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Home My WebLink AboutFood Service Establishment Inspection 95 (2) 1gC Establishment: Inspection Date: Time: - 3 U ROins REinsp ddresslCity: -�. Healt Dept: 5 , � <ndo-i 4✓ Class: 2 3C4 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 N/A DNC KEY: C[complies] NIO(not observed) NIA[not applicable] Q tie rgG]aFoOf� tpr } 3 DNC[does not comply] 0[other] RTE[ready-to-eat] Qpera ° � .a. .. 0412Rersonn I f i „ Si tatted Altemafe1 k n p +N! rtfecion restirtated ,b g 'y "1 NO rNlA t4 2' - 1. A Food workers have no exposed infected lesions/burns 21 r3ten documentation of traming progiam i 2 k � B Personnel with infection restricted +.p7oued source,whdl�sbme;no adult�rafetl N103 fJ1A' 4 C Communicable disease of worker reported to local health director c i A Approved shellfish,finfish,meat&poultry USDA approved ;14�Handviiashipg jh li£tes prpvided elands uvashed;clear "C N10 N/A 14 B Food cares in good condition(not dented,rusty,bloated,leaking) Li A Handwash facilities in all foodprep/dispensing&warewash areas r.. C Wholesomelnonadulleraled foods/safe B Handwash facilities in or immediately adjacent to toilet rooms cr D Commercial products(no home grownlcannedfood) C Handwash facilities accessiblelconvenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure E Handwashing at appropriate times ldlly,hazardoU(food)ne tflle uirsmants j r N10 NIA'°41 p � ut;Ing,��torage prepara�ton�dasyJay, e e'vifl tfaAsoifati8nv l� " ��i�' 5 "Go i n�" raticas A Hot holding greater than or equal to 140 F, (whole beeilporh roasts 1300F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450F. �, B Wounds covered adequately C I Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal Cookin I consumer advisoryposted �2'4 Sarr[tizatron rinsel(hot�watec=eherreisal)6 Cj NIO N/Ai i 0 A Approved sanitizeravailableladequateconoentrationofsanitizer~ '¢egra ,f'��T]Irfr®s toartttil"M d'd - B Food-contact surfaces and utensils used for potentially :. +" ' i"a#tai9e themtomlefei^sf t3rd�rftld ��. , hazardous food sanitized at least every 4 hours AK ° '94 C Adequate dishwasher sanitizer Ofinal rinse temp A Food thermometer available and accurate D Proper sanitizin rocedure B Proper food thermometerfor product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 .;� ,; }f prfotee�ted diiriri&t6i $a i C NI® NI11 3r ' A Cloths and/or sponges in good repair and clean dsplaysenNige and ran&per, ! 1 B Wiping cloths kept in sanitizer between uses . A Produce washed 0 B Raw meats notstored/prepared near ready-to-eat foods as < pntac pfa plea�n a� N1 ?CIA 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 V C Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor 3 lo,Ho t c ldWer onf p esst�rd;[i'r4i lded'as requited"",C' 1oi 1 lA�J`3!l VW C Han washmgraoaessones provided C Nl0" 5 1 A No unnecessary handling RTEandlorcooked fo �, ��1 e� I3,artdligg of fold minima : ]s:.� a !}u ry gfoods bare hands Soap 1 paper towels 1 drying device available B Dispenser(s)working: ❑Soap ❑Paper towel. B Minimize food handling,other than ready-to-eat,with bare hands C I Handwash sink(s)clean 1 waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice p 0 -DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debatable and does not affect your score. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB Ifoodborne] PHFs are hot held at: IF. PHFs are cold held at: DF, 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: I IIs there a written illness policy that requires the food worker to report specific illness conditions Are temperatures recordedllogged for cold holding foodslequipment? 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 barrier between inspector&QFO? Y N ff-M 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): Indicate the title of above person(circle all that apply):QFO DA Mgr Cook Owner FW Is cooling monitored for time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain signature of the person who received the QFO responsibilities information at the time of the [where: here a produce washing policy? Y N ♦Describe what is washed and inspection: Note: This report is a two page form(total of 62 debltable items) Page 1 of 2 lok" k 111"�kl' oat E Addr6s is, ADDITIONAL FOUR POINT ITEMS Pr KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. 31 Sewage disposal approved. ,41 4 .Unwrapped foods not re served :M ; -Potentially hazardous foods not re-served i -Operating as required No cross connections,back siphonage,backflow I Toxic chemicals. 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 -Pesticides/rodenticides 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, 4.1 -Water quality in compliance designed,properly installed -Monitoring in compliance OTHER ITEMS KEY: DNC [DOES NOT COMPLY] Sources of food: Original container,properly labeled 11 40 Garbage/rubbish storage area/rooms,enclosures-properly constructed,clean Potentially hazardous food properly thawed 2 41 Garbagelrubbish disposed of in an approved manner,at approved frequency �10 Food dispensing utensils properly stored 1 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outeropenings protected against entrance of insects1rodents 44 Floors: Floor covering installed,constructed as required,good repair,clean Food-contact surfaces designed,constructed, maintained,installed, ('2 45 Floors graded,drained as required located46 Floor,wall juncture covered )onfbod-contact surfaces designed, constructed,maintained, 4 Mats removable,good repair,clean installed,located ! 7�p 48 Exterior walking,driving surfaces,good repair,clean .18 Single service articles,storage,dispensing 2 491 Walls,ceilings attached,equipment properly constructed,good 19 1 No reuse of single service article repair,clean-Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2 maintained,installed,located 50 Dustless cleaning methods used,cleaning equipment properly stored EQu'pment&Utensils� Cleanliness 1 51 Adequate lighting provided as required 21 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 231 Accurate thermometers provided,dish basket,if used 541 Rooms adequate,clean,adequate lockers provided,facilities clean 27 Nonfood-contact surfaces of utensils&equipment clean 155 Establishment and premisesfree of liter,no insectfrodent harborage, 28 Equip me nVuie n sils,storage,handling 1 no unnecessary articles 32 Properdisposal of waste water 1 56 Complete separationfrom living/sleeping quarters and laundry —33 Plumbing location,installation,maintenance 57 Cleanisoiled linensstored properly 1 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 159 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Pfopertoilet fixtures provided,good repair,clean 3 entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, 1 rodent proof,clean URoutine Inspection 13Reinspection 13 Preoperational Inspection INSP�CTO RSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 U 4 4 3 2 1 Total Rating �Sp1ht u 4--11-/ Lnl+� /� / Z --t 'y nt name s print na a 3Z DATE CORRECTIONS phone number title Z--�t Page 2 of 2 plus t continuation pages Focused Inspection 112002 1J — Page Of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INsrEcTION REMARKS FORM# _-44 f— ✓l v a� �(� (� d V U dK c e✓ 1 j'A A Cf`n s 4 k - U INITIAL(INSPECTOR) INITIAL(PERSON IN C Distribution: Ist-White-Health Department 2nd-Yel w-Ow an r