HomeMy WebLinkAbout575 Pleasant Valley Road EHS-106-Rev.11/05 INSPECTION REPORT STATE OF CONNECTICUT `ON ❑ REINSPECTION
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH - ❑ OTHER
410 Capitol Avenue,MS#11 FDP,Hartford,CT 06134
ESM BOLISHMENT �7� \. �r� CLASSLISHMENT i
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STREET TOWN
ADDRESS ' ;'�1 F L 0 X�
INSPECTIONOWNER or OPERATOR ��I — DATE and ME
Based on an inspection this day,the items marked below identify the violations in operation or facilities which must be corrected by the date specified below.
SOURCES OF FOOD EQUIPMENT&UTENSILS:CLEANLINESS VERMIN CONTROL
1 Approved source,wholesome, 4 21 Preflushed,scraped,soaked and racked 42 Presence of insects/rodents 2
nonadulterated 22 Wash water clean,proper temperature 1 43 Outer openings protected against entrance of 1
2 Original container,properly labeled 1 23 Accurate thermometers provided,dish basket,if used insects/rodents
24 Sanitizalion rinse(hot water-chemical) 2
FOOD PROTECTION Clean wiping cloths FLOORS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 \26 od-contact surfaces of utensils& [ 44 Floors:floor covering installed,
temperature requirements during storage, equipment clean constructed as required,good repair,clean
preparation,display,service,and r
food-contact surfaces of utensils& 1 45 Floors,graded,drained as required
transportation C, ui ment clean 1
P 46 Floor,wall juncture covered
4 Adequate facilities to maintain product 2 28 Equipment/utensils,storage,handling 1 47 Mats removable,good repair,clean
temperature thermometers Drovided
5 Potentially hazardous food properly thawed 2 48 Exterior walking,driving surfaces, 1
6 Unwrapped or potentially hazardous food 4 WATER SUPPLY C, good repair,clean
not re-served 29 Water source adequate,safe 4 49 Walls,ceilings attached,equipment properly 1
7 Food protected during storage,preparation, 30 Hot and cold water under pressure, 2 constructed,good repair,clean. Wall&ceiling
surfaces as required.
display,service&transportation 2 provided as required
8 Food containers stored off floor 50 Dustless cleaning methods used, 1
SEWAGE DISPOSAL I cleaning equipment properly stored
9 Handling of food minimized 2 31 Sewage disposal approved 4
10 Food dispensing utensils properly stored 1 32 Proper disposal of waste water 1 LIGHTING&VENTILATION
11 Toxic items properly stored,labeled,used 4 51 Adequate lighting provided as required 1
PLUMBING 52 Room free of steam,smoke odors 1
PERSONNEL 33 Location,installation,maintenance 1 53 Room&equipment hoods,ducts,vented as required
12 I Personnel with infection restricted 1 4 34 No cross connection,back siphonage,backflow 14
DRESSING ROOMS&LOCKERS
CLEANLINESS OF PERSONNEL TOILET FACILITIES 54 Rooms adequate,clean,adequate lockers 1
13 Handwashing facilities provided, 4 35 Adequate,convenient,accessible,designed, 4 provided,facilities clean
personnel hands washed.clean Installed _
14 Clean outer clothes,effective hair restraints 1 36 Toilet rooms enclosed with self-closing door
15 Good hygienic practices,smoking restricted 2 7 "?roper fixtures provided,good repair,clean HOUSEKEEPING
55 Establishment and premises free of litter,no 1
EQUIPMENT&UTENSILS: DESIGN, HANDWASHING FACILITIES insect/rodent harborage,no unnecessary articles
CONSTRUCTION &INSTALLATION 38 Suitable hand cleaner and sanitary towels or 1 56 Complete separation from living/sleeping quarters 1
16 Food-contact surfaces designed,constructed, 2 approved hand drying devices provided, and laundry
maintained,installed,located tissue waste receptacles provided
57 Clean/soiled linens stored properly 1
17 Nonfood-contact surfaces designed, 1 58 No live birds,turtles,or other animals 1
constructed,maintained,installed,located GARBAGEIRUBBISH STORAGE&DISPOSAL I (except guide dogs)
18 Single service articles,storage,dispensing 2 39 Approved containers,adequate number, 1
19 No reuse of single service article covered,rodent proof,clean SMOKING PROHIBITED
20 Dishwashing facilities approved design,adequately 2 40 Storage area/rooms,enclosures— 59 Smoking prohibited,signs posted at each 3
constructed,maintained,installed,located properly constructed,clean entrance
1
41 Garbage disposed of in an approved manner,
at approved frequency QUALIFIED FOOD OPERATOR
DEMERIT SCORE 60 Qualified Food Operator 3
4 R11K F kCTOR X-101,ATIONS IN RED 61 Designated alternate 2
Z 62 Written documentation of training program 2
Signature of Person in charge
TOTAL RATING Date Corrections Due
4 SIGNED(I ect r)
DESCRIBE FICIENCIES ON ON TION SHEETS
DISTRIBUTION:1" -White—Health Department 2"d—Yellow—Owner/Operator
Page I of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF A— INSPECTION
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INSPECTION REMARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1 st-White - Health Department 2nd-Yellow- Owner/Manager