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HomeMy WebLinkAboutFood Service Establishment Inspection 60 Establishment: ve vp LA L)Y'*- z Inspection Date: Time: o[ REins ddress/City: it UL Health Dept: class: t 2 3 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 N1A JDINCI KEY: C[complies] NIO[not observed] NIA[not applicable] I g s ifta BncdrQperato , ` Loo 3 DNC[does not comply] 0[other]b w RATE jready-to 1"tJ�ith.infec ion{re>£fri pd., 71 �] !4 z w., jildfiee . z . ;, :I A Food workers have no exposed infected lesions'/burns F atoof 1ramJng p a 2 B Personnel with infection restricted ✓ pist9tlsOm "o d ' t tE M! iaA�; C Communicable disease of worker reported to local health director : , A A roved shellfish finfish,meat&poultry USDA approved LAza ' ' t'fdrtieS�rovide ;'tat� waItdl" 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 grownicanned food) C Handwash facilities access iblelconvenient to use E Potentially hazardous foods received at proper iemperature D Personnel hands washed,clean I Proper handwash procedure 0 E Handwashing at appropriate times otetMOV17 IX00,00441h `tit§tnpe "pt r s � 1/0 NIA 0 , Ifi storag preparat�p f ' e tie d r'a�sp ran ,� ? i . - r15(=G6dd t►ygiel�rC<p �c cos !0 N/A u2a! A Hot holding greater than or equal to 144, (whole beef/pork roasts 1300r) Loo A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 45°F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating E Proper internal Cookin lconsumeradviso advisory posted hMI W, KN��;" ' 0 Approved sanitizeravailableladequate concentration of sanitizer VAR! �gtiat®faaurtteogat, r sett N B Food-contact surfaces and utensils used for potentially .. .:a pi<ow: S ;. hazardous f od anitized at least every 4 hours A Food thermometer available and accurate V C Adequate 'shwashersanitizer ❑final rinse temp D Proper san'izinq procedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units LV 0 C A Clo�thsMe andlorspong"a thei ' N '1 2 Cin I dr 3 s in good re pair and clean B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods Is?a 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 off the floor f" %d , dtWa 08 an ! 9 Gee COvr -� NI' d(`11 Ian dof f�dct(min trffl i.' A Soap 1 paper towels I drying device available A No unnecessary handling RTE and/or cooked foods with bare hands B Dispensers}working: ❑Soap ❑Paper towel B Minimize food handling,otherthan ready-to-eat,with bare hands C Handwash sink(s)clean I waste receptacle at handwash sink C Adequate utensil(s)for dispensing foodlice L 0 0 +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: OF. PHFs are cold held at: F. 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 1f.yea 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):CFO 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 CFO responsibilities information at the time of the Is there a produce washing policy? Y N *Describe what is washed and inspection: where: I Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 EUlst, >. . $Dael ltpptt a� ddrsss: . . . .t ,� OwnerprQper=aor .; .. ., . ADDITIONAL FOUR POINT ITEMS , KEY: DNC [DOES NOT COMPLY] 6 Foods not reserved. 4 31 Sewage disposal approved. -Unwrapped foods not re-served 4 -Potentially hazardous foods not re-served -Operating as required 37 No cross connections,back siphonage,backflow 11 Toxic chemicals. 4 -Stored properly,labeled properly,used properly 4 Proper elinstallation/backf aw prevention device/air gap for; -Sanitizer concentration not to exceed maximum permitted -Food equipment -Hose connections -Dish machines -No unnecessary toxics on the premises -Soda system carbonator -Beverage dispensers -Toilet tanks -Pest icideslrodenticides properly dispensed -Chemical dispensers -ice machines Proper drain for: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines ; -Well/well head protected from contamination -Water quality in compliance Ldes acilities. Adequate,convenient,accessible,-Monitoring in complianced,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food, Original container,properly labeled 1- 40 Garbagelrubbish storage arealrooms,enclosures-propedyconstructed,clean 1' Potentially hazardous food properly thawed 2" 41 Garbage/rubbish disposed of in an approved manner,atapproved frequency 10 Food dispensing utensils properly stored 1 42 Vermin Control: No insects/rodents present 2t 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected againstentranceofinsectslrodents 44 Floors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed, maintained,installed, 2 5; Floorss' graded,drained as required located 46 Floor,wall juncture covered 17 surfaces designed,constructed,maintained, 17 Mats removable,good repair,clean �nfood-contact talled,located �, g 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,good repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2 50 Dustless cleaning methods used,cleaning equipment properly stored maintained installed located Equipment&Utensils: Cleanliness I 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 Accu rate the rm om ete rs;provided,dish basket,if usedr 54 Rooms adequate,clean,adequate lockers provided,facilities clean - 271 Nonfood-contact surfaces of utensils&equipment clean I 55 Establishment and premisesfreeof litter,no insect/rodent harborage, 1 28 Equipmentlutensils,storage,handling 1- no unnecessary articles 32 Proper disposal of waste water 1 ; 56 Complete separation from Iivinglsleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1, 58 No live birds,turtles,orother animals(except guide dogs) 1 361 Toilet rooms enclosed withsetf-closing door 1 59 Seats 75 or more:Nonsmoking area provided,sign(s)pasted at 37 Propert6let fixtures provided,good repair,clean entrances),smoking area indicated by sign(s) 3 39 Approved garbagelrubbish containers,adequate number,covered, 1 rodent proof,clean 011outine Inspection ©Reinspection ❑ Preoperational Inspection I PECTOR: PE Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating si ature signaa ure I IV pri t me print name V_L C CA phone number title DATE CORRECTIONS DUE: 2� Page 2 of 2 plus continuation pages Focused rnspecdon112002 I ! Page of INSPECTION REPORT STATE OF CONNECTICUT L� FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION J �00 Z ti :S O INSPECTION REMARKS FORM# C S /L I INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: lst-White-Health Department 2nd-Yellow-Owner/Manager