HomeMy WebLinkAbout591 Ellington Road STATE OF CONNECTICUT - FOCUSED FOOD SERVICE INSPECTION REPORT - DEPARTMENT OF PUBLIC HEALTH
Establishment:PLEASANT VALLEY ELEMENTARY SCHOOL Inspection Date:10-Jan-2017rime: 9:40 am
ddress/Cit :0591 ELLINGTON ROAD,SOUTH WINDSOR Health Dept:South Windsor Health De t Class:
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 KEY:C[compliant] N/O[not observed] N/A[not applicable]
DNC does not comply] O other RTE read -to-eat
01.Approved source wm holesome nonadulterated roper sanitizing procedure
a. Approveds e is is ,m eat and poultry USDA approved e. Sanitizing between raw animal origin and ready-to-eat fo0
Fooci cans in good condition(not dented,rusty,bloated, 27-0 Uther
leaking)
c. Wholesome,nonadulterated foods,sae 26.Clean Wiping Cloths
a. o s and/or sponges in goo repair an c ean
Commercial products no home grown or canned food)
e. Potentially hazardous foods received at proper empera ure aping cloths Kep in sane izerbetween uses
o. Other
o. lutner
26.Food-contact Surfaces Clean
03.Hazardous Food Meets Temperature Requirements 26a. Food equipment clean,utensils clean,equipment interiors
a. Hot holding greater than or equal o woe beet or porK 11VU clean
roasts 130F) 26b. Single use gloves changed when soiled
Cold holding less than or equal o
c. ood-contact surtaces clean
c. Proper cooling Or o0
o. Other
Proper re-heating of food
Hot and cold water under pressure,provided as required
e. JProper internal cooking and consumer advisory posted
38.Handwashing Accessories Provided
U15o. Fther a. Soap paper towels rying device available
04.Maintain Product Tem Thermometers Provided Dispenser(s)working-soap paper towels
a. Food ermome er avai a e and accurate
c. Handwash sin s clean waste receptacle at handwashsin .
Proper food thermometer for product
o. Other
U2FC-- ermometers appropriately placed in cooler units
a2ro'.- er
60. Qualified Food Operator
07.Food Protection 61. Designated Alternate
a. Produce washed 62. Written documentation of training program
Raw meats no stored/prepared near ready-to-eatoo s e o owing in orma ion is nodebitable an does no a ec your score.
c. oo coveredproperly
KEY:QFO[qualified food operator],DA[designated alternate],
Adequate splash guars sneeze guar
PHF[potentially hazardous food], FB[foodborne]
PHFs are hot held at:(Deg.F)
e. o unauthorized personnelPHFs are cold held at:(Deg.F)
o pooling o eggs no cooked immediately Are internal cooking temperatures taken?
o. er To what temperature do you cook poultry(Deg.F)?
09.Handling of Food Minimized To what temperature do you cook ground beef(Deg.F)?
a. No unnecessary handling R I E and/or cooked oo s with are To what temperature do you cook pork(Deg.F)?
hands To what temperature do you cook roasts(Deg.F)?
Minimize food handling,other than ready-to-eat,with are
hands To what temperature do you cook OTHER(Deg.F)?
c7 Adequa e utensil(s)Tor dispensing Tood/ice Describe re-heating procedures:
o. er Are temperatures recorded/logged for cold holding foods/equipment?
12.Personnel With Infection Restricted Are foods cooked in advance and cooled?
a. Food workers have no exposed intected lesions urns Are leftovers saved?
Personnel with infection restricted List products cooled:
c. Communicable disease of worker reported o local health
Describe cooling methods:
director Is cooling monitored for time and temp?
13.Handwashin Facilities,Hands Washed Clean Is the monitoring of cooling recorded?
a. an was ace i es in a oo prep ispensing an warewas Is there a produce washing policy?
areas Describe what is washed and where:
Handwash facilities in or immediately adjacent o toilet rooms Describe illness conditions when you would exclude a food worker from
c.-Handwash facilities access bl a conven i ent to use working:
Personnel hands washed,clean roper handwash procedure What diseases related to foodborne illness are you required to report to the
local health department?
e. Handwashing at appropriate times Is there a written illness policy that requires the food worker to report specific
o. JUther illness conditions and diseases to the QFO?
15.Good Hygienic Practices Do you have a paid sick leave policy?
a. No eating NO smo ing while wor ing Is there a language barrier between inspector and QFO?
Wounds covered adequately IF YES,indicate language spoken by QFO/DA:
c. roper sinK used for handwashing G Can the QFO/DA read the inspection report?
T577 U t h er Indicate who answered the above questions(Name):
24.Sanitization Rinse hot water-chemical Notes
a. Approved sam¢er avai a e a equa a concen ra ion o Obtain signature of person who received the QFO responsibilities information
sanitizer at the time of the inspection:Signature on Page 2
Food-contactsurtaces and utensils used for potentially
hazardous food sanitized at least every 4 hours
c7 Adequa a dishwasher sane izer/Tinal rinse temp
Inspection#:269 Note:This report is a two page form (total of 62 debitable items) Page 1 of 3
STATE OF CONNECTICUT-DEPARTMENT OF PUBLIC HEALTH -410 CAPITOL AVENUE-MS#51 FDP-HARTFORD, CT 06134
FOCUSED FOOD SERVICE INSPECTION REPORT
Local Health Dept:South Windsor Health Dept Address/City: 1540 Sullivan Avenue
Establishment: PLEASANT VALLEY ELEMENTARY SCHOOL Inspection Date:10-Jan-201
ddress: 0591 ELLINGTON ROAD Owner or Operator:Chartwells
ADDITIONAL FOUR POINT ITEMS OTHER ITEMS
KEY: DNC[DOES NOT COMPLY] KEY: DNC[DOES NOT COMPLY]
6.Foods Not Re-served 44. Floors:Floor covering installed,constructed as required,good C
Unwrapped foods not re-served C repair,clean
Potentially hazardous foods not re-served 45. Floors graded,drained as required C
11.Toxic Chemicals 46. Floor,wall juncture covered C
Toxic chemicals stored properly,labeled properly,used properly C
Sanitizer concentration not to exceed maximum permitted 47. Mats removable,good repair,clean C
No unnecessary toxics on the premises 48. Exterior walking,driving surfaces,good repair,clean C
Pesticides/rodenticides properly dispensed
9.Water Source Adequate,Safe 49. Walls,ceilings attached,equipment properly constructed,good 1-DNC
repair,clean.Wall and ceiling surfaces as required
Well/Well head protected from contamination N/A
Water quality in compliance 50. Dustless cleaning methods used,cleaning equipment properly C
Monitoring in compliance stored
1.Sewage Disposal Approved 51. Adequate lighting provided as required C
Sewage disposal operating as required C 52. Room free of steam,smoke odors C
4.No cross connections, back siphonage, backflow
Proper type/installation/backflow prevention device/air gap for: C 53. Rooms and equipment hoods,ducts,vented as required C
ood equipment,soda system carbonator,chemical dispensers,hose 54. Rooms adequate,clean,adequate lockers provided,facilities C
onnections,beverage dispensers,ice and dish machinesJoilet tanks clean
Proper drain for:food equipment,dish and ice machines 55. Establishment and premises free of litter,no insect/rodent C
5.Toilet Facilities harborage,no unnecessary articles
Toilet facilities adequate,convenient,accessible,designed, C 56. Complete separation from living/sleeping quarters and laundry C
properly installed
OTHER ITEMS 57. Clean/soiled linens stored properly C
58. No live birds,turtles,or other animals(except guide dogs) C
KEY: DNC[DOES NOT COMPLY] 59. Seats 75 or more: Nonsmoking area provided,sign(s)posted C
02. Sources of food-original container,properly labeled C at entrance(s),smoking area indicated by sign(s)
05. Potentially hazardous food properly thawed C
10. Food dispensing utensils properly stored C
14. Food worker:Clean outer clothes,effective hair restraints C DEMERIT SCORE
16. Food-contact surfaces designed,constructed,maintained, C '4' '3' '2' TV wing
installed,located 0 0 1 0 1 1 1 1 99
17. Nonfood-contact surfaces designed,constructed,maintained, C Date Corrections Due: 10-May-2017
installed,located Person in Charge: Gina Valles/Louise Bastone
18. 1 Single service articles,storage,dispensing C Name, Title,
19. No reuse of single service article C Signature
20. Dishwashing facilities approved design,adequately C
constructed,maintained,installed,located
21. Equipment and utensils-preflushed,scraped,soaked and C '
racked
22. Equipment and utensils-wash water clean,proper C
temperature Inspector: Diane Collelo [1041]
23. Equipment and utensils-accurate thermometers provided, C Name,Signature,
dish basket,if used Phone Number 8603376182
27. Nonfood-contact surfaces of utensils and equipment clean C
28. Equipment/utensils,storage,handling C
32. Proper disposal of waste water C
33. Plumbing location,installation,maintenance C
36. Toilet rooms enclosed with self-closing door C
37. Proper toilet fixtures provided,good repair,clean C
39. Approved garbage/rubbish containers,adequate number, C
covered,rodent proof,clean
40. Garbage/rubbish storage area/rooms,enclosures-properly C
constructed,clean
41. Garbage/rubbish disposed of in an approved manner,at C
approved frequency
42. Vermin Control:No insects/rodents present C
43. Outer openings protected against entrance of insects/rodents C
Inspection#:269 Note:This report is a two page form (total of 62 debitable items) Page 2 of 3
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INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
Name of Establishment Town Date of Inspection
PLEASANT VALLEY ELEMENTARY SCHOOL SOUTH WINDSOR 10-Jan-2017
INSPECTION REMARKS
FORM#
49. Unclean attached ventilation hood
Ceiling fan/vent cover in dry goods room dust buildup.
Inspection#:269 Note: This report is a two page form (total of 62 debitable items) Page 3 of 3