HomeMy WebLinkAbout100 Evergreen Way (8) LaWIN W
Establishment: Inspection Date:^I \i \�q Time: 12'.. A ins REinsp
Address/City: 1 _ Health Dept: 1 class: 1 zC'37t
Based on an inspection this day,the items marked DRC 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 C N/O N/A JDNC I KEY: C[complies] N/O[not observed] N/A[not applicable]
60 Qualified Food Operator 3 DNC[does not comply] 0[other] RTE[ready-to-eat]
61 Designated Alternate 2 12 Personnel with infection restricted C 40 NIA 4
82 t8fio A Food workers have no exposed infected lesions I burns
Written documen n of training program
2 B Personnel with infection restricted
1 Approved source,wholesome,nonadulterated C N10 NIA 4 C Communicable disease of worker reported to local health director
A I Approved shellfish,finfish,meat&poultry USDA approved 13 Handwashing facilities provided,handswashed,cleart qj N10 WA 4
B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas JAI
C Wholesome/nonadulterated foods/safe jV B 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/Proper handwash procedure
0 E Handwashing at appropriate times
3 Poi t Irdous food meets temperature requirements C Nlb WA 4 0
during preparation,display,service and,transportation
1 G00d hygienic practices C W NtA 2
AHot holding greater than or equal to 1400F. (Whole beef/pork roasts 1300 F.) A ❑ No eating ❑ No smoking while working
B Cold holding less than or equal to 450 F. B Wounds covered adequately
C Proper cooling Proper sink used for handwashing
D Proper re-heating 0
E Proper internal cooking/consumer advisory posted 24 unitization rinse(hot vwater,-cherrUeallI.' C11 'NIA 2 3
0 A Approved sanitizeravailableladequate concentration ofsanitizer
4 Adequate facil€tles#Q maintain-productC NO NIA 2 B Food-contact surfaces and utensils used for potentially
-ternpiarat , rrncrrteters prpvjjdetl hazardous food sanitized at least every 4 hours
A Food thermometer available and accurate C Adequate ❑dishwashersanitizer Xnal rinse temp V
B Proper food thermometer for product L Proper sanitizing procedure
C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food
0
)Clean wiping Moths C
ti pbd yo
utri n,.
eparetta :G` fi 14? NfA
�t s" €t tra�is�l�l¢ri A Cloths and/or sponges in good repair and clean
A Produce washed B Wiping cloths kept in sanitizer between uses
B Raw meats not stored/prepared near ready-to-eat foods +oed- ntaCt swr faces lean C140
C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean K.
D N Adequate splash guards/sneeze guard g Single use gloves changed when soiled
No unauthorized personnel I
C )Food--contact surfaces clean
F No pooling of eggs not cooked immediately 0
8 Food containers stored off the floor 30 of and cold water under pressure,provided as fmuire4 C N/0'f l 2
0 38 Handwashing accessories provided A 1
9 Handifng°of food minimized Cj VO N/A 2 A I Soap/paper towels/ drying device available
A No unnecessary handling RTE and/or cooked foods with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel
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)for dispensing food/ice 0
0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The following information is not debitable and 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: 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 policy that requires the food worker to report specifi ^ess conditions
Are temperatures recorded/logged for cold holding foods/equipment? Y and diseases to the QFO? Y N *Do you have a paid sick I policy? Y N
Are foods cooked in advance and cooled? Y N ♦ overs saved? Y N Is there a language barrier between inspector&QFO? Y yes indicate language spoken
List products cooled: by QFO/DA: *Can the A read the inspection report? Y N
Describe cooling methods: Indicate who answered the abo�ques' me(print):
Indicate the title of above personapply):QFO DA Mgr Cook Owner FW
Is cooling monitored for ti temp? Y N Is the monitoring of cooling recorded? Y N .Obtain signature of the pers ho received the QFO responsibilities information at the time of the
Is there a prod washing policy? Y N *Describe what is washed and inspection:
where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2
fold - of olding_Temperatures. _Cooling- .
Section 19-13-1342(m)(3) Section 19-13-842 m 3
){ )
4 degrees F. or less 140 degrees F, or more Cooked potentially Hazardous Food shall
for all potentially hazardous foods EXCEPT whole beef be cooled:
and pork roasts which may be held hot at 130 degrees F. 0 F. to F. within 2 hours
or above, 0 F. to 453 F. within an additional
I Cooked; cooled and refrigerated food that is pre-
hours
pared for immediate service in response to an individual Methods
order may be served at any temperature, hallo pan(s) ,' deepor less)
Ice water baths stirring
1
Ready-to-eat food taken from a commercially
processed, hermetically sealed container shall be heated � Volume r action
to 140 degrees F. or greater for hot holding. Rapid chill refrigerator lastchiller)
Store foods in the cooling process
Internal_Cooking Temperatures Luonco�aered,but protected in a refri crated unit.
S€�ction19-13-B42(ni)(1)(A)(13)(QD) ver the toad when it is less than 45 degrees F.
Whole Roasts,CornedBeef,Pork Roasts
130"1. 121 minutes Reheating Temperatures
40"F. 12 m.1I1Ute5
145"F. 3 minutes
Section 19-13-B42(m)(3) j
Shell-Eggs,Fish,Meat,Pork Potentially Hazardous Food that is cooked,cooled,and
reheated for hot holding shall be reheated so that all
145"F 15 seconds parts of the food reach a temperature of at least 165
Ground_or Comminute eat and Fish,Products degrees F.for 15 seconds within 2 hours EXCEPT
145"F. 3 minutes unsliced portions of roast beef which may be reheated to
150"F. l minute 145 degrees F.for 3 minutes. l
155"F. 15 seconds
1580F. Instantaneously Ill Food Worker
Game Meats,lout ,Ground or Co _ inute_ Poultry Section.19-13-B42(r)of the Public.-iealth_Code
tea + Firs_h,_Mea_t,_PastaPW1try or
Stuffing containing PHF ingredients No person while affected with any disease in a communicable
form, or while a carrier of such disease, or while afflicted with
1 CM5"F. 15 seconds boils, infected wounds, sores or an acute respiratonnj infection,
_ is aver kie shall work in any area of a food service establishment in any
Raw animal food shall be rotated or stirred throcrgl�out car capacity in which there is a likelihood of such person contami-
nating during cooping to compensate for ctne�ret2 distribu food, drink or food contact surfaces with pathogenic
tion of heat, covered to retain surface moisture;heated to organisms, or transmitting disease to other individuals; and no
a temperature of at least 165 degrees F. in all parts of the person shall be employed in such an area or capacity. If the
food,and allowed to stand covered for 2 minutes after management of the food service establishment has
cooping. reason to suspect that any employee has contracted any
disease in a communicable form or has become a carrier
of such disease, he shall notify the local director of health
--- immediately.
j u V r A Viso
i
Section 19-13-1342(m)(1)(F)
Consumers shall be informed of the risks involved with the - isease/ - ent el to .....to Foo orne Illness
consumption of raw or undercooked animal foods by written I {List is net inclusive
I means such as: posters, brochures, menu advisories, table � •Campylobaoter -Hepatitis A -Trichinosis •Listeria
tents, etc, available at the food service establishment -Norwalk-like viruses -Salmonella -Clostridium
stating: "Thoroughly cooking meats, poultry, seafood, p infection
ens -Botu-Yerslism
a -Bacillus cereus •E. coli 4157
infection •Botulism •Virio infection
shellfish,or eggs reduces the risk of f000rne illness" •Shigella •Staph aureus •Scombroid Toxin
Exemptions to the food temperature requirements shall not be
onditioo s related to the transmission of..food borne
allowed at food service establishments serving highly suscep- illness: -Diarrhea -Vomiting -Jaundice -Sore throat
tible populations in hospitals, nursing homes, or similar health with fever -Fever with GI symptoms -Lesions containing pus
care facilities. Refer to Code for details. such as: boils and infected wounds
m
stablishment: Date of Inspection: l l l-
ddress: - Owner or Operator: C .
ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served. 4 31 Sewage disposal approved.
-Unwrapped foods not re-served 4
-Potentially hazardous foods not re-served -Operating as required
No cross connections,back siphonage,backflow 11 Toxic chemicals. 4 Proper type/installation/backfiow prevention device/air gap for: 4
-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
-Pesticides/rodenticides properly dispensed
Proper drain for:
29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines
-Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4
-Water quality in compliance
-Monitoring in compliance designed,properly installed
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
Sources of food:Original container,properly labeled 40 Garbage/rubbish storage area/rooms,enclosures-property constructed,dean 1
5 Potentially hazardous food properly thawed 2 41 Garbage/rubbish disposed of in an approved manner,at approved frequency
10 Food dispensing utensils properly stored f 42 Vermin Control: No insects/rodents present 2
14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outer openings protected against entrance of insects/rodents 1
4 Floors: Floor covering installed,constructed as required,good repair,clean 1
16 Food-contact surfaces designed,constructed,maintained,installed, 2 45 Floors graded,drained as required
located
6 Floor,wall juncture covered
17 Nonfood-contact surfaces designed,constructed,maintained, 1 47 Mats removable,good repair,clean
installed,located
2
8 Exterior walking,driving surfaces,good repair,clean
18 Single service articles,storage,dispensing 1
19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good 1
0 Dishwashing facilities approved design,adequately constructed, 2 repair,clean.Wall&ceiling surfaces as required
maintained installed located 50 Dustless cleaning methods used,cleaning equipment propedy stored
Equipment&Utensils: Cleanliness i 51 Adequate lighting provided as required 1
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1
2 Wash water dean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required
23 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,dean,adequate lockers provided,facilities dean 1
7 Nonfood-contact surfaces of utensils&equipment clean 1
55 Establishment and premises free of litter,no insect/rodent harborage, 1
8 Equipment/utensils,storage,handling 1 no unnecessary articles
32 Proper disposal of wastewater 56 Complete separation from living/sleeping quarters and laundry 1
3 PI mbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1
58 No live birds,turtles,or other animals(except guide dogs) 1
6 Toilet rooms enclosed with self-dosing door 1
59 Seats 75 or more:Nonsmoking area provided,signs)posted at
37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) 3
39 Approved garbage/rubbish containers,adequate number,covered, 1
rodent proof,clean Routine Inspection OReinspection 0 Preoperational Inspection
INSPECT R: P_ N IN BARGE: Othe pection:
_2
merit Ste: *Include demerits from page 1
4 3 2 1 Total Rating
sign signature
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0 33 E�tec,)t;v � DATE CORRECTIONS DUE: - t u Z i r��phone number title —
Page 2 of 2 plus 1 continuation pages Focused Iusp"t1o1L2oo2
Paged of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
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INSPECTION MARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Mana r