HomeMy WebLinkAbout500 Evergreen Way r
Establishment: ,,A Inspection Date: Time: Roinsp Einsp
Address/City: Health Qept: ?356 a 2 367
Based on an inspection this day,the items marked DNC identity t a 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 N10 NIA JDNC I KEY: C[complies] NIO[not observed] NIA(not applicable]
$a ;4yalied Sead`Oerator } y" a 3 DNC)does not comply] 0[other] RTE(ready-to-eat]
.; 2 n72, ;Persbrg frith,lrf(ec}ilcp�ts�ETibt�d , ; C lllAug4
61 De sgnated�liternate, ° F z = #_ ¢..a ,.
* T s } b�. �s ., •� oW. A Food workers have no exposed infected lesions 1 burns
62 Written doc�menfatipr ef�traming programs ..4.i l ; •rk 2
B Personnel with infection restricted
1 Apaved source,wholesiime;`nofiadultefated* Nla N1Ae 4r; C Communicable disease of worker reported to local health director
A Approved shellfish,finfish,meat&poultry USDA approved r - y
13 KHandwashmg facalrttes prgvrde<c�,�l�ntls heb,�crr�ean
B Food cans in good condition(not dented,rusty,bloated,leaking)
A Handwas tlities in all food pre n in &warewash areas
C Wholesomelnonadulteratedfoodslsafe B Handw sh fficilities in cg imm ly a ce Eat rooms
D Commercial products(no home grown/canned food) C Han a faci'tie i nt to use
E Potentially hazardous foods received at proper temperature oe
D P sonnet hen 'st, roper wash procedure 14
0 E H g appropr' fi
P6tentliliy Mza'idotitloo'd�mee'ts temperature requtreme I10 ITO, 0
during**storage, reparatron;d'€€Splay,service and transpo#tataon' yti % �, x t e 5 8t s#�y
{ x• `G`ooit h�9ie Jc_ pt1 e$x {,; ': A O v ,i�C 3N10 N/A 2
n ;�"�:
A Hot holding greater than or equal to 1400F. (wholeWeflpork roasts 1300F.) A ❑ No eating ❑ No smoking while working
B Cold holding less than or equal to450F. B Wounds covered adequately
C Proper cooling C Proper sink used for handwashing
D Proper re-heating 0
E Proper internal cooking l consumer advisory posted �2 :y njt #[ n� in a (hot Ovate ch nr f) C No._N
Approved sanitizer available/adequate concentration of sanitizer
Ade]q ratae f uft ea o msrrntarn predurt� �+ + o[lq �NlA3 P.. g Food-contact surfaces and utensils used for potentially
6 �' ° ;=, o: hazardous food sanitized at least eve 4 hours
Wteperature,thermometers provided: •. . .. every
?S'.aS!.
A Food thermometer available and accurate C Adequate Vishwashersanitizer ❑final rinse temp
D Proper sani izin rocedure
B. Properfood thermometerforproduct E Sanitizing between raw animal origin&ready-to-eatfood
C Thermometers appropriately placed in cool,erunits 0
0 i25 VeanAWtprng.Cloths .� a,. �, * A *.� 'Nl6'. 1f
eFood p�ravvtedtetl it AItq�� j-karage,prepaFationaar,,,�, , ,Gx VfO N1
g� �drpy,senrrpe$ndttran$portaten A Cloths and/or in good repair cleanAll
- - B Wiping cloths kept in sanitizer between uses
A Produce washed
B_ Raw meats not storedlprepared near ready-to-eatfoods op r, , C
6 F # trse � i`t10° NIA
C Food covered properly A Food equipment clean,utensils clea q cledo
D Adequate splash guards/sneeze guard B Single use gloves changed when oiled
E No unauthorized personnel C Food--contact surfaces clean
F No pooling of eggs not cooked immediately 0
B Food containers stored offthe floors '3U libt antl cold wafer under pressure,pro`vtded,as+reiiuire '.;t F pl N/A lf%
...I fc:#�il.sc .dt.:ay...rii..ao-_avt.. :, x
0 i38 Handwashit)graccessories provrd ;.:y * N10 NIA 1
5 ' ' " " �' "
L ndtlri .lif foodmmlrnrzed t ;<
�` — " paper towels! drying device available
' 'o Q ` A Soap 1
A No unnecessary handling RTE andlorcoeked foodswtth bare,hands B Dispenser(s)working: ❑Soap , ❑Paper towel
B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sfnk(s)clean/waste receptacle at handwash sink
C Adequate utensil(s)for dispensing food/ice 0
0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The following information is not debitable'and does not affect your scare. KEY: CFO[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 illness are you required to report to the local health department?
