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Home My WebLink AboutFood Service Establishment Inspection 60 (13) 01 Establishment: /�� 7—ia,Vs Inspection Date: / Time: RO[nsp� REins Address/City: % B1D 064j- i,¢—�j Health ept:��,�� e�.r roc►bSt,�_ Class: t z 4 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 N1O ITA DNC KEY: C[complies] NlO[not observed] NIA[not applicable] Q �Qito te,�fo 'w A" s 3 DNC[does not comply] O[other] RTE[ready to eat] " $ 2 Pere n I rtftiinfectivn resrct tl �C�kNl A4 fl G1tDesi natedA{fernate r641 re�� Q ma Q _.... aft �m_�___ _ _ ...�a.. e4 $4 4; Food workers have no exposed infected lesions!burns 1.62.1I41�r{tteri`aocutnentattori ofa#rarnlrtain ° a Cs N7QJ ` Personnel with infection restricted C Communicable disease of worker reported to local health director 1 A yaVed soGrce whbtesome,n, A Approved shellfish,finfish,meat&ppoultry USDA approved r� - 13 KFlandwashmg faGi tl ss�pp�o ed,l anc�sSrra h e r1 04 JAB B Food cans in good condition(not dented,rusty,bloated,leaking) a A Handwash facilities in all food prep/dispensing&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 accessiblelconvenient to use E Potentially hazardousfoods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure 0 E Handwashing at appropriate times 3 'MeiAli;fiAirdbuttfC'p '`e®tsui8n Pi "rat[{Ire��n�s�,,� !0 ' A� 14� O ditnng#atarage;preparattonF drsptay,;gervrca andtr8nsportation & o , € ;; #0 .1 r ,s_t:, �15 Go)dwhyg1eg!.Ct a ticeS atx e n .6sC 9 9 q ° A ❑ No eating ❑ No smoking while working �._ _.' �..� ,�_m,�..x : A Hot holding reaterihanore ualto140F. {whmeaeerrp°Acmeslstso°F.I B Cold holding less than or equal to 45 F. 8 Wounds covered adequately C Proper cooling I C Proper sink used for handwashing D Proper re-heating 0 4 nttizat�onin�sitwater `� e ) ' 7 A*21 E Proper internal cooking 1 consumer advisory posted -a. ,_ e �;___,s - _._ = Approved sanitizeravailable/adequate concentration of sanitizer .A er�at frl�tr� .to mintalnrp � Food-conact surfaces an utensils used for p , $Cll , Nl¢� 2 hazardoust tfood sanitized at least every 4 hours olentially peaaturefthehnometersr�vefC! = p 'A Food thermometer available and accurate C Adequate ishwasher sanitizer ❑#trial rinse temp D Propersaniizin procedure 6 Properfood thermometerfor product E Sanitizing between raw animal origin&ready-to-eat food Je C Thermometers appropriately placed in cooler units 0 S G eiQNTP �clbfihs �C 0•� � rd„ tying sto�ag '!° 141 c� i� _ . semrtce antlersy.,�iattyht a Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Vw meats not stored/prepared near ready-to-eat foods 0 fFebt1416h ae s Food.covered properly I L4r A Food equipment clean,utensils clean,equipment interiors clean Adequate splashguards 1 sneeze guard je B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean F No pooling of eggs not cooked immediately . k 0 8 Food containers stored off the floor 3 p of an�tcpwerrcrssureprANioe;arr ?NA 0 3$ _P aria('wsHiti�k�aibcessor]esprovtde `+ CNJpaNJ, s 1f li. OfObllnfriltZ�:� C:.,w i' �.` Soap J paper towels 1 drying device available A No unnecessary handling RTE andlor cooked foods,with bare hands k B Dispensers)working: ❑Soap aper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean J waste receptacle at handwash sink C Adequate utensil(s)fordispensing 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 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 ill s are you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illnes olicy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foodslequ' ent? Y N and diseases to the 0? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N re leftovers saved? Y N Is there a fang ge barrier between inspector&QFO? Y N If yes indicate language spoken List products cooled: by OFO1D . *Can the QFOiDA read the inspection report? Y N Describe cooling methods: Indic a who answered the above questions: Name(print): Indicate the title of above person(circle all that apply):QFO DA Mgr Cook Owner FW Is cooling monitored for time&temp? N Is the monitoring of 000ling recorded? Y N .Obtain signature of the arson who received the QFO responsi "' s information at the time of the Is there a produce washing polic . Y N ♦Describe what is washed and inspection: where: Note: This report is a two page form(total of 62 debitable items) Page t of 2 - a � � �• peg - . 4 4,4Date f.l�is opec i �i / _ 01 wn'er or_0 era tore- ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. .> -Unwrapped foods not re served 31 Sewage disposal approved. 4 -Potentially hazardous foods not re-served r, -Operating as required 7s No cross connections,back siphonage,backflow 11 Toxic chemicals. Proper typelinstallation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly k -Food equipment -Hose connections -Dish machines 8 -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. K a 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 40 Garbagelrubbish storage area/room s,enclosures-properly constructed,dean Q„ 5 Potentially hazardous food properly thawed 2:¢ 41 Garbagelrubbish disposed of in an approved manner,at approved frequency g 10 Food dispensing utensils properly stored 42 Vermin Control:No insects/rodents present 2 14 Food worker:Clean outer clothes,effective hair restraints rl 3 Outeropenings protected againstentranceofinsectslrodents 1 l z- . b loor Floor covering installed,constructed as required,good repaiiQea .i 16 Food-contact surfaces designed,constructed,maintained,installed, T5 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 5il 47 Mats removable,good repair,clean installed,located 48 Exterior walking,driving surfaces,good repair,clean 1174 18 Single service articles,storage,dispensing I;I lk 19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good �-:J repair,clean.Wall&ceiling surfaces as required "t" 1 20 Dishwashing facilities approved design,adequately constructed, maintained,installed located l _ 50 Dustless cleaning methods used,cleaning equipment properlystored Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked r 52 Room free of steam,smoke odors E 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 23 Accurate thermometers provided,dish basket,if used 541 Rooms adequate,clean,adequate lockers provided,facilities clean 1 4 27 Nonfood-contact surfaces of utensils&equipment clean z 55 Establishment and premisesfreeof litter,noinsectlrodentharborage, 1 28 Equipmentlutensils,storage,handling no unnecessary articles 32 Pro erdis osal of wastewater 56 Complete separation from living/sleeping quarters and laundry r P P � t 33 Plumbing location,installation,maintenance 3 57 Clean/soiled linens stored propertyto ` 58 No live birds,turtles,or other animals(except guide dogs) j< 36 Toilet rooms enclosed with self-closing door � 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet fixtures provided,good repair,clean entrances,smoking area indicated by sign(s) 39 Approved garbagelrubbish containers,adequate number,covered, rodent proof,clean I Routine Inspection OReinspection 13 Preoperational Inspection 9her Inspection: PE Demerit Score: +Include demerits from page 1 A 4 3 2 1 Total Rating si nature si nat r priant name riot name _ /� I C �� J OG��'`�`��"� DATE CORRECTIONS (DUE: lor dt phone number 111 Page 2 of 2 plus continuation pages Focused Inspection 112002 Page Of 4, INSPECTION REPORT STATE OF CONNECTICUT �2 FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTIO V O° {.)T13t INSPECTION REMARKS FORM# s ,. M a— m - .4 19 F --- .� N ram~ G J INITIAL(INSPECTOR) INITIAL gERSON IN CHARGE) // Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager 11� y �0 Pag of t,-ui_x INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF TNSPE TION - INSPECTION REMARKS FORMWave # eLJ �Y CR �G . � r INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager