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HomeMy WebLinkAboutFood Service Establishment Inspection 10 Establishment: f -,m z-77444/2L�lnspection Date: Time: (-ftinsp Einsp Address/City: q „ .) t _ l,� Health Dept: �,r i7— ass: 2 3 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. -- - RISK FACTOR-ITEMS.'-Listing snot inclusive of all passlbFe- ebT6le iitems C NIO NIA DNC KEY: C[complies] N10[not observed] N!A[not applicable] tiU dlalifled FgOd©perafor "' g DNC[does not comply] 0[other] RTE[ready-to-eat] 6t Destgn#dd%llternate 2 � :; .. t., fie ° ,_ :!. l [ A Food workers have no exposed infected lesions 1 burns `fit Written documentation ottra[ning program z B Personnel with infection restricted f [EIp1GY�tl SpurCR,+NhDleso�ne;rtOnadUlt�feted ',C ,N10 NIA '4 C Communicable disease of worker reported to local health director A Approved shellfish finfish,meat&poultrU DAapproved O , f-• „., Hanr�washtng faCill es provti ecf,hands rasped,clean C N6 rNik'�4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadulteratedfoods!safe D Commercial products(no home grown/canned food) B Handwash facilities in or immediately adjacent to toilet rooms C Handwash facilities accessibletconvenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean!Proper handwash procedure t 0 E Handwashing at appropriate times iepIN�' Ctrs fo ets tempsrste regii�Yeta �s` 'C �NIO�'�t '4� 0 t grxproparatton display,serYic and tfansportatiq , III ;P i �sg t eW a k w W FF A Hot holding greater than orequal to 140 F. (wholebeeflpork roaste iso°F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 45"F. A B Wounds covered adequately V AL C Proper cooling C Proper sink used for handwashing D Proper re-heating_ 0 E j Proper internal cooking I consumer advisory posted at zatio'h"r11 s;(i"`.ru'ater-[ehYe}nicaf) . ;C `N10;I NIA 2 Approved sanitizer availableladequate concentration of sanitizes 4 , Ade4ra tle afrtitai produot Cr ip tN/ t Food contact surfaces and utensils used for potentially Ferp¢� # , hero �tq�src�u41 t r '� E f hazardous food sanitized at least eve I hours A Food thermometer available and accurate C Adequate ❑dishwashersanilizer inal rinse temp B Proper food thermometer for product D Proper sanitizin rocedure E Sanitizing between raw animal on in&ready-to-eat food C Thermometers appropriately placed in cooler units g }(0 r25 i CteansnlA'I cloths '` C'FNIO rN1A �1 100 A Cloths andlors on es in good re airand clean PO ping cloths kept insanitizer between uses A Produce washed B Rawmeatsnotstoredlprepared near ready-to-eatfoods t1 Crs ' t �Saf��� C Food covered properly Food equipment clean,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 F No pooling of eggs not cooked immediately 0 8 Food containers stored offthe floor j fir`✓ 3>t rHot-an�poj` ��ndi' assure,ptoYtded as required I ;NIO 'F;VA `2 ,0 36€,Handwa&h[ngceas ilea ptouidetl .: C NIO A. A Soap I paper towels 1 drying device available A No unnecessary handling RTE andlorcooked foods with bare hands B Dispensers)working: OSoap ❑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 O 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 altemate],PHF[potentially hazardous food],FB(foodbome] PHFs are hot held at: OF. 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 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 thh od worker to report specific illness conditions Are temperatures recordedllogged for cold holding food quipment? Y N and diseases to the QF0? Y N b you have a paid sick leave policy? Y N Are foods cooked in advance and coaled Y N *Are leftovers saved? N Is there a language barrier betweep i Spector&QFO Y N It yes indicate language spoken List products cooled: by QFOIDA: 7 *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&to ? Y N Is the monitoring of cooling recorded? Y N .Obtain signature of t arson whe-receive the QFO responsibilities information at the time of the r'sthere a produce washing Iicy? Y N ♦Describe what is washed and inspecon:_ S. ��gfJ.ere: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 Esta6lishrnerit:. `` � % L7" L- '_ Date of,Irlis�ection: � Zf °access _ ��� v "" /j,��a _ ,Owna or,Operator: GU 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 11 Toxic chemicals. No cross connections, back siphonage,backflow 4'; Pro per type/installation/backflow prevention device/air ga for: 4' -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines - Sanitizerconcentration 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. -Food equipment -Dish machines -Ice machines 4 -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4" -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS o KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 1, 0 Garbagehubbishstoragearea/rooms,enclosures-properly constructed,clean 5 Potentially hazardous food properly thawed 2 1 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 ' 2 Vermin Control:No insects/rodents present 2: _ 14 Food worker:Clean outer clothes,effective hair restraints 1:: 3 Outer openings protected against entrance of insects/rodents 4 Floors: Floor covering installed,constructed as required,good repair,clean 1.. 6 Food-contact surfacesdesigned,constructed,maintained,installed, 2 5 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed, maintained, 47 Mats removable,good repair,clean installed,located jS 18 Single service articles,storage,dispensing 2 ` eriorwalking,driving surfaces,good repair,clean JL 19 No reuse of single service article 9 Uis,ceilings attached,equipment properly constructed,good 1; repair,clean.Wall&ceiling surfaces as required 0 Dishwashing facilities approved design,adequately constructed, e2` maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1 Equipment&Utensils Cleanliness 1 51 Adequate lighting provided as required 1` 1 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 2fnTQZ ate thermometers provided,dish basket,if used Rooms adequate,clean,adequate lockers provided,facilities clean 1 7 � food-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,no insect/rodent harborage, c! Equipmentfutensils,storage,handling 1 no unnecessary articles j .. 32 Proper disposat of waste water 1 56 Complete separation from livinglsleeping quarters and laundry 33 Plumbing location,installation,maintenance 1 571 Clean/soiled linens stored properly 1 58 No live birds,turtles,orotheranimals(except guide dogs) 1, 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 entrance(s),smoking area indicated by sign(s) 3 39 Approved garbage/rubbish containers,adequate number,covered, 1 rodent proof,clean ❑Routine Inspection ❑Reinspection 13 Preoperational Inspection INSPECTOR: PER N IN CHAgQE: Other Inspection: Demerit Score: •Include demerits from page 1 " 4 3 2 1 Total Rating sign ture oyr ; signature41 7 r . Pri name ✓ print e f9s_�� - �� ` �� a DATE CORRECTIONS DUE: /� phone number title �� '!!�' Page 2 of 2 plus continuation pages Focused inspection 11 �2 / Page t of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION 94 FORM# REMARKS r 4` W � -'� •plc.` � � o ,ew Z f � So INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Pa of ` INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC NEAT TH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF IN ECTIO INSPECTION FORM# REMARKS T L exA Date:�r fxFa _ fmpeado PASSWMENBWE BAR TURNSORANGE, AlUlEVM4UAC�NIPAWa' J _- 00 114a jQ a dC� INITIAL(INSPECTOR) 1NITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager