HomeMy WebLinkAboutSchool Inspection 591 Ellington Road a ,t
STATE OP CO 1C NIA u EvSD IC EPORtIt DEPARTME $ „
Establishment: Inspection Date: gILOW f Time: 1()L&U ROinsp Einsp
Address/City: Health Dept: �4
Based on an inspection this day,thMr 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 itemsj C 10 NIA DNCI KEY..: C[complies] Nl0[not observed] NIA[not applicable]
64 Qualified'Food Operator 3 DNC[does not comply) 0 jother) RTE[ready-to•eat]
61 Designated Alternate 2
fit Written documentation of program 12 Personnel with infection restricted C N10 N1A 4
A Food workers have no exposed infected lesions 1 burns
2'
B Personnel with infection restricted ✓
1 Approved source,wholesome,nonadulterated C N/0 NIA 4 C Communicable disease of worker reported to local health director
A Approved shellfish finfish meat&poultry USDA approved It 13 Handwashing facilities provided,hands washed,clean N/0 NIA 4
B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepidispensing&warewash areas
C Wholesome/nonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms
D Commercial products(no home grown/canned food) 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
3 Potentially-hazardous food meets temperature requirements c 0 N/A 4 0
during storage,preparation,display,service and transportation
15 Good hygienic practices /0 NIA 2
A Hot holding greater than or equal to 140°F. ("hole beef/pork roasts 1300 F.) V A ❑ No eating ❑No smoking while working
B Cold holding less than or equal to45"F. 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 posted 24 San itization o rinse(hot water chemical) C N/0 NIA 2
0 A Approved sanitizer available/adequate concentration of sanitizer
.4 Adequate facilities to maintain product C 10 ,NIA 2` g I Food-contact surfaces and utensils used for potentially
temperature;thermometers provided hazardous food sanitized at least every 4 hours
A Food lhermometeravailable and accurate C Adequate 42fdishwashersanitizer ❑final rinse temp
D Proper sanitizin rocedure
B Proper food thermomeierfor product E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in cooler units 0
0 25 Clean wiping cloths . C N/,0 NIA 1_
7' Food protected during:storage„prep`aration,, C 10 NIA A Clolhsandlorsponges in oodrepairandclean
display,service and transportationg
B Wiping cloths kept in sanitizer between uses
A Produce washed 0
B Raw meats notstoredlprepared near ready-to-eat foods 26 ;Food;dorrtactsurfacesclean, , C. o N/A 2
C Food covered properly A Food equipmentclean,utensils clean,equipment interiors clean
D Adequate splash guards I sneeze guard g Single use gloves changed when sailed
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 30 Hot-and,cold water under pressure,provided as require C' !0 NIA: 2
0 38 ;Handwashing accessories provided C N/0 NIA 1
9 Handling of food minimized N/0 N/A 2 A Soap!paper towels! drying device available
A No unnecessary handling RTE andlor cooked foods with bare hands B
Dispenser(s)working; ❑Soap ❑Paper towel
B
Minimize food handling,other than ready-to-eat,with bare hands r., C Handwash sink(s)clean I waste receptacle at handwash sink
C Adequate utensil(s)for dispensing foodlice 0
0 *DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The fallowing information is not debitable and does not affect your score. _KEIL: QFO[qualified food operator],DA[designated alternate),PHF[potentially hazardous food],FB[foodborne]
PHFs are hot held at: F. 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 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 If-yes indicate language spoken
List products cooled: by QFO/DA: *Can the QFO/DA 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
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Establishments Iae. i Ip�edtion
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ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served. z
-Unwrapped foods not re-served
�4g 31 Sewage disposal approved. 4"
�k 14 -Operating as required
-Potentially hazardous foods not re-served 037 >
11 Toxic chemicals.
No cross connections,back siphonage,backflow
4
-Stored properly,labeled properly,used properly fi Proper typelinstallationl backflow prevention device/air gap
-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 s
-Pesticides/rodenticides properly dispensed -Chemical dispensers -ice machines
Proper drain for:
29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines
-Well/well head protected from contamination { 4 35 Toilet facilities. Adequate,convenient,accessible, 4V
-Water quality in compliance ' q
-Monitoring in compliance designed,properly installed 4,
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
2 Sources of food: Original container,properly labeled 40 Garbagelrubbishstoragearealrooms,enclosures-properly constructed,clean 1
1
5 Potentially hazardous food properly thawed 920 41 Garbagelrubbish disposed of in an approved manner,at approved frequency [
10 Food dispensing utensils properly stored ! 2 vermin Control: No insects/rodents present 2'
14 Food worker:Clean outer clothes,effective hair restraints 737 Outeropenings protected against entrance of insects!rodents 'a
4 Floors:Floor covering installed,constructed as required,good repair,clean t
4,
16 Food-contact surfaces designed,constructed,maintained,installed, �2�. 5 Floors graded,drained as required
located `
$ 6 Floor,wall juncture covered ',
17 Nonfood-contact surfaces designed,constructed,maintained, !
7 Mats removable,good repair,clean
installed,located
2
8 Exterior walking,driving surfaces,good repair,clean
18 Single service articles,storage,dispensing
19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good 1
repair,clean.Wall&ceiling surfaces as required
20 Dishwashingfacilities approved design,adequately constructed,
maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly storedoil
Equipment&Utensils: Cleanliness 51 Adequate lighting provided as required 014*
21 PreFlushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1
22 Washwaterclean,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,facilities clean
27 Nonfood-contact surfaces of utensils&equipment clean ;
55 Establishment and premises free of lifter,noinsecUrodentharborage, �
28 Equipmentlutensils,storage,handling no unnecessary articles
56 Complete separation from living/sleepinguarters and laundry
32 Proper disposal of waste water p p q "4
33 Plumbing location,installation,maintenance 57 Clean/soiled linens stored properly
58 No live birds,turtles,or other animals(except guide dogs) kL
f
36 Toilet moms enclosed with self-closing door
59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at
37 Propertoilet Fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s)
i I
;^
39 Approved garbagelrubbish containers,adequate number,covered, !
rodent proof,clean MRoutine Inspection ❑Reinspection 0 Preoperational Inspection
Other Inspection:
PERSON IN CHARGE: Demerit Score: *Include demerits from page 1
4 3 2 1 Total Rating
sighature Si nature
print name print name
-Z,S'l� sS�' foa'r� Cam— DATE CORRECTIONS DUE:
phone number title
Page 2 of 2 plus_� _continuation pages Focused inepecdon 1/2002
Page of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
V 616 .Ulu" . wc SZ� 1S
INSPECTION REMARKS
FORM#
L S - 01� t�ri u
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: I st-White-Health Department 2nd-Yellow- Owner/Manager