HomeMy WebLinkAboutFood Service Establishment 17355 Ellingt 23
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Establishment: /2 Inspection Date: 11W.11L Time: If: Ninsp Einsp
ddressIcity: 429 VN,-`T Heal Dept: v/ as . 2
Based on an inspection this day,the items marked DNC ident]fy the violations in operation orfacilities which must be corrected bythe date spec)led on page 2.
RISK FACTOR ITEMS:Listing is not inclusive of all possible debitable items C N10 NIA JDNC I KEY: C[complies] N10[not observed] N/A[not applicable]
60 Qgaliffed Foed;Qperator g DNC[does not comply] 0[other] [ready-to-eat]
it ;DesignatedAtternate 2 12 C rN10
Personnel with infection restricted.:
2 A Food workers have no exposed infected lesions I burns
fit .Written documentation of training program
1 . Approved source,wholesome,nonadulterated 4 'N10 NIA 41 Personnel with infection restricted
P t t
C Communicable disease of worker reported to local health director
A Approved shellfish,finfish,meat&poultry USDA approved 13. Handwashtng facilities provided,,hands washed.clean C: N10 N/A 4
B Food Cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas
C Wholesomelnonadulleratedfoods!safe B Handwash facilities in or immediately adjacent to toilet rooms 4C
D Commercial products(no home grownlcannedfood) C Handwash facilitie cessfblelconvenientto use
E Potentially hazardous foods received at proper temperature D Personnel hands w 1 Proper handwash procedure
0 E Handwashing at app hate times
5. rRotentieilyy hazardous ood meeffs temperature:requtr"ements C N10 N!A 4 0
duriQ9 siorage,preparation,display,service and transportation ;
AS 'Good:hygtenlc,practices C RID WA 2:
A Hot holding greater than or equal to 14OeF. (whole beeffporkrossts 13&F.) A ❑ No eating ❑No smoking while working
B Cold holding less than or equal to 45 F. B Wounds covered adequately
C Proper cooling C Proper sink used for handwashing
D Proper re-heating 0
E Proper internal cooking l consumer advisory posted 0,o a .anitizaEron..ririse;(liotwa mica!} '= ': C rN10; R'2
oe
0 A provedsenitizeravailablelad quateoon ntration fsanitizer
F4 Ad a{e,fiacilltlesxto malntatn product *. �C (VIO 1WA, 2 B Food contact surfaces and utenst a y
rtemprrrature,tltlirmomgter' 'ptrovrdtl t hazardous food sanitized at least every hours
A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp
Proper
B Properfoodlhermometerforproduct
D
E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in 000lerunits 0
0 _ 25,;Clean wiping clothswon C N10° N1A; 1
Fi�od�protr�ttE? clut9k .irge,}preparations k 1Cz N10 lN1A 2y
• . K'�x'f T Cloths and/orsponges in ood repair and clean
�u }, ipleY,.serar�ce-and>trarisportafion , 9 P
4.k 4...A.
.5 y.: . .....:. .... ..... _ .. s.
B Wiping cloths kept in sanitizer between uses
A Produce washed
B Raw meats notstoredlprepared near ready-to-eat foods 36 ! dcrtdcrsrrxfa;cis*cl�ear� � ' x ' ,C°�N10 A 2
C Food covered properly A Food equipment clean,utensils clean, quipment interiors oleo
D Adequate splash guards/sneeze guard B Single use gloves changed when soile
E No unauthorized personnel C Food--contact surfaces clean
F No pooling of eggs not cooked immediately 0
8 Food containers stored off the floor 10 Hot Ad�coldiwafer,under�pressu' provided as°requtre^ t t [NA f2
Y t
0 g rt ndwashtng apcessorfes provided ic
W_ Nl.
9 H rtcfUng of#ood mmrmfZed,
A No unnecessary handling RTE and/or cooked foods with bare hands Soa ap owe! d ng device available
B Disp Ing: []Soap []Papertowel
B Minimize food handling,otherthan ready-to-eat,with bare hands C I Handwash sink(s)clean/waste receptacle at handwash sink
C Adequate utensil(s)for dispensing foodliee 0
0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The following information is not debitable and does not affect your score. KEY: QFO[qualified food operatorl,DA[designated alternate],li[potentially hazardous food],FB[foodbornel
PHFs are hot held at: OF. PHFs are cold held at: OF. Describe illness conditions when you ouId 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 illnes are you required to report to the local health department?
Roasts Other
Describe re-heating procedures: is there a written illness polio that requires the food worker to report specific illness conditions
Are temperatures recordedifogged for cold holding foodslequipm ? Y N and diseases to the QFO? N *Do you have a paid sick leave policy? Y N
Are foods cooked in advance and cooled? Y N *Are ovens saved? Y N Is there a language bar' r between inspector&QFO? Y N If indicate language spoken
List products cooled: by QFOIDA: *Can the QFOlDA read the inspection report? Y N
Describe cooling methods: Indicate who ans Bred the above questions: Name(print):
Indicate the titIll of above n hole all apply: FO Mg co
FW
Is cooling monitored for time&temp? Y N Is the onitoring of cooling recorded? Y N .Obtain sfgna re of the p r3pfi o roc h r on e time of the
Is there a produce washing policy? Y N ♦Des rihe what is washed and inspection:
where: Note; This report is a two page form(total of 62 debitable items) Page t of 2
- _ � I& HFaA T ��4fl0�C�API�T�L�A�UE�I l� lt� #5tlP�HAR'PFOR��C �O
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EA to
Date of Inspection;
didress.,. ':, %� Owner nr,;Operator.. .
7
y t.
ADDITIONAL FOUR POINT ITEMS
KEY: DNC [DOES NOT COM LY]
6 Foods not re-served.
-Unwrapped foods not re served 4 31 Sewage disposal approved. :
-Potentially hazardous foods not re-served -Operating as required
No cross connections, back siphonage,backflow
1 i Toxic chemicals. r 4
4 Proper ype/installation/backflow prevention device/air gap for:
-Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines
-Sanitizer concentration 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'
-Waterquality in compliance
-Monitoring in compliance designed,properly installed
OTHER ITEMS 0 7KEY: DNC [DOES NOT COMPLY]
2 Sources of food:Original container,properly labeled 0 Garbagelrubbish storage area/rooms,enclosures-properlyconstructed,clean 1
5 Potentially hazardous food properly thawed 2 41 Garbagelrubbish disposed of in an approved manner,at approved frequency
10 Food dispensing utensils properly stored `rig 42 vermin control: No insectslrodents present ;.Z;
14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected againstentranceof insectslrodents1
4 910
ors: Floor covering installed,constructed as required,good r air,clea
16 Food-contact surfaces designed,constructed, maintained,installed, .2 Floors graded,drained as required
located
6 Floor,wall juncture covered
17 Nonfood-contaclsurfaces designed,constructed, maintained, 1 ' 7 Mats removable,good repair,clean
installed,located 1
8 Exterior walking,driving surfaces,good repair,clean
18 Single service articles,storage,dispensing 2e
19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good
0 Dishwashing facilities approved design,adequately constructed, 2 repair,clean.Wall&ceiling surfaces as required g
maintained installed located 0 /less cleaning methods used,cleaning equipment properly stored
Equipment&Utensils: Cleanliness t Adequate lighting provided as required 7
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors
22 Wash waterclean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required
23 _Accuratethermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean
F
27 food-contact surfaces of utensils&equipment clean 1
55 Establishment and premises free of litter,noinsecUrodentharborage, ;1>
8 Equipment/utensils,storage,handling 1 no unnecessary articles
32 Proper disposal of wastewater 1 56 Complete separation from living/sleeping quarters and laundry X
33 Plumbing location,installation,maintenance 1' 57 Clean/soiled linens stored properly 1.
58 No live birds,turtles,or other animals(except guide dogs)
iT
36 Toilet rooms enclosed with self-closing door 1 ptt 1
59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at
37 Pro per to i let fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) 3 s
39 Approved garbagelrubbish containers,adequate number,covered, 1
rodent proof,clean PRoutine Inspection ❑Reinspection ❑ Preoperational Inspection
TOR: PERSON IN CHARGE: er Inspection:
Demerit Score: *Include demerits from page 1
4 3 2 1 Total Rating
,11 signature signature
7// X
mt name print name 9
ZY DATE CORRECTIONS DUE: 7
phone number 'P title rj
7 O v Page 2 of 2 plus continuation pages Focused Inspectlon uzooz
IZ' Page of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE F INSPECTION
INSPECTION REMARKS
FORM# l
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGe
Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager
Page of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
N 70FESTABLISHMENT TOWN DATE O 1NSPECTION
INSPECTION REMARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager