Loading...
HomeMy WebLinkAboutFood Service Establishment Inspection 10 (5) mom _ Establishment: Inspection Date 3 zo r Ze Time: /I: Szr Roinsp insp Address/City:��j `[�i Ix4_)e ,e ry� Health Dept:' _ i!,�,rr� Sc�� _ Class: 1 2 3 4 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 N/A DNC I KEY: C[complies] N10[not observed] NIA[not applicable] lti0. E(u",allied Food 0perator. 3 DNC[does not comply] 0[other] R7E[ready-to-eat] 12 ; Personnel witFi'infection restricted C N10 jN1A•'4 . 61 Designated Alternafe k 2 A Food workers have no exposed infected lesions!burns 62 Written ocumentatlon of training program 2 B Personnel with infection restricted }1 EApproved source,wholesome,rtonadulterated VIVO N!A ,4. C Communicable disease of worker reported to locol health director A Approved shellfish,finfish,meat&poultry USDA aRproved 13 :.Handwashing facilities provrdetl,"hands washed,clean, C Nlf) 'NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepldispensing&warewash areas C Wholesomelnonadulteratedfoodslsafe k B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) JL C Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature stiC 0 Personnel hands washed,clean I Proper handwash procedure 0 h - ,Pp E Handwashing at appropriate times tentially haratdbgs;foor meets tempelrature,requirdment8 �C N!0 NIA 4 O during storai2e,preparation'display,s4rYrrcj:ar�dk. ,t?ansportation w, _ _.... . . . : `: . I18 :13oodiftolenic practi .66 C ro..NIA 2 A Hot holding greater than or equal to 140oF. (whole beerrporkroaslsaaoo l) A ❑No eating ❑No smoking while working B Cold holding less than or equal to45oF. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 itiatl ,w m :t N/A Proper internal cooking lconsumer advisory posted 24Sanzo ic ;: CN!0fs h 0 Approved sanitizeravailabieladequateconcentration ofsanitizer ' t:° tie�uate taclllties to msiiftAtil`l r�tlu k,� A a ; . C�i1YlOs i�t! r:2 Food-contact surfaces and utensils used for potentially v, e�rtperature,thertrtpinetersprovided;� x.x hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate ❑dishwashersanitizer 11final rinse temp B Proper food thermometer for product D Pro ersanitizinq procedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0 x nrnrtpingscloths ',.r x ; , _ >Cu iNlO k A r1 7 Food�prtit P tluL.ring story +�,�p%�`p�a'a ion, ; : !0 'N! rK2� A ` servt06 dr `d try grtatiort l x e� n, Cloths and/or sponges in good repair and cleanle r �+ ac: a r+�lk A Produce washed B Wiping cloths kept in sanitizer between uses B Raw meats not stored/prepared near ready-to-eat foods r - . bC t2fi i otl contract suria�e paeanon C# NIOi Nl C Food covered properly 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 Ael C Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor �3tlikFfotka6d�@& aterunckr re$sure, rov[dedasvre uire jWA! 2r.J �, P . q .,.... . .. 36 Handwashing accessones provided' § {N!0 N ;1' �. HarttllIng,of�foojd a.- .w s `, C N!©INlA ;2 A Soap 1 paper towels! 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 handsAe C Handwash sink(s)clean lwaste receptacle at handwash sink C Adequateutensil(s)fordispensingfeodlice 0 0 +DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your scare. KEY: QFO[qual'l1ed food operator],DA[designated alternate],PHF[potentially hazardous food],FB[foodbornel 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 I 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 faodslaquipment? Y N and diseases to the Q ? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are le os saved? Y N Is there a language aMar between inspector&QFO? Y N ifif ves indicate language spoken v r List products cooled: by QFOIDA: *Can the QFOIDA re inspection r qri? Y N Describe cooling methods: Indicate who answere�d t ove quest' me( nt): Indicate the title of ve pe6 rso5-h�" rt/ all at a ly); A Mgr Cook Owner FW Is coding monitored for lime&temp? Y N Is the monitorin of cooling recorded? Y N .Obtain ai9eatury o person ive resoo s' illties information at the time of the Is there a produce washing policy? Y N ♦Describe who is washed and inspection:�`cc where: Note: This report is page form(total of 62 debatable items) Page 94nf 2 SfiA E Qi:GQIUNCTIGUT DEPARTI4H�NT QF PUBLtG•HEALTH 4'[Q CAPITQL,At/ENUE-MS#51 FAP-HARTFOFtD,GO 4' E f ROCIISED FQOD ERVI TN Pi�CTiO IaP-k ADDRESSX TY EstablishmentL�D S 7` `L?e�►J` Date of.,Inspection: . �. .�/ " ddr`es __� 7�GJt L : Owner or Operafor . ,:. ADDITIONAL FOUR POINT ITEMS ® KEY: DNC [DOES NOT COMPLY] � . 6 Foods not re-served. -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. 4 Proper 4 Pro ypelinstallationl backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizes 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: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well!well head protected from contamination-Water quality in compliance 35 Toilet facilities. Adequate,convenient,accessible, 4 -Monitoring in compliance designed,properly installed OTHER ITEMS z' '-" o.; KEY: DNC [DOES NOT COMPLY] ? 2 Sources of food: Original container,property labeled 1 0 Garbage/rubbish storagearealrooms,enclosures-properly constructed,dean ; 5 Potentially hazardous food properly thawed 2`, 1 Garbagelrubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 1= 2 Vermin Control: No insects/rodents present 2r 14 Food worker:Clean outer clothes,effective hair restraints 1' 3 Outeropenings protected againstentrance of insectslrodents r 4 Floors: Floorcovering installed,constructed as required,good repair,clean 1' 16 Food-contactsurfaces designed,constructed,maintained,installed, 2 5 Floors graded,drained as required " located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 47 Mats removable,good repair,clean Tmtplled, $ Exterior walking,driving surfaces,good repair,clean 1` 8 i gle service articles,storage,dispensing 2 19 No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good repair,clean.Wall&ceiling surfaces as required a 20 Dishwashing facilities approved design,adequately constructed, 2 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1` Equipment&Utensils: Cleanliness 1 51 Adequate lighling provided as required a1 i` 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 curate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1; 0onfood-contact surfaces of utensils&equipment clean 8, 55 Establishment andpremisesfreeoflitter,noinsect/rodentharborage,Equipmentlutensils,storage,handling LT no unnecessary articles l 32 Proper disposal of wastewater 56 Complete separation from livinglsleeping quarters and laundry '1 33 1 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1; 58 No live birds,turtles,or other animals(except guide dogs) i 36 Toilet rooms enclosed with self-closing door l 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 3 37 Propertoiletfixturespsovided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, 1 rodent proof,clean ; outine Inspection ❑Reinspection ❑ Preoperational Inspection - INSPECTOR: PERSON IN CHARGE: Other Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signature signature print name ¢tsrinttnname �C")T DATE CORRECTIONS DUE: phone number title v �' Page 2 of 2 plus continuation pages Focused Inspection rraoos Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF SPECTION 57 Y tV , Uv S INSPECTION FORM# ASKS 31 3G -A)a 725- d-t�, �l �G ' INITIAL(INSPEC OR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Pag of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSP/ECTION INSPECTION REMARKS FORM# L CG f ��-- a INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow- Owner/Manager