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HomeMy WebLinkAboutSchool Inspection 100 Arnold Way * 3Te1I�E Ok C01tTNG[ ,� � iS SFrI) FO®]D � 1` Ia1Vr PARrTMENT�©F pULIE �TH s Establishment: w II�vInspection Date: Time: ZL'10e R2nsp REinsp ddress/City: L"UCA.14 Health Dept: Class: 1 2 3 4 Based on an inspection this day,the items marked D C 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 NIO NIA DNCI KEY: C[complies] NIO[not observed] NIA[not applicable] 60 Qualified Food OperatoY 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 61 Designated Alternate 2 12 Personnel with infection'restricted C `N/0 NIA ,4 A Food workers have no exposed infected lesions!burns 62 Written documentation of training program 2 B Personnel with infection restricted 1 Approved source,wholesome,nonadulterated C NIO NIA 4 C Communicable disease of worker reported to local health director A I Approved shellfish,finfish meat&poultry USDA approved U 13 Handwashing facilities provided,hands washed,clean NiO, NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepldispensing&warewash areas C Wholesomelnonadulteratedfoodslsafe 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 Potentiall hazardous food meets temperature:requirements N1O NIA 4 0 during storage,preparation,display,service and transportation 15 Good'hygleric practices N1O' N/A 2: A Hot holding greater than or equal to 1400F. (whole beeflparkroaab 1300 F.) A ❑ No eating ❑ 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 Proper Jconsumeradviso 24 Sanitization'rinse hot water-chemical WO NIA 2 P 9 advisory posted { ) 0 A Approved sanitizer available/adequate concentration ofsanitizer 4 Adequate facilities to maintain,product C YO NIA 2 B Food-contact surfaces and utensils used for potentially tetriperature,-thermometers-provided - hazardous food sa itized at least every 4 hours A Food thermometer available and accurate 01 C Adequate dishwashersanitizer ❑final rinse temp B Proper food thermometer for prod uct L Proper sanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 0 25 on es; 'Clean wiping cloths C N/O NIA 1 7 Food,protected during storage,,preparation,. C NJO' NIA,``2 A Cloths and/or s in good re strand clean display,service and transportation P 9 9 P A B Wiping cloths kept in sanitizer between uses Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods 26 'Food-contact,surfaeesclean'% : !0 N/A 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 LK E No unauthorized personnel 40e 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 underpressure,provided as required 0' N/A 2' 0 38 Handwashing accessories provided C WO NIA, 1 . 9 Handling of food minimized C I N1O WA 2 p 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 I waste receptacle at handwash sink C Adequate utensils)for dispensing food/ice 0 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. Jill 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 U-M indicate language spoken List products cooled: by QFO/DA: *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 1 of 2 . xo ` Z - Il� . to of Inspection. ��4i/'e�s:� mi.'4 .e � � ,gy�4�S£,v_ c L ri O-lner �r•`a0perat�r. -�✓ ADDITIONAL FOUR POINT I EMS KEY: DNC [DOES NOT COMPLY] 1 6 Foods not re-served. Q` -Unwrapped foods not re-served 4 31 Sewage disposal approved. 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow 4 4 Pro per type/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration notto exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilettanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticides/rodenticides 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 OTHER ITEMS o KEY: DNC [DOES NOT COMPLY] o 2 Sources of food:Original container,properly labeled 1 40 Garbage/rubbish storage area/rooms,enclosures-properly constructed,clean ( , 5 Potentially hazardous food properly thawed 2' 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored :1`: 42 Vermin Control:No insects/rodents present 2` 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outeropenings protected against entrance of insectstrodents 1 44 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 46 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed, maintained, 1 47 Mats removable,good repair,clean installed,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,good 1 repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2: 1 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 1^ 51 Adequate lighting provided as required 1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 22 Wash waterclean,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 1 27 Nonfood-contact surfaces of utensils&equipment clean 1 55 Establishment and premises free of litter,noinsecUrodent harborage , 1 28 Equipmentlutensils,storage,handling I'.° no unnecessary articles 32 Proper disposal of waste water 56 Complete separation from livinglsleeping quarters and laundry 1 33 Plumbing location,installation,maintenance Llr 57 Cleanlsoiled linens stored properly 581 No live birds,turtles,or other animals(except guide dogs) 1 36 Toilet rooms enclosed with self-closing door 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 3.. 37 Proper toiletfixtures provided,good repair,clean en once(s),smoking area indicated by sign(s) .39 Approved garbage/rubbish containers,adequate number,covered, 1 rodent proof,clean Li EfRoutine Inspection OReinspection ❑ Preoperational Inspection IN PE 0 PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating si ature signature ,}S ,L.ycC1 �[�JC� phF?tnalme ` �41C7� print n e x/ Z ba[�umb title DATE CORRECTIONS DUE: phone number �7 (fir lJ o-n'? -o-t/ Page 2 of 2 plus- A continuation pages Focused Inspection 112002 Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION S 71 � - IN PECTION REMARKS FORM# u U� INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) c Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager