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HomeMy WebLinkAboutFood Service Establishment Inspection 29 (8) Establishment: OW SUS) Inspection Dater G Time: I ; RO[nsp REtnsp Address/City: f/' j::9 � Heath Dept: class: 1 2 36, 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 N!0 NIA JDNC I KEY: C[complies] NIO[not observed] NIA[not applicable] 60 Quailfted F460`O06Yatof 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 12 Pers'onhdt, ith.Infection restricted= 81 esignated Altornate- 2 C NrA•AA Food workers have no exposed infected lesions J burns 62 Written documentation:aft 2 B Personnel with infection restricted te Approved source;wholesome,nonaduiterated C N10 NIA '4 municable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved Af 13 'Ha dwashmg fac[lit[es p►avided,hands washed,clean C NIO A 4 B Food Cans in good Condition(not dented,rusty,bloated,leaking) -- 'Handwash facilities in all food prepidispensing&warewash areas C Wholesomelnonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities accessiblelconveniant to use E Potentially hazardous foods received at proper temperature D Personnel hands washed, clean!Proper handwash procedure E Handwashing at appropriate times 3 ', otehfially haia�dous;ftiod rntiets temperature roqPir, M[j& N!0 4 during storage,preparation;tlisplay,service soil transport ion,. . i hYgle cxpra G NJO': N/A: 2 15' Good, nll ctices A Hot holding greater than or equal to ldF. (whole beeflparkroasts 1300F.) Ael I A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to45aF. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing 4-1 D Proper re-heating E Proper internal cooking/consumer advisory posted 4 a #iia#tonsil ee,{hotwater!-chemicaE) i ; £!A 2 ,., : 0 A Approvedsanitizeravailableladequateconcentrationofsanitizer ¢ ' Adequate;?��diittje fo,rnain aim product; ,�h' C �110 NJA ':2 $ Food-contact surfaces and utensils used for potentially temperature;thetrmortte#ers providd hazardous food sanitized at least every hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp �. B Proper food thermometer for product D Proper sanitizin rocedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in coolerunits r 5 4 eah wtptng /oohs a C ;W h Fo dApro#gcfpd durJtgstrage�pr I'lleparatlam,° C N/0 'N k` a. •, s Ala service and trap fi oh Cloths and/or sponges in goad repair and clean - . : " B Wiping cloths kept in sanitizer between uses A Produce washed 0 > • B Raw meats not stored/prepared near ready-to-eat foods a6° iwo contact surfaces;clean C Food cove properly red 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 thefloor N• z Y 30:: n8 r7old waerxundir pressure,provided as required. iNl N1A 2 F:V r:Si i:hY •,F'7 f. ?•. - 1 k. . J A,.: i!:F. 0 �"H dwshing t>(t cessones pi ovtded :9 38 9 ,Handlingckfocfirrninimize! 3 N.0`NIA f I ' ` oap p er towels!drying device available A No unnecessary handling RTE and/or cooked#oods with bare hands ,B penser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready io eat,with bare hands C Handwash sink(s)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing foodlice 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 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 illness policy that requires the food worker to report speck illness conditions Are temperatures recorded/logged for cold holding foedslequip ent? 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 fe leftovers saved? Y N Is there a language barrier etween inspector&QFO? Y N If yes indicate language spoken List products cooled: by QFO/DA: *Can the QFO/DA read the inspection report? Y N Describe cooling methods: Indicate who answ ad the above questions:Name(print): Is cooling monitored for#line&temp? Y N s the monitoring of cooling recorded? Y N Indicate the title f above person(circle all that apply):QFO DA Mgr Cook Owner FW Obtain signet re of the person who received the QFO responsibilities information at the time of the Is there a produce washing policy? Y N ♦Describe what is washed and inspection:��=�f' _�. where' Note: This report is a two page form (total of 62 debitable Items) Page 1 of 2 STT C©NNEET ICUT' pEPARTMENT QF ?fJBLIG HEALH1t)CARI1`OL AUEtVUIIS#51 FDP-WARTFOR ;CT�163 ` F,OC17SED FOOD,SERUIC aI 1SmIc"nQN REP0RT k '1'1f1DE0T:; ITY: Establishment = Date of Inspection ddress `/ e6 Qwnernot Operator: G✓ / ° ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] Z o.j 6 Foods not re-served. -Unwrapped foods not re-served 4 31 Sewage disposal approved. 4N' -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow 4 4; Proper tvoeliostallation!_backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -5anitizerconcen#ration not to exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pest!cideslrodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines a< -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 _ KEY: DNC [DOES NOT COMPLY] ®, 2 .9D ces offood; Original ontainer,properly labeled >;• 0 Garbage/rubbish storage area/roorns,enclosures-properly constructed,clean f �_ f 5 Potentially hazardous food properly thawed 41 Garbage/rubbishdisposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 42 Vermin Control: No insects/rodents present =2 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected againstentranceofinsects!rodents l' 4 Floors: Floor covering installed,constructed as required,good repair,clean 1 16 Food-contact surfaces designed,constructed,maintained,installed, 2 45 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 1' € 7 Mats removable,good repair,clean installed,located 18 Single service articles,storage,dispensing i2 8 Exterior walking,driving surfaces,good repair,clean 1 19 No reuse of single service article t 9 Walls,ceili s�att equipmeLLi roperlyconstructed,good 1 repair,cle all&ceiling surfaces as re fired_ 0 Dishwashingfacilities approved design,adequatelyconstructed, wZ maintained installed located 50 Dustless cleaningg melho s use ,c eaning 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 olean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required rate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 27 food-contact surfaces of utensils&equipment clean 1 55 Establishment and pre mises free ofIitter,noinseGYrodentharborage, 8 Equipmentlutensils,storage,handling no unnecessary articles , k. 32 Proper disposal of waste water Fly, 56 Complete separation from living/sleeping quarters and laundry k- , N� 33 Plumbing location,installation,maintenance1, 57 Clean/soiled linens stored properly 36 Toilet rooms enclosed with self-closing door 58 No live birds,turtles,orother animals(except guide dogs) t 37 Proper toilet fixturesprovided,good repair,clean 159 Seats 75 or more:Nonsmoking area provided,sign(s)posted atentrance(s),smoking area indicated by signs} 39 Approved garbage/rubbish containers,adequate number,covered, T rodent proof,clean L_J ❑Routine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: PE OR: PERSON IN C-kIARU: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating lure rint name t name ' phone number DATE CORRECTIONS D E: titlg - c Page 2 of 2 plus continuation pages Focused Inspection vzooz Pa e of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF PECT ON INSPECTION REMARKS FORM# 0 r //f r o� l 3 � . INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distri•ution: 1st-White-Health Department 2nd-Yellow- O er/Manager �,�>, M I am Pag L, INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INS7,t, TION - INSPECTION REMARKS FORM# 71� 94�& INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White- ealth Department 2nd-Yellow- Owner/Manager