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HomeMy WebLinkAboutFood Service Establishment Inspection 10 (35) Establishment: 's fS inspection Date: Time: ROins_ El Address/City: /vo /2)&_O—LrL, Ag?e, 2:> Health Dept: , r,a,riv)SSv, Class: 1 2 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 NIO NIA DNC . KEY: C[complies] NIO]not observed] NIA[not applicable] A, Qua]ifled Eoo (pirator , ' u s 3 DNC[does not comply] O[other] RTE[ready-to-cat] 12 _ Personnel with infe t[o restricted C N161 WA '4 r�natedjAlternate 2 �, ,. :... f.�.z • ,� >,. 2 Food workers have no exposed infected lesions 1 burns ritten documentation of trammg progim Personnel with infection restricted A wr0eF wholesome,nonadu(terafeda L C N NJAIO 4 C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved Al13i Mindwashmg�facdlbes proufdptl hands washed clean C' B Food cans in good condition(not dented,rusty,bloated,leaking) k' ,..x lVh ` 4 A Handwash facilities in all food p iclispensing& arewash areas C Wholesomelnonadulteratedfoods/safe B Handw 'facilities in or ipyodlately adjacqint to toilet rooms D Commercial products(no home grown/canned food) C Hand ash ellities ac es co nient to use E Potentially hazardous foods received at propertemperature D Per nn n. d, I P per handwash procedure Han ing it appro a e 4 ote tially ftazardous}foodrme#%,tefiiperaturerrequiremerits; ¢ ing storage preparation,display,xservlce dridatrarisp0 fitign JA otl+In enic.pracErceS: Uk­ A Hot holding greater than or equal to 140 F. (whole beeupork masts iaao F) . A ❑ No eating ❑.No smoking while working B Cold holding less than or equal to W F. B Wounds covered adequately C Proper cooling C Pro a ink used for handwashing D Proper re-heating S 'nftization rinse(ho.Ewaer cl ®micas C ill , k E Proper internal cooking 1 consumer advisory posted k .,, . ,. _ _ 4 ; . . .-- A n mfedsanitizeravailableladequateconcentrationofsanitizer 4 Zi dequate factPitfes;to mafntam product y f. �C :N1Q Nl Food contact surfaces and utensils used for potentially ` 'Cerrnie°ratre thermometers prowled r;k e ' * . .; w hazardous food sanitized at least every4 hours A Food thermometer available and accurate C Adequate Ashwashersanitizer Ofinal rinse temp L Proper sanitizin rocedure H Proper food thermometer for product E Sanitizing between raw anima[origin&ready-to-eat food C Thermometers appropriately placed in cooler units k' 0 CI n.wtprngGcloth a r g v vC Ew , ..,:: : .+{K x , .f: ,a t ax s u ,'�, t :a�a� X•* ,: a t' god;ProteFetlAd4�l �9erP Pal .t �l:tern, �C3 NIO NI tli§ to service and trans ,or•atAh k o a, �:: A Cloths andlorsponges in goad repair and clean P T..r•t•.ae.{3 Wt t45''3,'kM rN' 2E�.,C:.i...� B Wiping cloths kept in sanitizer between uses A Produce washed B Raw meats not stored/prepared near read -to-eat foods * �, •et '�" 4 y y. gott�sti Fadeslisleanir,v,r. •:., r C Food covered properly Food equipment clean utensils clean,equipment interiors dean 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 & p S Food containers stored off ihe.floor "'" 4 z' 'ctsid'�rater Under pressure,:provlded as requtr'94 01T.N/. N�1� .sGrIYx2 ._...r.... ,: fia washing accessories prcvdpd;' " * r 4 C- N o., 1{andling.pf, o rnrmtzed at, as= C AN.C WAS o4k — 'Toap I paper towels I drying device available A No unnecessary handling RTE andlorcooked foods with bare hands B Dispenser(s)working: ❑Scap ©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 foodfice 10 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 ifoodborne] 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 illness are you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illne policy that requires the food worker to report specific illness conditions Are temperatures recordedfiogged for cold holding foods/equipment? Y N and diseases to the FO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are leftovers ved? Y N 6 Is there a langu a barrier between inspector&QFO? Y N Ifwes indicate language spoken List products cooled: by QFOIDA: *Can the QFOIDA read the inspection report? Y N Describe cooling.methods: Indicate who answered the a uestions:Nam (pri t): Indicate the title of abovupalrsohloil II that ap OA Mgr Cook Owner FW Is coolingmonitored for time&temp? Y N IS the'monitoring fcooling recorded? Y N +Obtain signature h wed he re nsibilities rmation at the time of the Is there a produce washing policy? Y N *Describe wh is washed and inspection: where: Nate: This report 1 a two pa a form(total of 62 debitable items) Page 1 of 2 f f -. .� r b ate�talnp� t�on 5N n Caw er, Cfpe oratol .�,.err, r ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. -Unwrapped foods not re-served `�4� 31 Sewage disposal approved. -Potentially hazardous foods not re-served -Operating as required " 11 Toxic chemicals. r 34 No cross connections,back siphonage,backflow 't,' 41 -Storedproperly,labeledproperly,used ro erl Pamper typelinstallationl ckffow prevention device/air g�for: properly y �' P -San itizer concentration notto exceed maximum permitted ; -Food equipment -Hose connections -Dish machines -Soda system carbonator -Beverage dispensers -Toilet tanks ". -No unnecessary toxics on the premises , -Pesticideslrodenticides properly dispensed -Chemical dispensers -Ice machines ; i a'h Proper drain for: 29 Water source adequate,safe. -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 ta 0 Garbagelrubbish storage ar4rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properlythawed fL 4 bage/rubbish disposed of in an approved manner,at approved frequent 10 Food dispensing utensils properly stored E 42 Ver m Control: No insectslrodents present v�` ' 14 Food worker:Clean outer clothes,effective hair restraints �1 uter openings protected against entrance of insects/rodents ors: Floor covering installed,constructed as required,good r air, can 16 Food-oontact surfaces designed,constructed,maintained,installed, 5 Floors graded,drained as required ` ted � - 6 Floor,wall juncture covered 17 Xonfood-contact surfaces designed,constructed,maintained, 7 Mats removable,good repair,clean installed,located i L 18 Single service articles,storage,dispensing yL 8 Exterior walking,driving surfaces,good repair,clean 1 19 No reuse of single service article It 49 Walls,ceilings attached,equipment properly constructed,good 1= clan.Wall&ceiling surfpces as required E 20 Dishwashing facilities approved design,adequately constructed, E1.1 maintained installed located = 50 l7 less cleaning methods used,cleaning equipment property stored 1 Equipment&Utensils! Cleanliness 51 Adequate lighting provided as required i 21 Preflushed,scraped,soaked and racked S2 Room tree of steam,smoke odors 22 Wash water clean,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 27 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premisesfreeof litter,noinsectlrodentharborage, 1 28 Equipment/utensils,storage,handling s i � no unnecessary articles � erdisposalofwastewater ¢ ' 56 Complete separation from livingisleeping quarters and laundryAT , 57 Clean/soiled linens stored properly 33 Plumbing location,installation,maintenanceF14 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door a 37 Propertoiletfixturesprovlded,good repair,clean 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at entrance(s),smoking area indicated by signs) . 39 Approved garbage/rubbish containers,adequate number,covered, (1k ' rodent proof,clean s outine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: N Demerit Score: •Incllude demerits from page 1 4 3 2 1 Total Rating signature n u p Rt name print rIl �� "� �`� DATE CORRECTIONS CrZ phone number title Page 2 of 2 plus continuation pages Focused Inspection 112002 Page Of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF IN PEC ION `SL7-11- W �/—/I /,� INSPECTION REMARKS FORM# Q Ej—,17 L - 43 i' f , -� --- G � w INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME ,OFJESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION REMARKS FORM# An- r ��� o ILe�21 StZ OR '�7 4. Z-el y 4 r - � INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager Page of 3 v,-ot,---v INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION REMARKS FORM# vr-)�. INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager