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HomeMy WebLinkAboutFood Service Establishment Inspection 40 .�:.`s.'�`.:(�.•� "mac"r.. I elf .s Establishment: Inspection Date: Time: 0,3 W) kLROJnsp REinsp Address/City: Health Dept: <Se r)' :-.� , r�/� Class: 1 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 I NIO NIA DNC KEY: C[complies] NIO[not observed] NIA[not applicable] . =Wallfled:Food.Operator. 3 DNC[does not comply] 0[other] RTE[ready-to-eat] s 12• Personnel with Enfection restricted" 61 Designated Alterntite:; 2 G N10 NJA„ 4' 62 of training program 2 A Food workers have no exposed Infected lesions I burns itten documentation B Personnel with infection restricted 1, Appr'.o�ed source,wholesome`,nonadulteratetl , C N/0 NIA 4 C Communicable disease of worker reported to local health director K A Approved shellfish frnfish meat&poultry USDA approved M 13 HandWdihiha facilities pcoyldOA handswashed,clean °G ,N10 N1A '4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepldispensing&warewash areas C Wholesomelnonadulterated foods/safe }C B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities accessiblelconveniant to use E Potentially hazardous foods received at proper temperature AX D Personnel hands washed,clean!Proper handwash procedure' E Handwashing at appropriate times 3 rPotentielllyhazardous food meets temperature requ[remettfs C N10.JVJA 14 O k dtlring storage,pTepasatlon,display,senrlce and transportation r15 Good hygienic practices N(0: N1A' 7 A Hot holding greater than or equal 10 14eF. (whole badpork roasts 1300F.) 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 0 E Proper internal cooking I consumer advisory posted 124 Sanitiaation rinse(hot water=chemical) C KN10 N1A 2 0 A Approved sanitizer availableladequate concentration of sanitizer 'Qi Aiiegetate. feI;tltties;to maintain product a J t C wQ N1A 2 g Food-contact surfaces and utensils used for potentially t i teen erature thermometers rovided hazardous food sanitized at least every 4 hours pr p h d ti # t .,. I t :g A Food thermometer available and accurate C Adequate ❑dishwashersanilizer ❑final rinse temp L Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-ealfood C Thermometers appropriately placed in 000lerunits 0 0 . x. k ;..• x m r 25 ',.Clean viripl�g cloths * , r 4 1 C IN10 rNIA,, 1..: 17$ r ;ptelc�tel d`urfing;storage,preparation,v C NIO INlAr i 2 r x: i i z A" Cloths and/or sponges in good repair and clean � d'ieplley service-t r#tdddd tra tsp rktafR K ce a#r a m s A st [ # W A Produce washed B Wiping cloths kept in sanitizer between uses 0 B Raw meats not stored/prepared near ready-to-eat foods 46+:Food contact�surfaces iClloan.=;*.v; r C IN WA 2 C Food covered properly a.Ak:r8t 4 W: 11 it u F !t ,F, W.�•a A to t�''F.3,4 A Food equipmentclean,utensils clean,equipment interiors clean D Adequate splash guards)sneeze guard B Single use gloves changed when soiled E No unauthorized personnel k C Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor 30 ,Hot ain�;GQ�dw'•ater.uiids`r psstire; F pratrhded as require r A ,2 :c:.: r .:.a. ♦ x rx.x:. �;•..�.�,� v'.t w t s: 0 t38 Herldw8$hkng scre§sQrtes provided' ;:.�. rC QUO, ;N1P k• u .. ... 9k° mHHHHHHHH ntllin�of fold mirnm.ized x .: Ci'.N10 NIA :2. A Soap!paper towels 1 drying device available A No unnecessary handling RTEand/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)for dispensing foodlice 0 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY QFO[quafi6ed food operator],DA[designated alternate],PHF Dotentally hazardous food],FB[foodborne] PHFs are hot held at: IF. PHFs are cold held at: OF, Describe illness conditlons 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: I Is there a written tllne policy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foodslequip ent? Y N and diseases to the FO? Y N *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N +Are eftovers saved? Y N Is there a Ian gua barrier between inspector&QFO? Y N If ves indicate language spoken List products cooled: by QFOIDA: 7 *Can the QFO/DA 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 onitoring of cooling recorded? Y N .Obtain signature cAthe person who received the QFO responsibilities information at the time of the Is there a produce washing policy? Y N ♦D scribe what is washed and inspection: el �l t where' Nate: This report is a two page form(total of 52 debitable items) Page 1 of 2 U CQNMtet M,J� TMEMT VF PUBLIC-HEALTH 410 CAOiTOLAVENUE MS#SI FDP-HARTF'ORD,�CT 0§134 k s u FOCjjSF F�O�? Ski+R'V,IChr T TS CTSt1N R PQRT Lots ll.tIEALT'Hr�I�Pr? .�, ADDRESS/GITY Establishment• aGe.�.t" t�, /7'�'h� / date of Inspection: / donee, ' D s : Owner or Operator: ADDITIONAL FOUR POINT ITEMS >0 KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. - 4 31 Sewage disposal approved. Unwrapped foods not re-served 4. -Potentially hazardous foods not re-served -Operating as required 1 Toxic chemicals. No cross connections,back siphonage,backflow 1 :4. 4 Proper ype/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -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 -Chemical dispensers -Ice machines -Pesticides/rodenticides properly dispensed Proper drain for: 29 Water source adequate,safe, -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 © KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,property labeled 1' 0 Garbagelrubbishstoragearealrooms,enclosures-properly constructed,clean „1 5 Potentially hazardous food properly thawed Z;; 1 Garbaga/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 hairrestraints 1'u 3 Outer openings protected against entrance of insects!rodents ;- 4 Floors: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, 2 45 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contactsurfaces designed,constructed, maintained, 7 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 9 Walls,ceilings attached,equipment properly constructed,good 1. repair,clean.Wall&ceiling surfaces as required c 20 Dishwashing facilities approved design,adequately constructed, 2 . maintained installed located 50 R Dustless cleaning methods used,cleaning equipment property stored �1 Equipment&Utensils! Cleanliness 1 51 Adequate lighting provided as required -777 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 231 Accurate thermometers provided,dish basket,!fused 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1 27 Nonfood-contact surfaces of utensils&equipment clean All 55 Establishment and premises free of litter,no insect/rodent harborage, 28 Equipmentlutensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 1? 56 Complete separation from livinglsleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 1' 57 Clean/soiled linens stored properly r 581 No live birds,turtles,or other animals(except guide dogs) 1•. 36 Toilet rooms enclosed with self-closing door 1 . 59 37 Proper toilet fixtures provided,good repair,clean Seats 75 or more:Nonsmoking area provided,sign(s)posted at entrance(s),smoking area indicated by sign(s) 3 39 Approved garbage/rubbish containers,adequate number,covered, 1 rodent proof,clean ❑Routine Inspection ❑Reinspection ❑ Preoperational Inspection — INSPECTOR: PERSON IN CHARGE: Other Inspection: � Demerit Score: •Include demerits from page 1 Vgnature 4 3 2 1 Total Rating signature r pri name print name rt `�� `" �Sh'c'"4 phone number, title DATE CORRECTIONS DUE: -' , Page 2 of 2 plus continuation pages Focused Inspection V2002 Page /Of l i,av INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION Z/,O A rNSPECTION REMARKS FORM# �Lc INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) M t j Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager