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Home My WebLink AboutFood Service Establishment Inspection 86 (13) �n Establishment: Inspection Date: 7710174 Time: " R ins REinsp Address lCity: Health Dept _I A� 4,1�4 Class: 1 2 3 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:lasting is not inclusive of all possible debitable.Items C NIO I NIA JDNC KEY: C[complies] NIO[not observed] NIA[not applicable] [ comply] [other] [ready-to-eat] 3 DNC does not corn 1 0 other RTE fia ' " g *v x r:F 2 i1 ,person'nelwth rnfiection cestrrec C NI0 N/A 4' Desr Hated Alternate s - r ] A Food workers have no exposed infected lesions!burns 62�,. itten documentation of tramtng;p�.ograie„ +� {� �,; ;,�. B r roved source w}i'olesotne,t br a�u'ite'i tad j°• Personnel with infection restricted C NtQ`NTA 4' : Communicable disease of worker reported to local health director Approved shellfish,finfish,meat&poultry USDA approved. B Food cans in good condition(notdented,rusty,bloated,leaking) 3 Handwashinffac111tr]esprovrtletl .hands washed;}c)se C !Nftl,! A Handwash facilities in all food prep/dispensing&warewash areas C Wholest)melnonadulleraledfoodslsafe Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean 1 Proper handwash procedure r E Handwashing at appropriate times fP tontially ltazardou food meets temper re requirements C e4. during ssttorage,prepaiat(on,display,sefvlce and transportattort n 5r odatt gienrc rpfrtSes 4 a '� ,,5 t .' C�NI N! 2 x.zA : A Hot holding greater.than or equal to 14O°F. (wnorebeefrpuk roasts 1300F.) A ❑No eating ❑No smoking while working B Cold holding less than or equalto45'F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating E Proper internal cooking I consumer advisory posted d2�'a� itttizatron ri n e' h�lOt water c errilQal Fj�i° N10 A 2 0 Approved senitizeravailableladequate concentration ofsanitizerZTE i4 Ade d t' cilrtres to maim tin pro lu .F#r C } N1A� 2 B Food-contact surfaces and utensils used for potentially temperature,th+rrmometers prbv a�tl !�`s "�"' e e t e � s a hazardous food sanitized at least every 4 hours A Food'thermometeravailableandaccurate C Adequate dishwashersanitizer Ofinalrinsetemp B Proper food thermometerforproduct D Pro ersani!zing procedure Ar- E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 lF � tw.te 5k'.AeBn$ pgQhy } uE#� ati4r� .s Foodrprbtetdjdurrng storages preparai*r .d a Cj ,(�A, _. ° disp[ayseavrce and fransp6raito � Clothsandlorspongesingoodrepairandclean Ac B Wiping cloths kept in sanitizerbetween uses A Produce washed B Raw meats not stared/prepared near ready-to-eat foods 26 d�darrt�atksi�agesxalaan C Food covered properly >:._., �� . t�;:: . _ ;. Food equipmWR entclean,utensils clean,equipment interiors clean D Adequate splash guards!sneeze guard g Single use gloves changed when soiled £ No unauthorized personnel C Food--contact surfacesclean F o pooling of eggs not cooked immediately IK 0 F od containers stored off the floor V Ra = mY Intl�ata"W aKi d dbr•pr+'ssur��rovlded:as to u1 e� ,NIA 3$ Handw�siih�`accesson20fir;.utdetl tg 'Hantlifn of fo dxmrnimrzetl" C N!f} NIA I - ° A Soap I paper towels I drying device available A No unnecessary handling:RTEandlorcooked 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/waste receptacle athandwash sink IC Adequate utensil(s)for dispensing food/ice D 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not-debatable and does not affect your score. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB Ifoodbome] 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!line are you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness polic that requires the food worker to report specific Illness conditions Are temperatures recordedllogged for cold holding foodslequipment? N and diseases to the QFO? N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are le over saved? Y N Is there a language barn between inspector&QFO? Y N Iflf vas indicate language spoken List products cooled: by QFOIDA: *Can the QFOIDA read the inspection report?-Y N Describe cooling methods: Indicate who answ ed the above questions:Name(print}: Is cooling monitored for time&temp? Y N Is the monitorin of cooling recorded? Y N Indicate the title of above arson(circle all that apply):QFO DA Mgr Cook Owner FW •Obtain signatur of the arson who received the QF pensibilities-infomration at the time of the Is there a produce washing policy? Y N ♦Describe who is washed and inspection: where: Note: Thls,repo js a two page form(total of 62 debitable items) Page 1.of 2 a Date of Inspection: D d.'dress ' Owner or Operstor:/Lr , 'J ADDITIONAL FOUR POINT ITEMS r �o KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. 31 Sewage disposal approved. -Unwrapped foods not re-served : - Aerating as required -Potentially hazardous foods not re-served ; 11 Toxic chemicals. No Bross connections,back siphonage,backflow -Storedproperly,labeledproperly,usedproperly =4 �er pehnstalfationlbackflowpreventiondevicelalr gap for: -San itizerconcentration notto exceed maximum permitted -Food equipment -Hose connections -Dish machines -No unnecessary toxics on the remises -Soda system carbonafor-Beverage dispensers -Toilet tanks ry p -Chemical dispensers -Ice machines -Pesticides(rodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. " ; -Food equipment -Dish machines -ce machines -Well I well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4' -Water quality in compliance designed,properly installed -Monitoring in compliance < OTHER ITEMS KEY: DNC [DOES NOT COMPLY]A t urcesoffood: Originalcontainer,properlylabeled 40 Garbagelubbishstoragearealrooms,enclosures-properly constructed,clean Potentially hazardous food properlythawed 41 Garba elrubbish disposed of in an approved manner,ata roved frequency " t�+ 9 P PP PP � a. ; 10 Food dispensing utensils properly stored ial V in Control: insects dents present 14 Food worker:Clean outer clothes,effective hair restraints Ou openings protected against entrance of inserts/rodent 44 ors: Floor covering installed,constructed as requi oo pair,clean,_ 16 Food-contactsurfaces designed,constructed, maintained,installed, t2 E 5 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contactsuaacesdesigned,constructed,maintained, f installed,located i4 7 Mats removable,good repair,clean 18 Single service articles,storage,dispensing Exterior walking,driving surfaces,good repair,clean ' A49 ' s,ceilin s attached,equipment r y g19 No reuse ofsingle service article �� 9p open constructed, pod � 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 E I : I iress 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 f 23 A�curate thermometers provided,dish basket,if used Rooms adequate,clean,adequate lockers provided,facilities clean 1 7 o�nfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,no insect/rodent harborage, l Equipmentlutensils,storage,handling 1 no unnecessary articles 32 Proper disposal of wastewater 1 56 Complete separation from living/sleeping quarters and laundry 1 33 Piumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 58 No live birds,turtles,or other animals(except guide dogs) jilt 36 Toilet rooms enclosed with self- iagd �c S�l� 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet fixtures proviC90 repair,clears entrance(s),smoking area indicated by sign(s) 39 Approved garbagelrubbish containers,adequate number,covered, t rodent proof,clean routine Inspection ❑Reinspection ❑ Preoperational Inspection INSPECTOR: PARSON IN CHARGE: Other Inspection: Demerit Score: •Include demerits from page I 4 3 2 1 Total Rating i nature silfhature_ print name print name phone number n/ / A title DATE CORRECTIO S DUE: d�il�f�b�7Z5 Page 2 of 2 plus continuation pages &A r Page—L Of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OO IN PECT pN INSPECTION FORM# REMARKS (l /dr -75�) 1100, g`- 41-4 zy INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager ` Page of 04i9f e INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TO DATE OF INS ECTION INSPECTT REMARKS FORM# c� V u v qq t i 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 OF ESTABLISHMENT TOWN DATE OF IN ECTION INSPECTION REMARKS FORM# j me c INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow- Owner/Manager