HomeMy WebLinkAboutFood Service Establishment Inspection 85 (26) Establishment: e,,u i Inspection Date: Time: R insp Einsp
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Based on an inspection this day,the items marked DNC identify the violations in operation or facilities which must be corrected bythe date specified on page 2.
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K FACTOR ITEMS:Listing is not inclusive of all possible debitable items C N10 NIA DNC KEY: C[compiles] NIO(not observed] N/A[not applicable]
Etta tried Fi d;Opefalorn+ 4 t #x #a W "t " 'V t 3 DNC[does not comply] 0[other] RTE[ready-to-eat]
:.:;ter ros F wikoi yr yt;W W.M *.
r1$ Per d t el tt 'r jfeGtton re�stirtbc end "r C N10 tNa#1 �4
f esagnaled Alternate t: k 3 t.. .: :.
ntan df' rb m r A Food workers have no exposed infected lesions 1 burns
"Writtenidocume tto train)n 9f B Personnel with infection restricted
A�ppr`oved soave,wholesome,oonatlu a a etl�r s C� W NIA
..�. C Communicable disease of worker reported to local health director
A Approved shellfish,finfishi meal&poultry USDA approved 9
B Food cans in good condition(not dented,rusty,bloated,leaking) �13 NOW LIP TI!
A Handw facilities in all food prep! i ensing& rewash areas
C Wholesomelnonadulterated foods/safe tely,
ad
B H d sh facilities in or i d I ooms
D Commercial products(no home grown/canned food) C a sh,fapihtij a e let` V ie to use
E Potentially hazardous foods received at proper temperature D Personnel; an ed, can!Pro a andw h procedure
0 E dwa6 lhg at appropriat s
4 r Ppt af#y liazardaus;fbod moe s tetrt� F00.�t�u'ir1rnents.;t :N e N!A'!�4# p
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rill g storage,�preparatlon,dPsp�y,servtce.and transportafion .e x
Gt�O •L ll=ciijj
rac!iaes
'..0 Nlb .VA"` 2
A Hot holding greater than or equal to 140°F. (whole beerrpafkroasts 10 F.) A ❑Na eating ❑ No smoking oboe working
B Cold holding less than or equal to45 F. AAB Wounds covered adequately k
C Proper cooling C Proper sink used for handwashing
D Proper.re-heating
tz seo : t {C ro hw : _E Proper internal cookin Iconsumeradviso advisory c
Approved sanitizer available/adequate conc entratlon of sanitizer
+ tleuYfaUliesto arraintairi roduct C �p : . �f Food-contact surfaces and utensils used for otentiall
ck e;'x'"" 'Y hazardous food sanitized at least eve 4 hours y
ter rriperattttrr;thertnorneters�provr�etl� � every
A Food thermometer available and accurate C Adequate ❑dishwashersanitizer [Xnal rinse temp
D Proper sanitizin rocedure
B Proper food thermometer for product T Sanitizing between raw animal origin&ready-lo-eat food
C Thermometers appropriately placed in cooler units
C - 8"C afiivping d(ofhsCi
o Fodrerte�during#sfra epreparation, C ;]�
p r
�splayr.service anti transporteftton Cloths and/or sponges in good repair and clean
A Produce washed B Wiping cloths kept in sanitizer between uses
0
B Raw meats not stored/prepared near raady-foeatfoods jr m ��*
fat food-cdtf�su` + elep ay a G Nl I� l
C Food covered-properly —
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 o pooling of eggs not cooked immediately C
8 Vood containers stored off the floor w t k .
Ot';Jotand colihwa eriuhd�r]rss"p ,:provided as require G 1 CV1A 2�
z .n:.
1 B 'Ha was to arscessonesa
�, . 9 Pro M �� a+.0 NJ4a=NJA e1;
t9r i !d n9aof aodtmimmtzed'.-";.; : : ••* a: 1 III 4 2` .. ,. .. u :
u °�`"•A"'a a ° A Soap I paper towels! drying device available
_A,
No unnecessary handling RTE andlorcooked foodswith bare hands B Dispenserertowking: ❑Soap ❑Paperiowel
B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean waste receptacle at handwash sink
C Adequate utensil(s)fordispensing foodlice p
•DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The following information is not debitable end 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: IF Describe illness conditions when you would exclude a food worker from working:
Are internal 000king 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 th squires the food worker to report specific illness conditions
Are temperatures recordedilogged for cold holding foods/equipment?. N and diseases to the QFO? Y *Do you have a paid sick leave policy? Y N
Are oads cooked in advance and cooled? Y N *Are leRever saved? Y N Is there a language barrier h6tween inspector&QFO? Y N Iflf vas in ' e language spoken
List products cooled: by QFOIDA: *Can the QF A read htpection report? Y N
Describe cooling methods: Indicate who answenfil the above questions:N e(pr•
Indicate the title of above person(circle all Idt a }• O DA Mgr Cook Owner FW
Is cooling monitored for time&temp? Y• N Is the marital of cooling recorded? Y N •Obtain signature of a person who race' d t Q responsibilities information at the time of the
rwhe7re:
roduce washing policy? Y N *Describe w t is washed and inspection:
Note: This report.Is No o a o. (tot of 62 debitable items) , Page 1 of 2
0AJ _ Date of Inspection
to f f weer or Operii �011 i� 4 '
ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served. , 31 Sewage disposal approved.
-Unwrapped foods not re-served
-Operating as required
-Potentially hazardous foods not re-served
37 No cross connections,back siphonage,backflow .a
11 Toxic chemicals. 4x
I I Pro eerr type/installation)backflow prevention device/air ga fj�or:
-Stored properly,labeled properly,used properly ;
-Food equipment -Hose 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:
29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines
-Well 1 well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible,
4
-Water quality in compliance . {
w
designed,properly installed
-Monitoring in compliance
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
2 Sources of food;Original container,properly labeled rO Garbage/rubbish storage arealrooms,enclosures
properly constructed,clean
5 ntially hazardous food properly thawed 1 Garbage/rubbish disposed of in an approved manner,at approved frequency
10 Fqd6 dispensing utensils properly stored 4 ' 2 vermin control: No insectslrodents present2
Food worker:Clean outer clothes,effective hair restraints 17 43 Outeropenings protected against entrance of insects/rodents
3 " 4 Floors: Floor covering installed,constructed as required,good repair,clean '
16 F d-contact surfaces designed,constructed,maintained,installed, 5 Floors graded,drained as required ;
ted 141 46 Floor,walljuncture covered
17 nfood-contact surfaces designed,constructed, maintained, tso
'
installed,located ats removable,good repair,clean
48 Exterior walking,driving surfaces,good repair,clean
18 Single service articles,storage,dispensing 2 E
49 Walls,ceilings attached,equipment properly constructed,good c 1
19 No reuse of single service article
repair,clean.Wall&ceiling surfaces as required
20 Dishwashing facilities approved design,adequately constructed, t2
maintained installed located � stlesscleaning methods used,cleaning equipment properly stored 1° `
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 53 Rooms&equipment hoods,ducts,vented as required
Accurate thermometers provided,dish basket,if used 4 Rooms adequate,clean,adequate lockers provided,facilities clean k
7fd ttf of &equipment
noo -contact surfaces o utensils equpmen clean F
55 Establishment and premisesfreeof litter,no insect/rodent harborage,
28 Equipmentlutensils,storage,handling no unnecessary articles
2 ' per disposal of wastewater 56 Complete separation from living/sleeping quarters and laundry
57 Cleanlsoiled linens stored properly
33 Plumbing location,installation,maintenance
58 No live birds,turtles,or other animals(except guide dogs)
36 Toilet rooms enclosed with self-closing door
59 Seats 75 or more:Nonsmoking area provided,sign(s)posted a1 )
37 Proper toilet fixtures provided,good repair,clean r entrance(s),smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,cove d irlt 2
rodent proof,clean outine Inspection ❑Reinspection ❑ Preoperational Inspection
Lij Other Inspection:
T R. Demerit Score: *Include demerits from page 1
4 3 2 1 Total Rating
signature si ure
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r' t name / pri t nania
� �� ��� CORRECTIONS
hone 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 INSP TION
INSPECTION
MARKS
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) AL
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