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Home My WebLink AboutSchool 91 Ayers Road z:, ,rA. s 1 S IA G t� KPYjVE I ,UT • `fYt O II T O D g � `I,�i1�PtkY � • �P 61jT OF PURL Lr AFielbfli Establishment: 40 Inspection Date: Time: ROinsp Einsp Address/City: Health Dept: , ✓ 2 3 Based on an inspection fMis 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 /0 NIA DNC I KEY: C[complies] N10[not observed] NIA[not applicable] 60. 'Qualified Food Operator = 3 DNC[does not comply] 0[other] RTE(ready-to-eat] 61 Designated Alternate 2 12 _ Personnel with infection restricted N/O N/A- 4' 62 Written documentation of training program 2 A Food workers have no exposed infected lesions 1 burns B Personnel with infection restricted 1 Approved source,wholesome,nonadutterated C 10 NIA ;4'- C Communicable disease of worker reported to local health director A Approved shellfish,finflsh,meat&poultry USDA approved 13 ,Handwashing facilities provided,hands washed,clean 10 NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadu Iterated foodslsafe 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 1 Proper handwash procedure 0 E Handwashing at appropriate times 3 Potentially hazardous.food.meets temperature requirements l NIA 4 0 during storage,preparation,display,service and fransporlation 1'S Good hygienic practices C N10 °N/A 2 A Hot holding greater than or equal to 140eF. (whete beerlpork masts 13001 A ❑No eating ❑ No smoking while working L. 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 Proper internal cooking I consumer advisory posted 24 Sanitization`rinse(hot water-chemical) C .N10 N/A 2 0 A Approved sanitizer available/adequate concentration of sanitizer 4 Adequate facilities;to maintain product C N10 NUA 2 g Food-contact surfaces and utensils used for potentially temperature,thermometers provided' hazardous food sanitized at least every4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer Effinal rinse temp D Proper sanitizing procedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units O 0 25 Cleamwlping sloths C N10 NIA 1 7 Food protected during storage,preparation, 101' N/Al,2 A Clothsandlorsponges in oodre repair display,service and transportation ' 9 p A Produce washed B Wiping cloths kept in sanitizer between uses 0 B Raw meats not stored/prepared near ready-to-eat foods 2& Food-contact surfaces clean' C'.N10. NIA 2 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 0 8 Food containers stored off the floor 30' Hot and cold water under pressure,provided as required N10 NIA '2 0 381 Handwashing accessories provided: C WO NIA 1 9 Handling of food minimized C< N/01 NIA 2,i A Soap 1 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 10 eat,with bare hands C Handwash sinks)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 0 �4 -DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. _M: 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 reoordedllogged 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 vu 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 Cock 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 t � r - y i Esbltshment{ ; ` }Date l � Address p ¢ TOWn@foC�OperatpfL .y r , t u.vv ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. -Unwrapped foods not re-served 4 31 Sewage disposal approved. -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals; 34 No cross connections,back siphonage,backflow 4 -Stored properly,labeled properly,used properly Proper typelinstallation/backflow prevention device!air gap for: -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 n fi -Chemical dispensers -Ice machines -Pesticideslrodenticides properly dispensed Prover drain for: a 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, �41? -Water quality in compliance Y 11 '# -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY 2 Sources of food: Original container,properly labeled t a 40 Garbage/rubbish storage arealrooms,enclosures-properly constructed,clean 5 Potentially hazardous food properly thawed 2� 41 Garbagelrubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored p1 42 Vermin Control: No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outeropenings protected againstentrance of insectslrodents . am, 44 Floors:Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, i 45 Floors graded,drained as required located k g_ 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 1„ a 471 Mats removable,good repair,clean installed,located � t 8 Exterior walking,driving surfaces,good repair,clean f 18 Single service articles,storage,dispensing �2,; 19 No reuse of single service article 0 9 Walls,ceilings attached,equipment properly constructed,good repair,clean.Wall&ceiling surfaces as required q 20 Dishwashing facilities approved design,adequately constructed, 411 installed located 50 Dustless cleaning methods used,cleaning equipment properlystored maintained Equipment&Utensils: Cleanliness 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,facilities clean 27 Nonfood-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,no insectlrodent harborage, 28 Equipmentlutensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 56 Complete separation from living/sleeping quarters and laundry � 57 Clean/soiled linens stored properly � 33 Plumbing location,installation,maintenance 4 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 37 Proper toiletfuxtures provided,good repair,clean 4 4 59 Seats 76 or more:Nonsmoking area provided,sign(s)posted at 4 entrance(s),smoking area indicated by sign(s) ,, 39 Approved garbage/rubbish containers,adequate number,covered, rodent proof,clean Nikoutine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTOR: PE SO I �E Demerit Score: *Include demerits from page I AddDzL ( 'A4M l 4 3 2 1 Total Rating ture sig at pr1rif name / print WaFKd ou zx/vz DATE CORRECTIONS DUE: p one number title W Page 2 of 2 plus continuation pages Focused lmpectlon 1/2002 Page of 3 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION S INSPECTI&A REMARKS FORM# AIL D� 1;0 u INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager