HomeMy WebLinkAbout87 Evergreen Way (5) EHS•106-Rev.11/05 INSPECTION REPORT STATE OF CONNECTICUT E ROUTINE INSPECTION ❑ REINSPECTION
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ PREOPERATIONAL ❑ OTHER
410 Capitol Avenue,MS#11 FDP,Hartford,CT 06134
NAME OF ESTABLISHMENT�—
ESTABLISHMENT '(a ja—L. C i\ CLASS
STREET TOWN
OWNERADDRESS
INSPECTION
OPERATOR l L DATE and TIME C (t]: j3oe'
V
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 3L Accurate thermometers provided,dish basket,if used insects/rodents
4 nitization rinse(hot water-chemical)
FOOD PROTECTION Clean wiping cloths 1 FLOORS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 26 Food-contact surfaces of utensils& 2 44 Floors:floor covering installed,
temperature requirements during storage, equipment clean constructed as required,good repair,clean
preparation,display,service,and
transportation 2 onfood-contact surfaces of utensils& 1 45 Floors,graded,drained as required 1
equipment clean 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 provided
5 Potentially hazardous food properly thawed 2 48 Exterior walking,driving surfaces, 1
6 Unwrapped or potentially hazardous food 4 WATER SUPPLY Igood 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
W8 ,,d
y,service&transportation 2 provided as required surfaces as required.
containers stored off floor 50 Dustless cleaning methods used, 1
SEWAGE DISPOSAL cleaning equipment properly stored
9 Handling of food minimized 2 311 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 1 Personnel with infection restricted 4 1 34 No cross connection,back siphonage,backnow 4
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 1
15 Good hygienic practices,smoking restricted 2 37 Proper 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 1 Nonfood-contact surfaces designed, 1 58 No live birds,turtles,or other animals 1
constructed,maintained,installed,located GARBAGEIRUBBISH STORAGE&DISPOSALI I(except guide dogs)
18 Single service articles,storage,dispensing 2 39 1 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 1 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 3 2� 1 7 RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2
L
r 62 Written documentation of training program 2
TOTAL RATING I Date Corrections Due Signature of Person in charge nn,,
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SIGNED(Insp for
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DESCRIBE EFICIENCIES ON CONTINUATION SHEETS
DISTRIBUTION:I" -White—Health Department 2°d—Yellow—Owner/Operator
Page of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
INSPECTION FORM# REMARKS
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager