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HomeMy WebLinkAboutFood Service Establishment Inspection 65 c 3 Establishment: , L rcr� �[ s ection Date: 7i Time: ROins REinsp Address/City: {e Health ept: class: 1 2 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 NIO WA DNC I KEY: C[compliesl N10[not observed] NIA[not applicable] fi0 Qualified Food 0 era or ° 3 DNC[does not comply] 0[other] RTE[ready-to-eat] gyp' 12 Personripl with infection restricted 61 rDestgndtad Pilternate 2 ;. C, NIQ NIA:;'4 Food workers have no exposed infected lesions!burns i 62 Written dr0quihbritationi6f trainingprogram 2 B personnel with infection restricted 1 A provt d source,wholesome,nonadultsrated `C. N?0•NI C Communicable disease of worker reported to local health director ot A I Approved shellfish,finfish,meat&poultry USDA approved /tCI I 13 `.Handv✓ashing facilities provided,ISands washed,clean C N10- NlA: 4' B Food cans in good condition(not dented,rusty,bloated,leaking) q Handwash facilities in all food prepldispensing&warewash areas C Wholesomelnonadulteratedfoodslsafe B Handwash facilities in or immediately adjacent to toilet rooms D Commercialproducts(nohomegrownlcannedfood) C Handwash facilities accessiblelconvenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure 0 E Handwashing at appropriate times 3 ' 50Wtially hazardous fta� �m'ee s tei p"erafure requirements iC N1O VIA 141 0 during storagieprepara'� display ervice and transportation i t x: k • .=: Good`h gienit: praGtice.'s'= f`UO N1A :2 A. .. .. .� F A.. Hot holding greater than or equal to 140 F. (whole haeflperk roests13o°F) A ❑No eating ❑ No smoking while working B Cold holding less than or equal to450F. B Wounds covered adequately C Proper cooling Ad I I C Proper sink used for handwashing D Proper re-heating 0 24 ;Sanittzatl , , C ll�O WA t2-:E Proper internal cooking lconsumer advisory posted :s .. 0 A Approved sanitizeravailableladequateooncentradonofsanitizer [4 1° Adequate' "c Iitresto+matntatn roduct �" �" h x w, ! p - � C iNlO N!A g Food-contact surfaces and utensils used for potentially $ ftperature,rthetYrigrt�te�s provtrf r s` hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer '{final rinse temp B Proper food thermometer for product D Proper sanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 i 5 [:Cfea i in elothsw 7� I "odt rots t u'i t?:�o"ra a re"`ration` C �N o" p 9 .C'1N1O NIA 1 ' p 09# 9 gyp+ " 2 Cloths andlors on es in good repair and clean E 1 lrary�seMeewartdrtr 'rrs of t t , ;, w , x : t w r P 9 g P`� per . a:...'�.,..a:.::s�. .# ":, ..,. .•, n .R...a...a' ["3�:a.s:a� ,;(;a'r . A Produce washed B Wiping cloths kept in sanitizer between uses 0 B Rawmeafsnotstoredlprepared near ready-to-eat foods ie oAd co ntac�ytda"uifa6es�clear '° � C ,N10 ;t�IA l i:.xp•.a. .iA..Iwn. gym. ¢c�'bls, il>r W,3 ,3%'i - C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards sneeze guard B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean I F No pooling of eggs not cooked immediately 8 Food containers stored off thefioor ,. 430'1 liot andcbJdrwaer under prtissirre,rproaided as regtursT �C NIA 1224 f 0 3 Han w in i k i Ar F'l. F9 Hand i of�fooid minimize "< £kd mash}g �ceso{rie ISO$`Mt a s r'tiVOW'. P: " '""' A Soap!paper towels 1 drying device available A No unnecessary handling RTE and/or cooked foods with bare hands B Dispenser(s)working: ❑Soap ❑Papertowel 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 *DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qual'dred food operator],DA[designated alternate],PHF Dotentally hazardous food], FB[foodborne] PHFs are hot held at: OF. 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 wriftegAillness policy that requires the food worker to report specific illness conditions Are temperatures recordedilogged for cold holding foodslequipment? N and diseases the QFO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are left ors saved? Y N Is there aJ nguage barrier between inspector&QFO? Y N If ves indicate language spoken List products cooled: by QF l A: *Can the QFOIDA read the inspection report? Y N Describe cooling methods: Indicate who answered the above questions: Name(print): Indicate the title of aboA@n cle all that ap DA Mgr Cook Owner FW Is cooling monitored for time&temp? Y N Is the mo itoring of cooling recorded? Y N .Obtain signature thor F re sibs 'es information at the time of the Is there a produce washing policy? Y N ♦Desc I e what is washed and inspection: 41 where: Note: This report is a two page form(total of(32 a -table items) Page 1 of 2 STa 1TE OF CONNEC'fICUT DEPARTMENTF PUBLIC:HEALTtf 41©'GAP#TOL AVENUE lfAS#$1 FDP HARTF�RD;CT{O6 34 A F F_(JCUSED';FU66`SEAVICE INSPLCTIOI� REPE3RT LO�CA�,HI?AL`TH bEP1 y ` y"J" cufru�Sa6�= ADDkESSICITY: : Establishmetif: /�tA=�U,3 u,/ / i¢rJdUL` �'t�. vzJ!Dafe of.lnspectlan; ddress. .;l�-c Owner or`Operator; 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 Proper typelinstallation/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 -Pesticideslrodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4::. -Water quality in compliance -Monitoring in compliance designed,properly installed OTHER ITEMS Vi KEY: DNC [DOES NOT COMPLY] lo' 2 o rcesoffood: Original container,properly labeled 1 > 0 Garbagelrubbishstoragearealrooms,enclosures-properly constructed clean i 1. 5 Potentially hazardous food properly thawed 4 1 Garbagelrubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils property stored _:Cw 42 Vermin Control: No insectslrodents present Z i - 14 Food worker:Clean outer clothes,effective hair restraints °1 43 Outeropenings protected against entrance of insects/rodents F 1 4 Floors: Floorcovering installed,constructed as required,good repair,clean 1` 16 Food-contact surfaces desi gn ed,constructed,maintained,installed, 2 45 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 1471 Mats removable,good repair,clean installed,located 8 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing Z, v 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, maintained installed located 50 Dustless cleaning methodsused,cleaning equipment properly stored Equipment&Utensils: Cleanliness 1" 51 Adequate lighting provided as required 1 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 2 Wash water clean, tem temperature proper p 53 Rooms&equipment hoods,ducts,vented as required -AeNS ate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean f 27 food-contact surfaces of utensils&equipment clean 1 5 Estab I is h me nt and p rem isesfrea of litter,no i n sect/rod ant harbo rage, r l„ 28 Equipmentlutensils,storage,handling no unnecessary articles 32 Proper disposal of wastewater 1P„ 56 Complete separation from living/sleeping quarters and laundry I ' 33 Plumbing location,installation,maintenance Glh.' 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 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 3 37 Propertoiletfxtures provided,good repair,clean entrances),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, 1 rodent proof,clean aoutine Inspection OReinspection 0 Preoperational Inspection PECTOR: PERSON_IN CHARGE: Other Inspection: Demerit fcore: *Include demerits from page 1 G 4 3 2 1 Total Rating signature sign to � f priinnt name_ pri ame V DATE CORRECTIONS DUE: �1� phone number title � �� Page 2 of 2 plus continuation pages FocusedInspecHon 112002 Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF SPEC ON INSPECTION REMARKS FORM# y/ �3,9 6x� � I r l ✓+.-�/�-f 65s�b 73 (' — A / , / Mr. Fecha Emp:r- /`C�/(/�� Empleado �" PASS WHEN BLllE BART 9RANGf A2A U."�RA C 0�xulAti`iA *1604/71'C' - � -� L INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: lst-White-Health Department 2nd-Yellow-Owner/Manager Page�f INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION L/Z�ZA/, INSPECTION REMARKS FORM# � li GJ &1.e f/61010 INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE Distribution: Ist-White- ealth Department 2nd-Yell Ai Owner/Manager . . c: 7: ; qL® . . . > / 7ZY \ kpca } \ . \K : § -1R RO . .