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HomeMy WebLinkAboutFood Service Establishment 855 John FItc i11 it Establishment: A- V-rAVb,i\j, 41Z pdrispection Date: Time: Roinsp Eins ddress/City: `�{ Health Dept: t J , 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. 11-1 RISK FACTOR ITEMS: Listing is not inclusive of all possible debitable items C VO WA DNC I ►EY: C(complies] NIO[not observed] NIA[not applicable] dtfl:bd,Operator 1 A 3 DNC[does not comply] 0[other] RTE(ready-to-eat] ' ,, .� 1M_aPers� ��nnel,yrith=infection restrteted trD1g „ a ��Oa NI 4 A tier a q Food workers have no exposed Infected lesions/burns a r B Personnel with infection restricted pp ovecT sq_uree„whole¢om ;gonadu#seated ti" C- 10!IN 4! C Communicable disease of worker reported to local health director A I Approved shellfish,flnfish,meat&poultry USDA approved #Harlick**,h�ng mfacIlrties-provrded;hands washed„'clean' ; t ,t )NTA,I'4 B Food cans in good condition(not dented,rusty,bloated,leaking) A M N handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadu Iterated foodsisat B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities accessiblelconvenient to use E Potentially hazardous foods received at proper temperature p Personnel hands washed,clean!Proper handwash procedure 0 E Handwashing at appropriate times N entlall t azdrdous,f6dd rtieets�tein e'Y9t 1Pr 0I�e s p E 1 ` � � �,.r t �I 0 so p� afo OAK, e a 1 a`to �,4* µ w ro f i:,�. t5i Good hY9tenicpraciices a C° NIOtllAa"2 g 9 q A ❑ No ❑ No smoking � t° A Hot holding greater than ore ual io 140 F. (whole besrr �,nes�rso°al g g 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 0 =24 �.s �.to. K"(' s .9, 1 m x CE Proper internal cooking l consumer advisory posted q i INIA. 2 0 A Approvedsanitizeravailableladequate concentration ofsanitizer e at gi{t�p 4p�m�rn'atnprol�ct C PUO� NQ' 2'. g Food-contact surfaces and utensils used for potentially sg} fh�fin I ' " hazardous foods tized at least every 4 hours A Food thermometer available and accurate C Adequate dishwashersanitizer ❑final rinse temp D Pro ersan[tizinrocedure B Properfood thermometerfor product E Sanitizing between raw animal origin 8 ready-io-eatfood C Thermometers appropriately placed in coolerunits 0 0 t r � ,4�l�.r lgfSa Oag� i ti(jl M !Y17A, 2 ; - '� " .t, I,11 /A p tk AK lho!„ Ilisertvtce and4tr�arfs cfi ti r A Cloths and/or sponges in good repair and clean ' .x _ f B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods rF©odq©r�tactrurat�esyc�ean F ICI`N10 NI C Food covered properly A Food equipmentclean,utensils clean,equipment interiors clean D Adequate splash guards 1 sneeze guard B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean No pooling of eggs not cooked immediately 8 Pood containers stored off the floor "'mil f ' � ` "' " � �' 0 N111�3 t ot"nt �AN+k8�er-gin .,r pressure,.provided as 9 'e �2,. 0 _ _ niVsftt�g dCcessoriespovided'> ". ' N1Q Iq q ; 9 9� ff tl S !� Z s I 4t�f0i N TA2vt , A No unnecessary handling RTE and/or cooked foods with bare hands oap 1 paper towels! 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!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. M: QFO[qualified food operator],DA[designated alternate],PHF]potentially hazardous food],FB[foodborne) PHFs are hot held at: F. 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 specific illness conditions Are temperatures recorded/logged 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 ff-M indicate language spoken List products cooled: 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: I I Note: This report is a two page form(total of 62 debitable items) Page t of 2 3 F ' `r. asra - :, •," Establishmek r w es V, s We . ddress: - �' .a x mOVner o3peraor. f�til` � - s ADDITIONAL FOUR POINT ITEMS r 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 37 No cross connections,back siphonage,backflow 11 Toxic chemicals. q -Stared properly,labeled properly,used properly 4 Proper type/!nstallation/backflow prevention device/air gap for: -Food equipment -Hose connections -Dish machines -Sanitizes concentration not to exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticideslrodenticides properly dispensed Proper drain for: 2x ,Purce adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well/well head protectWrom contamination 35 Toilet facilities. Adequate,convenient,accessible, 4 -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS z", KEY: DNC [DOES NOT CO rTLY] 7. 2 Sources of food: Original container,properly labeled 1 40 Garbage/rubbishsloragearealrooms,enclosures-properlyconstructed clean 5 Potentially hazardous food properly thawed 2 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 F od dispensing utensils properly stored 1 2 Vermin Control No insects/rodents present 2 Food worker:Clean outer clothes,effective hair restraints p 43 Outer openings protected against entrance of insects/rodents 1 44 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 46 Floor,wall juncture covered 7 onfood-contact surfaces designed,constructed,maintained, 1 47 Mats removable,good repair,clean stalled,located 18 Single service articles,storage,dispensing 2 48 Exterior walking,driving surfaces,good repair,clean t' 19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good 1 20 Dishwashing facilities approved design,adequately constructed, 2 epair,clean.Wall&ceiling surfaces as required maintained D installed located 50 stlesscleaningmethodsused,cleaningequipmentproperlystored + Equipment&Utensils• Cleanliness 1' 51 Adequate lighting provided as required 21 Pretlushed,scraped,soaked and racked p 52 Room free of steam,smoke odors 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 23 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 'rt 27 Nonfood-contact surfaces of utensils&equipment clean 1 r 55 Eslablishmentand premises free of liter,no insect/rodent harborage, 2.9 Equipment/utensils,storage,handling 1 no unnecessary articles 3 roperdisposalofwastewater 1:; 56 Complete separation from livinglsleepingquarters and laundry Plumbing location,installation,maintenance 571 Clean/soiled linens stored properly & ..-. 58 No live birds,turtles,orother animals(exceptguide dogs) 36 Toilet rooms enclosed with self-closing door 1 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet fixtures provided,good repair,clean en#rance(s),smoking area indicated by sign(s) 0 39 Approved garbage/rubbish containers,adequate number,covered, 1' rodent proof,clean Moutine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTO PERSON IN CHARGE: Demerit Score: *Include demerits from page 1 ( 4 3 2 1 Total Rating sl ture signature [Z I")mv� (, - �p V� pri t a e prin na e Z ne n mb title DATE CORRECTIONS DUE: �� Page 2 of 2 plus continuation pages F-e d1n pedal 112002 Page 3 of J INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION. 14u INSPECTION REMARKS FORM# l �tl ,3 -r- (� 0 A 1A ,� trU Cr W W -� U tA u wb,�2 4 �:Jt t:JE 22 4' LIL J�� OfWJA � C �( c. LA Ll h A�f.Clfd _Ii�, n/ 61�2p A�JA �A�y�,a K_� i Gj -� Su1A t C j i.N CjMto INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager