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Home My WebLink AboutFood Service Establishment Inspection 83 (8) Establishment:-j:jL1 ,67- ° -ct,c inspection Date: Time: Ro` ins .-fiE[n ddress/City: Health Dept: !�A,1T.4 Gi-c✓7GTe Class: t 2 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 1 N10 N/A DNC KEY: C[complies] N10[not observed] N/A[not applicable] ab ,Qualified FoodKQperator a + *s" 4 1�-4'''Al 3 DNC[does not comply] 0[other] RT£[ready-to-eat] T "" v I,""% ` F " �' fit ;'Pe",r,"Sorrel yrith infection r, err t d 4+1 Me"st na ed Alte ate.; 2 r 9 A Food workers have no exposed infected lesions!burns 62` Written�oclimentet oh of tralr 1h9,"prog vain # _; r 2 B Personnel with infection restricted 1 Approved source,wholesome,ionadulterated s t (:, NIO N! _ C Communicable disease of worker reported to local health director A Approved shellfish finfish meat&poultry USDA approved i 3° tsfantlwashmg facilities prouided,shandstvashed clean C ; B Food cans in good condition(not dented,rusty,bloated,leaking) ' A Handwash faddities-in all food prep/d"eAe&w wash areas C Wholesomelnonadulleratedfoodslsafe B Handwash f sin or i me ' I 'ac oms D Commercial products{no home grown/canned food} C Handwa 3t' s ssy I 1 on use E Potentially hazardous foods received at propertemperature D Perso el hands son!Proper and ash procedure Hand shin t appropriate tlm 3 ntlalEy hiazaCdous food ttte�ts temparatuie feulreh#entN i irig s oi;i preparation,display*service*and trail;portat(nr f' 4 b h r 1:5 ;GOOtl iil}rgl@nic practices , f; 2 s. .. A. A Hot holding.greater than or equal to 140 F. (whole beevporkroasrs i F) A ❑ No eating ❑ No smoking while working B j Cold holding less than or equal to45°F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking lconsumer advisory posted Y24SanitiafiorirrriSeM{hotwater achem"ioal� 0 A Approved sanitizeravailableladequate concentration ofsanitizer 4' r:Adequatefaarlltieseto mair%tain,productm v + C NfO NIA ro2 g Food-contact surfaces and utensils used for potentially ' temgerature, hermblinp ems p yid d * .k a}` hazardous food sanitized at least every 4 hours _ >. : __. . .. A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper B Proper food thermometer for product Pro ersanitizinrocedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in coolerunits 0 i f Yd "m•'Y L t 4{ iY''-6 :t a #F lie':• 1 �• x x :C�estnywt[�ing C NIO: N/A 1 :. OOd protectedadur•ing,storage,spteparail-on,t. Z k, 82 'tl ii`t#y `s �tvfce4antl trenspot t it n w ,u A Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Rawmeats not stored/prepared near ready-to-eat foods Z 2&Todd"c''on4L_.t#s.r�fAV'#cieafi "' _ : xv �':�: .u. i—h7i rc. ( NIA 2 C Food covered properly A Food equipmenlclean,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 Food containers stored off the floor x 3os Wot and cold waterunder pressure,provided tit`fe4urf 101 N/A 2- �._4 A t s1.' . R :M 0 ,., N Mr C N10 NIA 1 38 HandwaSilmg,eccessortes provided. ,Htjndiin ofifood minimized x .�:::w . + r C� IUO N!At . _ .. ..... _.:... .. :.. ,,� ,.� . g # ` A Soap!paper towels! drying device available A No unnecessary handling RTEand/or cooked foods with bare hands B Dispenser(s)working: Map. ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean!waste receptacle at handwash sink C Adequate utensi[(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 altemate],PHF[potentially hazardous food],FB[focdborne] 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 icy that requires the food worker to report specific illness conditions Are temperatures recordedllogged for cold holding foodslequipment? N and diseases to the QF . Y N *Do you have a paid sick leave policy? Y N Are foods looked in advance and cooled? Y N Are leftov s saved? Y N Is there a language arrier between inspector&QFO? Y N if vas indicate language spoken List products cooled: by QFOIDA: *Can the QFOIDA read the inspection report? Y N Describe cooling methods: Indicate who nswered the above questions:Name(print): Indicate the title ave person(circle all thVFO ly):QFO DA Mgr Cook Owner FW Is coding monitored for time&temp? Y N Is the monito ng of cooling recorded? Y N .Obtain signa re o the p son who received res sibilities information at the time of the Is there a produce washing policy? Y N *Describe hat is washed and inspection: where: Note: ThIsrei16rt is a two page.form f of 62 debitable items) Page 1 of 2 IRA ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. ~ 31 Sewage disposal approved. 4` -Unwrapped foods not re-served � -Potentially hazardous foods not re-served -Operating as requiredv 11 Toxic chemicals. F_4F 74 No cross connections,back siphonage,backflow -Stored properly,labeled properly,used properly -Sanitizer concentration not to 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 Proper drain for: ; 29 Water source adequate,safe. E -Food equipment -Dish machines -Ice machines ` -Well!well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4 -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storage arWrooms,enclosures-property constructed,clean tentiatlyhazardousfoodproperlythawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency Food dispensing utensils properly stored 1 a 42 Vermin Control: No insects/rodents present 62 14 Food worker:Clean outer clothes,effective hair restraints ', 43 Outer openings protected againstentranceof insectslrodents1 t, 44 Floors: Floor covering installed,constructed as required,good repair,clean .` 16 Food-contact surfaces designed,constructed, maintained,installed, 5 Floors graded,drained as required i ®cated 6 Floor,wall juncture covered 17 nfood-contact surfaces designed, constructed,maintained, 0"b 7 Mats removable,good repair,clean r installed,located rfL 48 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 19 No reuse of sin le service article 49 Walls,ceilings attached,equipment properly constructed,good g repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored EEquipment&Utensils: Cleanliness 51 Adequate� lighting provided as required E`er 21 PreFlushed,scraped,soaked and racked . 52 Room free of steam,smoke odors [.)� 22 Wash water clean,proper temperature t r r 53 Rooms&equipment hoods,ducts,vented as required " 23 Accurate thermometers provided,dish basket,if used ti 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1 27 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premisesfreeof litter,no insecurodent harborage, 28 Equipmentlutensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 4 56 Complete separation from livinglsleeping quarters and laundry 3 lumbing location,install on,maintenance " 7 Clean/sailed linens stored properly R 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 Propertoiletfixturesprovlded,good repair,clean ,, entrances,smoking area indicated b sign(s) ( } g Y Ee 39 Approved garbagelrubbish containers,adequate number,covered, 1 rodent proof,clean Routine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: Sher Inspection: Demerit Score: *Include demerits from page 1 " 4 3 2 1 Total Rating ig re signature Done n me print name st CORRECTIONS DUE: number title Page 2 of 2 plus continuation pages Focused Inspection 112002 Page P / of a INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION //, �, 116 C�Lr�/U�SLR-%[1l�lG L<Z1 �'1J1�.S INSPECTION REMARKS FORM# 31 Z -3 J 6/ 1 .- �- - 3 C1 10- V ell r s vise INITIAL(INSPECTOR) INITIAL(PERSON IN CHARG ) Distribution: 1st-White-Health Department 2nd-Yellow-Owner ager Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF JNSPECT ON INSPECTION REMARKS FORM# '2 6 U v s a � INITIAL(INSPECTOR) INITIAL(PERSON IN C GE Distribution: 1 st-White-Health Department 2nd-Yellow- Owner/ a ger