HomeMy WebLinkAboutFood Service Establishment 982 Establishment: .4017_ Inspection Date: Time: Q p Eirl
Address/City: 9k, 5 i i�„l Health Dept: WA. ,b Class: 1 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 is not inclusive of all possible debitable items C N10 NIA IDNCI KEY: C(complies) Nl0[not observed] NIA[not applicable]
I80 L t 0�Ilfvd,:&d Operator 3 DNC[does not comply] 0[other] I[ready-to-eat]
Bi ignatedAlt®mate 212. Petsonrtluii[tW rrffecion restricted
s , Food workers have no exposed infected lesions 1 burns
f4 itten documentation of training program 2
Personnel with infection restricted
1 �Apptoved source,Wholesome;nonailulterated C N10 N! 4 C Communicable disease of worker reported to local health director
A Approved shellfish,finfish meat&poultry USDA approved n13 i anclwaaFirng;fac7liti�s prpovf&d,''h'ndttulrastied,cleaft C l{V10<!NIA 4
B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepld[spensing&warewash areas
C Wholesomelnonadulteraledfoodslsafe B Handwash facilities in or i mediately adjacent to toilet rooms
D Commercial products(no home grown/canned food) C Handwash facilities siblelconvenient to use
E Potentially hazardous foods received at proper temperature D Personnel hands wash ,clean! handwash procedure
0 E Handwashing at appro a times
�3 t P�. �' I i�aza" dglustt'Qod rrle'�- l+U� �w=� 4 0
1�I�grag8,f rep8ratto �tll3 fctso° r' �
obi hygtefni praQttctrs� W a� 2
A Hot holding greater than or equal to 140°F. (whole beef/pork roasts139aF) A ❑ No eating No smoking while working
B Cold holding less than orequal to450F. B Wounds covered adequately
C Proper cooling 'Proper sink used for handwashing
D Proper re-heating .6e 0
E Proper internal cooking I consumer advisory posted 5faiittf� rQ + t�r� chemical)
�s
Approved sanitizeravailableladequateconcentrationofsanitizer
41 a opt tip , _ B Food-contact surfaces and utensils used for potentially
al'
t hazardous food sanitized at least every 4 hours
f
A Food thermometer available and accurate C Adequate Odishwashersanitizer Ofinal rinse temp
Proper
B Proper food thermometer for product D
E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in cooler units 0
0 g5 CIearrwPl{a9:o[oths .0 +[QUO `llA 1
Im 00" r.4 A Cloths and/or sponges in good repair and clean
J L
B Wiping cloths kept in sanitizer between uses
A Produce washed
0
B Raw meats not storedlprepared near ready-to-eatfoods r2B� ii#actsu"tFBQescip�rl -C �Wo, N1A 1
L ^•' ..,.._a Ci.�!
C Food covered properly
A 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 off the floor all i,Wot and cold.water under pssUtQ, rowdedyassiequtrs €C 0 NIA $2
' t t v
38 Handwashing accessones;ird . • c e 4alAi a
9 �Nd�if9.offood minimized i C. 11� q Soap 1 paper towels/ drying device available
A No unnecessary handling RTE and/or cooked foods with bare hands B Dispenser(s)working; Elsoap ❑Paper towel
B Minimize food handling,ocher than ready-to-eat,with bare hands C Handwash sink(s)clean!waste receptacle at handwash sink
C Adequate utensil(s)for dispensing footllice 0
0 +DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The following information is not debitable and does not affect your score. KEY: 4FO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodborne]
PH Fs are hot held at: OF. PHFs are cold held at: IF. Describe ill s 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 dise as related to FB illness are you required to report to the local health department?
Roasts Other
Describe re-heating procedures Is there written illness policy that requires the food worker to report specific illness conditions
Are temperatures recordedhogged for cold holding oodsfequipment? Y N and di ases to the Ql Y N *Do you have a paid sick leave pollcy? Y N
Are gods cooked in advance and cooled? Y *Are leftovers saved? Y N is t re a language barrier between inspector&Cil Y N If yes indicate language spoken
List products cooled: by QFOIDA; *Can the QFO/DA read the inspection report? Y N
Describe coaling 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 Is the monitoring of cooling recorded? Y N .Obtain slgnature of th pe on who receive the QFO responsibilities information at the time of the
Is there a produce washing policy? Y ♦Describe what is washed and inspection: ,. �� Ut_ 7-4 � fsZ Q
where: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2
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OCiTS Il iaof)-S Xt LTG flYSP CTIQ �REIrORT
EL(3CAL'H1=ALTHDEPT` `; �>7', �i1t,�1117 'ADDRESS/CITY: x
Establishmenf /Z Date of Inspec#ion.
,.dd SSs lZ >�t�G�`l/�¢<i'� /»� Owner or`Qper 0`r: 6 L v
ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served.
-Unwrapped foods not re served 4 31 Sewage disposal approved. 4:
-Potentially hazardous foods not re-served -Operating as required
No cross connections,back siphonage,backflow
11 Toxic chemicals. 4
4 Pro�ypelinstallation!backflow prevention device)air gan for:
-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
-Pesticideslrodenticides properly dispensed PrQ er dLahjor:
29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines
-Well/well head protected from contamination-Water quality in compliance 35 Toilet facilities. Adequate,convenient,accessible, 4
-Monitoring in compliance designed,properly installed
OTHER ITEMS c KEY: DNC [DOES NOT COMPLY]
2 Sources of food:Original container,properly labeled 1 0 Garbagelrubbishstoragearealrooms,enclosures-properly constructed,dean
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 Outeropenings protected against entrance of insects/rodents 1
4 Floors: Floor covering installed,constructed as required,good repair,clean 1.
16 Food-contact surfaces designed,constructed, maintained,installed, 2 5 Floors graded,drained as required
oc ed
6 Floor,wall juncture covered
17 pod-contactsurfaces designed,constructed,maintained, 1:' M s removable,good repair,clean
installed,located
8 Exterior walking,driving surfaces,good repair,clean 1
18 Single service articles,storage,dispensing 2 z.
19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good
repair,clean.Wall&ceiling surfaces as required ~
20 Dishwashing facilities approved design,adequately constructed, 2 }l
maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored
Equipment&Utensils: Cleanliness 1 51 A eq ate lighting provided as required
21 Preflushed,scraped,soaked and racked m free of steam,smoke odors `1
22 Wash waterclean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required
23 curate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1
2 pod-contact surfaces of utensils&equipment clean 1 > 55 Establishment and premises free of litter,no insect/rodent harborage, 1'
28 Equipmentlutensils,storage,handling 1 no unnecessary articles
32 Properdisposal of waste water 1 56 Complete separationfrom living/sleeping quarters and laundry 1
33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1
58 No live birds,turtles,or other animals(except guide dogs) 1'
36 Toilet rooms enclosed with self-closing door 1
37 Proper toilet fixtures provided,good repair,clean 59 Seats 75or more:Nonsmoking area provided,sign(s)posted at 3
entrance(s),smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered, 1
rodent proof,clean outine Inspection ❑Reinspection ❑ Preoperational Inspection
TOR: PERSON IN CHARGE: Other Inspection:
- / 7 Demerit Score: *Include demerits from page 1
G d'4'o C G� S'�f� 4 3 2 1 Total Rating
signature �^ signature
Lx'1 eJYV
ame print name c..�
phone number title
DATE CORRECTIONS DUE: �/� °L
Page 2 of 2 plus continuation pages Focused Inspection I12002
g,�-; Pagej Of4
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPE ION
INSPECTION REMARKS
FORM#
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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
NAME OF ESTABLISHMENT TOWN DATE OF INSPEC ION
INSPECTION REMARKS
FORM#
e
� A
INITIAL(INSPECTOR) ��7 INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager
B. Demonstrable elements of competency
(i) Assess the potential for foodborne illness in a food service establishment—perform operational food safety
assessment;recognize and develop standards,policies and procedures,select and train employees;implement self
audit/inspection program;revise policy and procedure(feedback loop);implement crisis management program.
(ii) Assess and manage the process flow—identify approved source;implement and maintain a receiving program;
implement and maintain storage procedures;implement and maintain preparation procedures; implement and
maintain holding/service/display procedures; implement and maintain cooling and post preparation storage
procedures;implement and maintain re-service procedures; implement and maintain transportation procedures.
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D 1� b L attest that L l' /l''S A/
(Print Name of Owner or Operator) (Print Name of Alternate Person in Charge)
is employed as the alternate person in charge and has demonstrated to me the elements of knowledge and
demonstrable elements of competency as described in A and B, as listed above.
Signature and Title:',-[V CA=::e, Tu'j Date: 1-- 13 /6
(Signed by Owner/Operator
roof'`the Establishment)
Signature and Title: • �- f� Date:
(Signed by Alternate Person in Charge)
Name of Establishment:
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0 1540 SULLIVAN AVENUE• SOUTH WINDSOR, CT 06074
0R•c� . TELEPHONE(860)644-2511
January 14,2016
Jonel Tushe,Manager
Bella Pizza
982 Sullivan Avenue
South Windsor,CT 06074
Subject: Qualified Food Operator Requirements
Bella Pizza,982 Sullivan Avenue,South Windsor,CT
Dear Mr.Tushe:
On January 13,2016,I conducted an inspection of the above referenced food service establishment. At
that time you provided me a copy of your Qualified Food Operator(QFO) certificate. The certificate
you provided was a ServSafe Food Safety Training Certificate as opposed to a the required document
ServSafe Food Safety Manager Certificate according to Connecticut Public Health Code, section 19-
13-B42(s)(4). A ServSafe Food Safety Manager Certificate is the appropriate exam name for the _
Qualified Food Operator to obtain in order to be considered certified in a supervisory position.You also
stated that Elton Tushe was the Designated Alternate, and that he had a ServSafe Certificate, but the
paperwork was not available at the time of the inspection.
For your reference I have enclosed a list of the approved testing organizations.You and/or one of your
full-time managers who meets the criteria for a QFO (see attached) must complete the course
and receive a passing score on the exam within sixty (60) days. Another option would be to hire
someone with the correct certification.
Proof of certification must be provided to the health department by March 13,2016.
Please contact me if you have any questions or need any additional information at 860-644-2511, ext.
248.
Sincerely,
Diane L.Collelo
Environmental Health Inspector
Enc.Qualified Food Operator Requirements,Sponsored Classes&Exams 2016
Qualified Food Operator Approved Testing Organizations