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HomeMy WebLinkAboutItnerant Vendors Inspection 000 Chapel R Establishment: Inspection Date: Time: ROinsp insp Address/City: Jc} v Heal h Dept: ', (� n cy✓ : 1 2 30 Based on an inspection this day,the items marked DNC identify t 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 10 WA DNC (LEA: C[complies] NIO[not observedl NIA(not applicable] FtlOertlEor 3 DNC[does not comply] 0[other] RTE[ready-to-eat] y q ice ' 1 r �9� al-withdii@S7 I t�`d ' ski e 1 s a .; i a4etllterrtat z _ _ . .. ., I�10A S, A Food workers have no exposed infected lesions!burns W.rittien#dotiiimentattp�OFftir ' r 2 B Personnel with infection restricted 'rbtletlts�urce,wq ; I iN(0 I.�I 1 +.�:�,- .� � C Communicable disease of worker reported to local health director A 1 Approved shellfish,finfish,meat&poultry USDA approved 1014404 m 4aditltres toLtetl hart stas'ed cte moll B Food cans in good condition(not dented,rusty,bloated,leaking) `T"" ` "t kaifi "e' "l' �,fit`"-t "' A Handwash facilities in all food prepidispensing&warewash areas C Wholesomelnonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities access!blelconvenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure C E Handwashing at appropriate times In III lhaaartlou> fo $n i putreit � 0 a pFe'affitl� dispt�r s s �brt.fo _ 5i- - «x ° V i t �1 Obod h re r eskkl: A Hot holding greater than or equal to 140 F. (whole beeapork roasts 130 F.) A ❑No eating ❑ No smoking while working B Cold holding less than or equal to 45°F. r,/ B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking I consumer advisory postedSanrQnri (tonrtchemiat 0C1a ,7 0 A Approved sanitizeravailableladequateooncentrationofsanitizer I I r 4errt o (3 IIV�O g Food-contact surfaces and utensils used for potentially rorrl hazardous food sanitized at least every 4 hours _ v, . : ' A Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eatfood C Thermometers appropriately placed in cooler units 0 0n �tSl©ths� sz� �r 3 r A Cloths andlor sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats notstorediprepared near ready-to-eat foods r r. ]j € 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 F No pooling of eggs not cooked immediately 0 8 Food containers stored offthe floor grate`under4 saurq; ro��rr � sfifd'; [_ a�.aa„ . a.'�:.,, �. 0 �� �hn9 d+ I gfalf 14 , " (N14 t t. A Soap 1 paper towels 1 drying device available A No unnecessary handling RTE andlorcooked foods with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean 1 waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/Ice 0 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. JfE QFO(qualified food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodborne] PHFs are hot held at: IF. 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 written illness policy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foods/equipment? 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 indicate language spoken List products cooled: by QFOIDA: *Can the QF01DA 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 Is there a produce washing policy? Y N ♦Describe what is washed and inspection: where: Note: This report is a two page form(total.of 62 debitable items) , Page 1 of 2 f . i;st�bltshmertt .tom �� ( [date ofinspecya�n� X .. O1hIt OF'O@Fs1tOF, s 3 eLc*! �( + :`s ADDITIONAL FOUR POINT ITEMS LAKEY: 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 k -Operating as required 4 r, No cross connections, back siphonage,backflow 11 Toxic chemicals. 4 4 Proper typelinstallationl backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizes concentration not to exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticidesfrodenticides 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 s, OTHER ITEMS o; KEY: DNC [DOES NOT COMPLY] 2 Sources offood: Original container,properly labeled 1 [42 Garbage/rubbish storage arealrooms,enclosures-propedyoonstructed,clean 1 5 Potentially hazardous food properly thawed 2 Garbagelrubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1 Vermin Control: No insectslrodents present 2 14 Food worker:Clean outer clothes,effective hair restraints 1 Outer openings protected against entrance ofinsectslrodenls 4 Floors: Floor covering installed,constructed as required,good repair,clean 1 16 Food-contact surfaces designed,constructed,maintained,installed, 2 45 Floors graded,drained as required located 6 Floor,wall juncture covered 1 N nfood-contact surfaces designed,constructed, maintained, 1 7 Mats removable,good repair,clean Insialletl,located 1 48 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 2 19 No reuse of single service article 49 Walls,ceilings attached,equipment properly constructed,goad repair,clean.Wall&ceiling surfaces as required e 20 Dishwashing facilities approved design,adequately constructed, 2 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils• Cleanliness 1, 51 Adequate lighting provided as required _ 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 23 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilitiesclean 1 27 Nonfood contact surfaces af utensils&equipment clean 1 55 Establishment and premises free of lifter,no insect/rodent harborage, 1' 28 EquipmenUutensils,storage,handling 1 no unnecessary articles 32 Proper disposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry =; 33 Plumbing location,installation,maintenance 1' 57 Clean/soiled linens stored properly f 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosedwith self-closing door 1 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at s 37 P roper to i let fi xtu re s provided,good repair,clean entrance(s),smoking area indicated by sign(s) ti. 39 Approved garbage/rubbish containers,adequate number,covered, I rodent proof,clean DRoutine Inspection Reinspection ❑ Preoperational Inspection INS E PERSON I Other Inspection: Demerit Score: +Include demerits from page 1 4 3 2 1 Total Rating Si aiure signature , pri tmje \\ print a e zvy)7z . DATE CORRECTIONS DUE: phone number tr le Page 2 of 2 plus _.,.-_continuation pages Fansed Inspection 112002 Page ,3 Of as INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION (L&?&�� Y\�4 6�/_ /(-I � L,�� �� INSPECTION REMARKS FORM# (�1k— Ca A J bO vi INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) _ Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager