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HomeMy WebLinkAboutFood Service Establishment 535 Evergreen f nT e�+'UOI�� S .V'�G��T ION$ �iSIv3si�tll Establishment: jyuc3 Inspection Date: Time: Roins Einsp Address/City: v,,Q Health Dept: _ r:J e Class: 1 2 3 Based on an inspection this day,the l ems marked DNC identify he 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 NIO NIA DNC KEY: C[complies] NIO[not observed) NIA[not applicable] 60 QUall(I6 00d Operator 3 DNC[does not comply] 0[other] RTE[read-to-eatj 61 :DeslgnatedlAlternate> 2 12 Personnel with infection restricted -C . /0 N/A '4 fit Written documentation of training program 2 A Food workers have no exposed infected lesions I burns $ Personnel with infection restricted 1 . Approved source;wholesome,nonaduiterated N10 N/A 4` C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved V 13 Handwashing facilities provided,hands washed,clean C''N10 NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) L000 A Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadulteratedfoodslsafe VB 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 I Proper handwash procedure 0 E Handwashing at appropriate times 3 Poteht[alty'hazardous food meets temperature requireinerits' C N10 NIA 4 0 during storage,preparation,display,service and,transportation " '15 "Good hygienic,practices C N10 -NIA 2 A Hot holding greater than or equal to 1400F. (whole beef/pork roasts 1300 F.) V A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to45'F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating V 00 E Proper internal cooking I consumer advisory posted _74- 24°Sanitization'rirrse,(hdt'water-chemical) C N10;N1A =2- 0 A Approved sanitizer ava ilableladequate concentration of sanitize r 4 Adequate;facilities,to mafnfarn jrgtlucts = frC N10 iNIA '_2 B Food-contact surfaces and utensils used for potentially temorature,'thermometers provided a hazardous food nitized at least every 4 hours Foo.. _-._ dthermometeravailableandaccuraie C Adequate dishwashersanitizer ❑final rinse temp A D Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-io-eatfood C Thermometers appropriately placed in cooler units Q 0 25 ,Clean wiping�cloths /Q NIA- 1- 7 i z 910 protected-during storage,,preparation, ;C N10 -NIA'2 A Cloths and/or sponges in good repair and clean t �laj , 11, dis -servlce,end traneportationi B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods V 26 ?Fobd-contact surfaces,clean, N10 4NlA ;2 C Food covered properly A 'Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards 1 sneeze guard i B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean F No pooling of eggs not cooked immediately ol 0 8 Food containers stored off the floor 30 :Hot and cold water under pressure,provided as required .0 N10 11A '2'I 0 '38 f Handwashing accessories provided AIQ. FWA "-1 9 Hanillirrg offfpod nninlmized �`. _: -, C ;NlO'NIA ;2 A No unnecessary handling RTE and/or cooked foods with bare hands A Soap!paper towels l drying device available B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean I waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 0 i •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The fallowing information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food], FS[foodborne] PHFs are hot held at: F. PH Fs 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 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 foods cooked in advance and cooled? Y N *Are leftovers saved? Y N Is there a language barrier between inspector&QFO? Y N If ves indicate language spoken List products coaled: by QFOIDA: ♦Can the QFOIDA read the inspection report? Y N Describe cooling methods: Indicate who answered the above questions:Name(print): Indicate the title of above person(circle all that apply):QFO DA Mgr Cook Owner FW Is cooling monitored for time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain signature of the person who received the QFO responsibilities information at the time of the Is there a produce 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 C a - �T► 'CIF GONN GTICf�T ©� �kRTMFI T/1j}� F'IJBL�Gt�f�EAL'T�Fy��+",4�'tQ:*A§T4�ryL1�1IEN#�U 1�13 51FDf' HARTFORb,CT Q6134 CEb ©��_SER;VICfE rI) SPEPl �l �1, rPVF ,y b' C 4 LO AC,WEALT�I DEPT �� k Iy t T� ✓ ADDRESSICITY L',' r'E i UA1?) ' t ` Establtshm'ent S ;; D"ate of Inspectiort ddress (N Owner or Opera#or: ADDITIONAL FOUR POINT ITEMS of KEY: DNC [DOES NOT COMPLY] F 6 Foods not re-served. 4 31 Sewage disposal approved. -Unwrapped foods not re-served 4 -Operating as required -Potentially hazardous foods not re-served 34 No cross connections,back siphonage,backflow "E lI Toxic chemicals. 4 Proper typelinstallation/backflow prevention device/air gapfor: 4 -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration notto 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, -Food equipment -Dish machines -Ice machines 4' -Well Iwell head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4 -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sourcesoffood: Original container,properly labeled 40 Garbagelrubbishstoragearea/rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properly thawed 41 Garbagelrubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 42 Vermin Control: No insects/rodents present 2 Bf $ 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected againstentrance of insects/rodents 1„ 4 Floors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed, maintained,installed, 2'; 5 Floors graded,drained as required located x 6 F loor,wa I I j u nctu re cove re d 17 onfood contact surfaces designed,constructed,maintained, 1 - 7 Mats removable,good repair,clean installed,located 8 Exterior walking,driving surfaces,good repair,clean ' 18 Single service articles,storage,dispensing 2 19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good �1 repair,clean.Wall&ceiling surfaces as required ." 0 Dishwashing facilities approved design,adequately constructed, 2: maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1. Equipment&Ute.gsiI& Cleanliness i 51 Adequate lighting provided as required 1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean -1 ,fx. 27 Nonfood contact surfaces of utensils&equipment clean 1 55 Est@ bl ish ment a nd premises free ofIitfer,no insectlrodent harborage,29 . EquipmenUutensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 1',` 56 Complete separation from livinglsleepirig quarters and laundry 1 33 Plumbing location,installation,maintenance iw; 571 Clean/soiled linens stored properly 58 No live birds,turtles,or other animals(except guide dogs) $ 36 Toilet rooms e nclose d wi th self-clos i ng door 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at �f` 37 Proper toilet fixtures provided,good repair,clean entrances),smoking area indicated by sign(s) . r� 39 Approved garbage/rubbish containers,adequate number,covered, 1 rodent proof,clean fftutine Inspection ❑Reinspec'on ❑ reop ttor al Inspection Other Inspection: �c �` IN PE PERSON IN Ham: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating s€ ature signature pri t ame_ / print name phone number title` DATE CORRECTIONS DUE: o Page 2 of 2 plus continuation pages Focused Inspection 1/2002 Page-3 Of 3 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWNd DATE tOF INSPECTION \Y-\�401 L 1 INSPECTION REMARKS FORM# 2') 7c.> ten+ ( 3 �k tAl J\A 4w �,-,dj,� �24 L OL cipm S�1� A INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager