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HomeMy WebLinkAboutFood Service Establishment Inspection 57 Establishment; inspection Date: i / Time: Roinsp R nsp Address/City: — c� / Health Dept: �.� .L ass: 2 3 4 Based on an inspection this day,the items marked DNC identify the violations in operation or facilities which must be corrected by the date speci led on page 2. RISK FACTOR ITEMS:Listing is not inclusive of all possible debitable items C N10 NIA DNC KEY: C[complies] NIO[not observed] NIA[not applicable] 60 r Qya[ified FQO Operator �� 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 1.2f Pd so" net u¢ ar a 'on rest Ic ¢Ith N I designated"titeirta ». 52 Wcttten docpmeri4tion dr li ing pf<ogr m 2 A Food workers have no exposed infected lesions!burns B Personnel with infection restricted ro�edaQurce,Wholesorae;,noin' dlt�rated, �C �tflf3�h11A ft4' municable disease of worker reported to local health director A Approved shellfish fnfish,meat&poultry USDA approved 13htn facUtt es'pi �►ided Ah�tndswashed ctearf hC:iNO x �:4 B Food cans in good condition(not dented,rusty,bloated,leaking) Handwash facilities in all food prep/dispensing&Warewash areas C Wholesomelnonadu Iterated foods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/cannedfood) C Handwash facilities accessiblelconvenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean 1 Proper handwash procedure 0 E H _ashing at appropriate times �3 =Potetttia[I ha4ardd,0Joc d meets tehlp9rature requirements C N!b' i ll � ditrjrrg s�gra9e,preparatrpp,gtspleYrservtce�nd tranepotta{ion r' r ; � d H i Sri practt�es r C NIt7' A 2 . A Hot holding greater than or equal to 140 F. (whole NV/pork roasts iao°el A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450 F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking 1 consumer advisory posted ,2 i t t iitt 11?C �n►at cl r!}jttial� C 0 A Approved sanitizeravailableladequateconcentratlonofsanitizer Ade iae gtlrtr�t ttf trratntatrt r dttet a` r. tor/ B Food-contact surfaces and utensils used for potentially r r 4 4 a a }ttttr2itrf3,#hetrnmete► pr4t $ "` ` hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp B Proper footlthermometer for product D Proper sanitizin rocedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 C �r� W.�>r �t ] x. � ,� � � A Cloths and/or sponges in good repair and clean et B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not storedlprepared near ready-to-eat foods t2t3+��rad �turfafear��y C N!0 ;NlA 2 C Food covered properly A Food equipmentclean,utensils clean,equipmentinteriors clean` D Adequate splashguardslsneeze guard B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfacesclean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor �' d d �tQY,under pressure,pro!ided'a's require- )0!70 'NIA, 2 0 A 9 cress s pro V a t)rte sided_ C 0 'NIA 1 A No unnecessary handling RTE and/or cooked foods with bare hands A Soap 1paper towels/ drying device available B Dispensers)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 foodlice 0 0 1 -DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated allemate],PHF[potentially hazardous food],FB[foodborrej PHFs are hot held at: IF. PHFs are cold held at: F. Describe illness conditions when you would exclude a food worker from working: Are internal cooking temperatures taken? Y N +To what temperature do you wok: Poultry Ground Beef Pork What diseases related to FB illness are u required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy that r quires 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 bamer be n inspector&QFO? Y N If yes 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): Is cooling monitored for time&temp? Y N Is the monitoring of Wolin recorded? Y N Indicate the ti of above person(tole,all that apply):QFO DA Mgr Cook Owner FW Obtain signature f e erson ho receiveO the QFO responsibilities information at the time of the Is there a produce washing policy? Y N ♦Describe what is washed and nspection: / where: Note: Thl report is a two age fdrm(total of 62 debltable items) Page 1 of 2 G�NNECTI WTF;�DE ENT'tSF Pllt3LIC H LTH 41�CAPt-�'OLA1/ENU� #51FOP 'HARTFORD,CT 06134 Jjt k9C D V 5ER['ICE_ INSJPECTI0S,REFCiRT L =f W 417W btPT fi g,4DORESSICITy hment. Date of in spe ctton 7.f5wner orOpeator. . L ' TEMF— C MInPLYjTM a 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 74 No cross connections, back siphonage,backflow ' ll Toxic chemicals. 4 Proper typel[nstallationl backflow prevention devicelairgafio -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines - Sanitizerconcentrationnot#p 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: 29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines 4 -Weil I well head protected from contamination 35 Toiletfacilities. Adequate,convenient,accessible, 4' -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS KEY: DNC [DOES NOT COMPLY] c 2 Sources of food: Original container,properly labeled 1 ' 0 Garbagelrubbishstoragearealrooms,enclosures properly constructed,dean 1. 5 Potentially hazardous food properly thawed , 41 Garbage/rubbish disposed ofinan approved manner,atapprovedfrequency L: 10 Food dispensing utensils properly stored 42 Vermin Control: No insects/rodents present 2 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected against entrance of insectsfrodents 4 Floors:Floor covering installed,constructed as required,good repair,clean , 16 Food-contact surfaces designed,constructed,maintained,installed, 2' 45 Floors graded,drained as required a `,- ed 6 Floor,wall juncture covered 17 N od-contact surfaces designed,constructed, maintained, 1 7 Mats removable,good repair,clean s---installed,located 1 18 Single service articles,storage,dispensing 2 8 Exteriorwalking,driving surfaces,good repair,clean 19 No reuse of single service article al ,ceilings attached,equipment properly constructed,good g 20 Dishwashing facilities approved design,adequately constructed, 2 repair,clean.Wall&ceiling surfaces as required maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required 21 Preftushed,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 23 Arc4,rate thermometers provided,dish basket,if used 71 5 Rooms adequate,clean,adequate lockers provided,facilities clean 12 21 N ood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,no insect/rodent harborage, 17 . Equipmentlutensils,storage,handling r :' no unnecessary articles } 6 Complete separation from living/sleepinguarters and laundry K. -Pro erdisposalofwastewater i�: P Pq ry �1t 33 Plumbing location,installation,maintenances 57 Cleanlsoiled linens stored properly w1-- 58 No live birds,turtles,or other animals(except guide dogs) 1 t rooms enclosed with self-closing door 1 59 Seats75 or more:Nonsmoking area provided,sign(s)posted at r ' 7�ro� er toilet fixtures provided,good re air, can r3, entrance(s),smoking area indicated by sign(s) 39 Approved garbagelrubbish containers,adequate number,covered, 4=° rodent proof,clean outine Inspection ❑Reinspection 0 Preoperational Inspection TOR: PERSON IN CWARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signature signetu print name print"me— I l phone number title DATE CORRECTIONS DUE: 6 3� �� ! Page 2 of 2 plus c continuation pages r.,'11-i5,40 r�o Page of _ -INSPECTION-REPORT _ ._. . _ .__ ___ ._ _ _ STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH NAME OF ESTABLISHMENT TOWN DATE OF INSPEC ION INSPECTION FORM REMARKS # -7 w a Z �.� un.� INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow-Owner/Manager Pageof - -INSPECTION-REPORT STATE OF CONNECTICUT-.- - FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH NAME OF ESTABLISHMENT TOWN DATE OF SPECTION INSPECTION FORM# REMARKS ; e 0 ,t t >� .3 � �. . . —<.vcte, j 4-1 INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE}\ Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager