)for ciispensingfood/ice p 0 1 •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. 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 a you cook: Poultry Ground Beef Par What diseases related to FS illness are you required to report to the local health department? Roasts Other Describe re-heating pro edures: Is there a written illness policy that requires the food worker to report specific illness conditions Are temperatures recordedilogged 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 I ovens saved? Y N Is there a language barrier between inspector&QFO? Y N if yes indicate language spoken List products cooled: by QFOIDA: 4 *Can the QFO/DA read the inspection report? Y N Describe cooling methods: 4 Indicate who an ered the above estions:Name(print): Is coaling monitored for time 8 temp? Y N Is 1h monitoring of cooling recorded? Y N :ndicate the title of a ve person cle all a apply):QF�A Mgr Cook Owner FW Obtain signature of a arson cei d t QF re onal ilities information at the time of the Is there a produce washing policy? Y N *Describe what is washed and inspection: where: Note: This I two page rm(total o 62 debitable items) Page 1 of 2 STATE:OF CONINECTIOTIDEPARTMENT OF PUBLIC IWEALTH-410 APIT%AVENUE`�I f #51 FDP-HARTFORD,CT 06134 OC1]SE7] UOD SEii VICE 1i P CT€)1Y 1[tEPf)RT m LOt;AHFALTH DEPTH A©DRES.SiCITY .�, - Establlshment: -riW, Date of lnipectlon' Ll .. .. Address: _� ;Owner or Operator: ADDITIONAL POUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not reserved. -Unwrapped foods not re-served 4 31 Sewage disposal approved. 4 -Potentially hazardous foods not re-served -Operating as required 74 11 Toxic chemicals. No cross connections,back siphonage,backflow A. 4 Proper type/installation/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 foxics an 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 -Waterquality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS z ; C: KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 40 Garbagelrubbishstoragearealrooms,enclosures-property constructed,clean 5 Potentially hazardous food properlythawed 2 41 Garbage/rubbish disposed of in an approved manner,at approved frequency (° I 10 Food dispensing utensils properly stored 1 C Ve in Control: No insects/rodents present 2 14 Food worker:Clean outer clothes,effective hair restraints ;1 Ou eropenings protected against entrance of insectslrodents 1 Floors: Floor covering installed,constructed as required,good repair,clean 1 d-contact surfaces designed,constructed, maintained,install 5 Floors graded,drained as required "� located 6 Floor,wall juncture covered 17 N f atl contactsuriaces designed,constructed,maintained, 1? 7 Mats removable,good repair,clean installed,located 48 Exterior walking,driving surfaces,good repair,clean 1 1$ 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, 2R maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensilsi Cleanliness 1 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors .1:.` 2 Wash waterclean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 23 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean NJY' 27 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of lifter,no insectlrodentharborage, P: 28 Equipment/utensils,storage,handling ; no unnecessary articles 32 Proper disposal of wastewater 56 Complete separation from livinglsleepingquarters and laundry ,t ` 33 Plumbing location,installation,maintenance 1 ri 57 Clean/soiled linens stored properly 1K- 58 No live birds,turtles,orother animals(except guide dogs) 1 36 Toilet rooms enclosed with self-closing door i 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 3 37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated bysign(s) 39 Approved garbage/rubbish containers,adequate number,covered, `1' rodent proof,clean ❑Routine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTOR: 'PERSON HARG Demerit Score: •Include demerits from page 1 07 J�j All 4 3 2 1 Total Rating signature r print namerrn ,-� , DATE CORRECTIONS DUE: ��� phone number title c41ky— l Page 2 of 2 plus continuation pages Focused specdon 112002 Page / of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF NSPEQTION INSPECTION REMARKS FORM#f o "� - c-J2 2d& � d V/// .4 99 derG Emp: Fmpteado BAA7UBNSORANGE VVV rsumuucuuoouwmu AMU MAMLOMwu /1180°Frn-c bo c� c� INITIAL(INSPECTOR) 4z Zzl� INITLAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager Page�,j INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION � v7h� wi�BS� INSPECTION REMARKS FORM# e s 44 AL-,el' ie, L74 "::j� 100, , ®I—t.c� v ZZ► INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: I st-White-Health Department 2nd-Yellow-Owner/Manager