Roasts Other
Describe re-heating procedures: Is there a written illness po' that requires the food worker to report specific illness conditions
Are temperatures recordedilogged for cold holding foods/equipment? Y N and diseases to the QFO Y N *Do you have a paid sick leave policy? Y N
Are odds cooked in advance and cooled? Y N *Are leftovers save Y N Is there a language vier between inspector&QFO? Y N If yes indicate language spoken
List products cooled: by QFOIDA: ♦Can the QF01DA read he inspection report? Y N
Describe cooling methods; Indicate who swered the above questio ; Name(print): Clow
Indicate the,i le of a e arson(circle that apply):QFo ..DA Mgr Cook Ow g r FW
Is cooling monitored for time&temp? Y N Is the monitoring of ooling recorded? Y N .Obtain signature the arson h r ived the sponsibilities information at the time of the
Is there a produce washing policy? Y N *Describe what washed and inspection:
where: Note: This re ort' wo page f r (total of 62 debitable items). Page 1 of 2
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ADDITIONAL FOUR POINT ITEMS KEY.- DNC [DOES NOT COMPLY] /
6 Foods not re-served.
-Unwrapped foods not re-served 4 31 Sewage disposal approved. 4
-Operating as required
-Potentially hazardous foods not re-served
34 No cross connections,back siphonage,backflow
11 Toxic chemicals.
4 Proper type/installationtback to rev r:
-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 h -Chemical dispensers I-Ice machines
-Pesticides/rodenticides properly dispensed 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
-Monitoring in compliance designed,properly installed
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
2 Sources of food: Original container,properly labeled a 40 Garbage/rubbish storage arealrooms,enclosures-properly constructed,clean
5 Potentially hazardous food properly thawed 2. 41 Garbagelrubbish disposed of in an approved manner,at approved frequency
10 Food dispensing utensils property stored k 42 Vermin Control: No insectslrodents present
Fkt
14 Food worker:Clean outer clothes,effective hair restraints 11,5 a 43 Outer openings protected against entrance of insects/rodents
oors: Fit orcovering installed,constructed as required,good re ir,cle n EJ,
16 FA-contact surfaces designed,constructed maintained ' tolled, X' 5 Floors graded,drained as required
located
?, 6 Floor,wall juncture covered
17 Nonfood-contact surfaces designed,constru d ai d
7 Mats removable,good repair,clean '.
installed,located -
48 Exterior walking,driving surfaces,good repair,clean
18 Single service article sto a ispensing
9 Is,c s attached,equipment property constructed,good !a
9 No reuse of single service article .. eilin 1
rep a',ciea all&ceiling surfaces as required
20 Dishwashing facilities approved design,adequately constructed,
maintained installed Located 50 Dustless cleaning methods used,cleaning equipment properly stored .;
Equipment 1 51 Adequate lighting provided as required X
21 Preflushed,scraped,soaked and racked %* 52 Room free of steam,smoke odors
22 Wash water clean,propertemperallure ,
53 Rooms&equipment hoods,ducts,vented as required
23 ccurate thermometers provided,dish basket,if used .j '
54 Rooms adequate,clean,adequate lockers provided,facilities clean !
27 nfood-contact surfaces of utensils&equipment clean r
- 55 Establishment and premises freeof lifter,no insect/rodent harborage,
Equipmentlutensils,storage,handling '. no unnecessary articles
32 Properdisposal of wastewater 56 Complete separation from living/sleeping quarters and laundry ILI
. 57 Cleanlsoiled linens stored properly
33 Plumbing location,installation,maintenance I C
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 at
37 Proper toilet fixtures provided,good repair,clean
22 entrance(s),smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered, h
outine Inspection OReins ection 0 Preoperational Inspection
rodent proof,clean L; .� Cher
P p p PjNSPECTOR; PER E: Inspection:
Demerit Score: *include demerits from page 9
4 3 2 1 Total Rating
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Page of�L},
/AN
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF IV8PEC ION
/2///
INSPECTION REMARKS
FORM# ,�
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Mang
Page
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INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTI
INSPECTION REMARKS
FORM#
44
Z2el
INITIAL(INSPECTOR) INITIAL(PERSON IN CHARG
Distribution: I st-White-Health Department 2nd-Yellow- Owner/Manager