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HomeMy WebLinkAboutFood Service Establishment 465 Buckland TziCE . ONNECI{zJ � oi �t ..a PC 1 P _ INPAIIMEtVG F OfUBLICS }€EAL+Tfi lob + r Establishment: ,,, Inspection Date: Time: v A RO[nsp RE[nsp Address/City: L\0� (�,�,C�LfoA (j - __ Health Dept: S• W' : 1 z 3 a Based on an inspection this day,the items marked DNC identify t e 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 IDNC I KEY C[complies] NIO[not observed] NIA[not applicable] 60 Qualified Food Operator 3 DNC[does not comply] 0[other] RTE[r dy-to-eat] 61 Designated Alternate 2 12 Personnel with infection restricted C N10 NIA 4 q Food workers have no exposed infected lesions 1 burns 62 Written documentation of training program 2 B Personnel with infection restricted 1 Approved source,wholesome,nonadulteratetl C N10 N1A ,d C Communicable disease of worker reported to local health director A Approved shellfish,frnfish,meat&poultry USDA approved 13 Handwashing facilities provided,hands washed,clean N10 NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepldispensing&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 iblelconveniant to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean 1 Proper handwash procedure E Handwashing at appropriate times 3 Potentially hazardous food meets temperature requirements C. Nll0 Nl 4' 0 during storage,preparation,display,service and transportation 15 Good hygienic practices N10 NIA 2: A Hot holding greater than or equal to 140°F. (whole beef/pork roasts 130 F) A ❑ No eating El No smoking while working B Cold holding less than or equal to450F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Properinlernaicookinglconsumeradvisoryposted 2 Sanitization rinse(hot water-chemical) C WO NI 2 . 0 A Approved sanitizer available/adequate concentration ofsanitizer 4 Adequate facilities to maintain product C N10' 1% 2; B Food-contact surfaces and utensils used for potentially temperature;thermometers provided.: hazardous Vad sanitized at least every 4 hours A Food thermometer available and accurate C Adequate dishwasher sanitizer ❑final rinse temp Lo D Pro ersanitizi rocedure B Properfootl thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 25 Clean wiping cloths C NI0 N/A 1 1 ' Food protected during storage'.preparation, -C. Ni N/A 2 display,service and transportation A Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Produce washed O B Raw meats not stored/prepared near ready-to-eat foods 16 Food-contact si rfaces:elean C N10 NIA 2 mpg 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 S Food containers stored offthe Floor 30� Hot and cold water under pressure,,provided as require TUNtO NIA 2 0 �S 3ti Handwashing accessories provided C W0; NI 1 T—Varrdling of food min ized G IO NIA 2 A Soap l paper towels l drying device available A No unnecessary handling RTE and/or cooked 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)fordispensing food/ice 0 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated alternate],PHF[potentially 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 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 lf=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 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 i of 2 imiwel Date of lrfspection ddressc � �„6C (nI - Owner orOpe`rator ADDITIONAL FOUR POINT ITEMS KEY: DNC (DOES NOT COMPLY M 6 Foods not re-served. u -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. re 4 Proper typelins allationl backflow p venti evice it gap for: -Stored property,labeled properly,used properly -Food equipment -Hose connections -Dish machines -San itizer concentration notto 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: 24 Water source adequate,safe. 47' -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination JLdeosi1i'gnfe'dci lities. Adequate,convenient,accessible, 4-Water quality in compliance-Monitoring in complianceproperty installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] o, 2 Sources of food:Original container,properly labeled 1' 40 Garbage/rubbish storagearsalrooms,enclosures-properly constructed,clean t 1. 5 Potentially hazardous food properly thawed 2: 41 Garbagelrubbish disposed of in an approved manner,at approved frequency 14 ood dispensing utensils properly stored 1.} 42 Vermin Control:No insects/rodents present 2`; Food worker:Clean outer clothes,effective hair restraints 1 ' 43 Outeropenings protected against entrance of insects/rodents 1 4 Floors:Floorcovering 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 Nonfood-contact surfaces designed,constructed, maintained, 7 Mats removable,good repair,clean installed,located 18 Single service articles,storage,dispensing z 8 Exterior walking,driving surfaces,good repair,clean 1 49 Walls,ceilings attached,equipment properly constructed,good 19 No reuse of single service article 1 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 Equipment&Utensils: Cleanliness 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 54 Roomsadequate,clean,adequate lockers provided,facilities clean 1 2 Nonfood-contact surfaces of utensils&equipment clean ' 55 Establishment and premisesfree of litter,no insect/rodentharborage, 1 8 quipmentlutensils,storage,handling 1 no unnecessary articles 32 Proper disposal of wastewater q,,, 56 Complete separation from 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) 36 Toilet rooms enclosed with self-closing door 1 a, 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at :3 3 ropertoilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) ffi 39 Approved garbagetrubbish containers,adequate number,covered, 1 rodent proof,clean a outine Inspection DRetnspection © Preoperational Inspection PERSON IN CHAR Other Inspection: tzE: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating I nature signature / 0 ,mow'911-"7 ri t na� ��� print name one number J tit//e//%�C DATE CORRECTI NS DUE: f\ ZPPage 2 of 2 plus continuation pages Focused Inspection I12002 Page of 3 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION Awoc o+ns � av- v, 15 , W -) 3 Imo" INSPECTION i FORM# REMARKS �OUAAL-\, s V� r sec `t I U -01,1\1 A A,--) kn L� 12" a AAL In u c -i VL 01 A� VA A)��A LV�J-a!� �- ,. �. � S. c. v wt dso al WQ t ✓ 04 `✓,e i Q rNITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) C� Distribution: J st-White-Health Department 2nd-Yellow-Owner/Manager