HomeMy WebLinkAboutFood Service Establishment Inspection 60 (12) ., v
Establishment: fcat, S Inspection Date: Time: oinsp E[nsp
Address/City: 1,961 w oT Heath ept: Class; 1 2 64
,44
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 NIO NIA JDNC I KEY: C[complies] N10[not observed] N/A[not applicable]
=80Quahfled F40d Operator 4 '� DNC[does not comply] 0[other] RTE[ready-to-eat]
3 12 Personnel with infeot estricted k _; C ISO;,NIA
M
`6t �esjgnetedAltei pate � a, 2 ., _.. _ onr
A Food workers have no exposed infected lesions/burns
,62J.,Vrlttdn docbmentation of training pri geam i 2B personnel with infection restricted
�1r Approved'-sb' rce,wltoles0me,�n0nadul#eMed ,r a a C N/or NIA 4 C Communicable disease of worker reported to local health director
A Approved shellfish,finfish;meat&poultry USDA approved t r4,hjn )III, Clea, andWiinggaes pw ILrr 0 N/A 4;
B Food cans in good condition(not dented,rusty,bloated,leaking) A I Handwash facilities in all food pr spensing&warewash areas
C Wholesomelnonadulterated foods/safe B Handw facilities i or i el latent to toilet rooms
D Commercial products(no home grown/canned food) C Han sh fa ,l on nie use
E Potentially hazardous foods received at proper temperature V D Perso nel hands wash
eaelegF 1 Proper wash procedure
E Handwashing a ppropriate times
Potentially hazardous food rrne6ets temperature requilie ents� C hUO,k .A� 0
duking storage preparation,,dlspiay,service and transporatton; m
�' �' a 't. `.c r x r. "`�` �5; �'a00d�h/gl e n IC-praCtIC@S +a=-=e(,'s N10 2�
K WA4
A Hot holding greater than or equal to 140OF. (whole beerlpukroasts 1300F.) A ❑ No eating ❑ No smoking while working
B Cold holding less than or equal to 45 F. B Wounds covered adequatelyf'
C Proper cooling C Proper sink used for handwashing
D Proper re-heating X 0
E Proper internal cooking I consumer advisory posted 24 80gitlzatr a o h
, 0n N LA 2
Approved sanitizer available/adequate concentration of sanitizer
iYequate'�#a0ihtig>�to,
R'1 ,'"" Food-contact surfaces and utensils used for potentially
� �� (3��Nl'Oa ¢
y s hazardous food sanitized at least eve 4 hours
mperatu ,theiimometersrprovided� - every_
thermometer C Adequate ❑dishwasher sanitizer ❑final rinse temp
A Food
D I Proper sanitizin rocedure
B Properfoodthermometerforp'roduc#
E Sanitizing between raw animas origin&ready-to-eat food
C Thermometers appropriately placed in cooler units 0
0 75' 'Pwanivi in }cl'th" i Cn PUQ +JIA
4aT-mgk ,`k g,
sT �Fooc pro e�tedl'c� rIng storage,�prei a a ton, C, ► A 1 ?, A Cloths and/or in good repair and clean e j 10fsl4�, etrvatce and transportatonR �$ p#.
B Wiping cloths kept in sanitizer between uses
A Produce washed 0
B Raw meats not stored/prepared near ready-to-eat foods 4 4 s4ftaibes4clean " �' Nis N177 Av g
C Food covered properly kA Food equipment clean,utensils clean,equipment interiors clean
D Adequate splash guards/sneeze guard j( B Single use gloves changed when soiled
E No unauthorized personnel IC C Food--contact surfaces clean
F No pooling of eggs not cooked immediately hi 0
8 Food containers stored off the Floor R` ° °'
3D� Ft t ah�csltl Wafer uncer�pressurer povidel as reurred'�
A M
� � # k A
0 39 lHandwashin accessorWi orc�vtdeU'
9Handlin +Of fCOdfit111niml2ed w - a
t!(� A.°2 A Soap 1 paper towels 1 drying device available
A No unnecessary handling RTE and/or cooked foods with bare hands B
Dispenser(s)working: ❑Soap. ❑Papertowel
B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean l waste receptacle at handwash sink
C Adequate utensil(s)fordispensing 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: 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 Pork What diseases related to F6 illness ar you required to report to the local health department?
Roasts Other
Describe re-heating procedures: Is there a written illness policy the equires the food worker to report specific illness conditions
Are temperatures recordedilogged for cold holding foodstequipmenw Y N and diseases to the QFO? Y ♦Do you have a paid sick leave policy? Y N
Are ods cooked in advance and cooled? Y N +Are le vers saved? Y N Is there a language barrier etween inspector&QFO? Y N If yes indicate language spoken
List products cooled: by QFOIDA: *Can the QFOIDA read the inspection report? Y N
Describe cooling methods: Indicate whom wered the above questions:Name(print):
Indicate the title of above persoYffe
all that apply):QFO DA Mgr Cook Owner FW
Is cooling monitored for time&temp? Y N Is ttidmonitormg of cooling recorded? Y N .Obtain signal of th arsonived the QFO responsibilities information at the time of the
Is there a produce washing policy7 Y N ♦Describe what is washed and inspection;
where: Note: This report is—a two fte form(total of 62 debitable items) Page f of 2
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ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served.
31 Sewage disposal approved.
-Unwrapped foods not re-served
-Potentially hazardous foods not re-served -Operating as required
No cross connections,back siphonage,backflow
11 Toxic chemicals. �4A Proper typelinstallation/backflow prevention device/air gap for:
-Stored properly,labeled properly,used properly
-Food equipment -Nose 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
Pesticideslrodenticides properly dispensed proper drain for: b
29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines ,
-Well!well head protected from contamination r 35 Toilet facilities. Adequate,convenient,accessible, 4_
-Water quality in compliance 0
-Monitoring in compliance designed,properly installed
I �
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
2 Sources of food:Original container,properly labeled 40 Garbageirubbishstoragearea/rooms,enclosures-properly constructed,clean *ls
5 Potentially hazardous food properlythawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency
10 Food dispensing utensils properly stored 42 Vermin Control: No insecfslrodents present
14 Food worker:Clean outer clothes,effective hair restraints =1" 43 0 ter openings protected against entrance ofinsectsirodents
Odors:Floor covering installed,constructed as repair requiZ , o d clean
16 Food-contact surfaces designed,constructed, maintained,installed,
S Floors graded,drained as required
�.�- r
located
6 Floor,wall juncture covered p
17 nfood-oontaclsurfacesdesigned,constructed,maintained,
7 Mats removable,good repair,clean �
installed,located ,t
g 8 Exterior walking,driving surfaces,good repair,clean1
18 Single service articles,storage,dispensing 2 � u
19 No reuse of single service article i 49 Walls,ceilings attached,equipment properly constructed,good1
repair,clean.Wall&ceiling surfaces as required
20 Dishwashing facilities approved design,adequately constructed, Pi
inslalled located
50 Dustless cleaning methods used,cleaning equipment properlystored
maintained
Equipment&Utensils: Cleanliness 51 Adequate lighting provided as required
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors
22 Wash water clean,proper temperature t'
� 53 Rooms&equipment hoods,ducts,vented as required � .e
231 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1
W .1
27 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises fraeof fitter,no insectlrodentharborage, 1.
28 Equipmentlutensils,storage,handling �31; no unnecessary articles
32 Proper disposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry
I _
57 Clean/soiled linens stored properly
33 Plumbing location,installation,maintenance
58 No live birds,turtles,or other animals(except guide dogs)
3 Toilet rooms enclosed with self,cloa'm door 37 r -
Proper toilet provide ,good repo' clean a
59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at
entrance(s),smoking area indicated by sign(s)
39 Approved garbagelrubbish containers,adequate number,covered, ,',
rodent proof,clean ( Routine Inspection ❑Reinspection ❑ Preoperational Inspection
PER N IN C A E: Other Inspection:
Demerit Score: *Include demerits from page 1
4 3 2 1 Total Rating
signature JWignature
p. me print name
L� DATE CORRECTIONS DUE:
'phone number
f title
Page 2 of 2 plus_L-continuation pages Focused Inspection 1l2002
Pagel Of
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INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF SPECTI N
INSPECTION REMARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) A V
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Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager