HomeMy WebLinkAboutFood Service Establishment Inspection 28 (3) EHS-106-Rev.11105 INSPECTION REPORT STATE OF CONNECTICUT ❑ ROUTINE INSPECTI ❑ REINSPECTION
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH ❑ PREOPERATIONAL ❑ 0
410 Capitol Avenue,MS#11FDP,Hartford,CT 06134
NAME OF ESTABLISHMENT
ESTABLISHMENT I fit/ r� CLASS
STREET TOWN
ADDRESS y /�
OWNER or INSPECTION
OPERATOR AZZZ DATE and TIME
Based on an inspection this day,the items marked below identify the violations in operation or facilities which must be corrected by the date specified below. -
SOURCES OF FOOD EQUIPMENT&UTENSILS:CLEANLINESS VERMIN CONTROL
1 Approved source,wholesome, 4 21 Preflushed,scraped,soaked and racked [43
Presence of insectslrodents 2
nonadulterated 22 Wash water clean,proper temperature 1 Outer openings protected against entrance of 1
2 Original container,properly labeled 1 23 Accurate thermometers provided,dish basket fused insects/rodents
24 Sanifization rinse(hot water-chemical) 2
FOOD PROTECTION 25 Clean wiping cloths 1 F RS,WALLS&CEILINGS
3 Potentially hazardous food meets 4 , 26 od-contact surfaces of utensils& 4 'FI rs:floor covering inst ,
temperature requirements during storage, -E�uipment clean 'constructed as requir d,good repair,clean
preparation,display,service,and
transportation
7 Noo�food-contact surfaces of utensils& 1 45 Floors,graded,drained as-required ment dui clean
q p 46 Floor,wall juncture covered
4 Adequate facilities to maintain product 2 28 1 Equipmentlutensils,storage,handling 1 47 Mats removable,good repair,clean
tem erature,thermometers provided
5 Potentially hazardous food properly thawed 2 48 Exterior walking,driving surfaces, 1
6 Unwrapped or potentially hazardous food 4 WATER SUPPLY good repair,clean
not re-served 29 Water source adequate,safe 4 49 Walls,ceilings attached,equipment properly 1
7 Food protected during storage,preparation, 30 Hot and cold water under pressure, 2 constructed,good repair,clean. Wall&ceiling
display,service&transportation 2 provided as required surfaces as required.
8 Food containers stored off floor 50 Dustless cleaning methods used, 1
SEWAGE DISPOSAL cleaning equipment properly stored
9 Handling of food minimized 2 311 Sewage disposal approved 4
10 Food dispensing utensils properly stored 1 32 Proper disposal of waste water 1 LIGHTING&VENTILATION
11 Toxic items properly stored,labeled,used 4 51 Adequate lighting provided as required 1
PLUMBING 52 Room free of steam,smoke odors 1
PERSONNEL 33 1 Location,installation,maintenance 1 53 Room&equipment hoods,ducts,vented as required
12 1 Personnel with infection restricted 14 34 1 No cross connection,back siphonage,backflow 14
DRESSING ROOMS&LOCKERS
CLEANLINESS OF PERSONNEL TOILET FACILITIES 54 Rooms adequate,clean,adequate lockers 1
13 Handwashing facilities provided, 4 35 Adequate,convenient,accessible,designed, 4 provided,facilities clean
personnel hands washed clean installed
14 Clean outer clothes,effective hair restraints 1 36 Toilet rooms enclosed with self-closing door 1
15 Good hygienic practices,smoking restricted 2 37 Proper fixtures provided,good repair,clean HOUSEKEEPING
55 Establishment and premises free of litter,no 1
EQUIPMENT&UTENSILS: DESIGN, HANIDWASHINGFACILITIES insectlrodent harborage,no unnecessary articles
CONSTRUCTION &INSTALLATION 38 Suitable hand cleaner and sanitary towels or 1 56 Complete separation from livingisleeping quarters 1
16 Food-contact surfaces designed,constructed, 2 approved hand drying devices provided, and laundry
maintained,installed,located tissue waste receptacles provided
57 Cleanlsoiled linens stored properly 1
17 Nonfood-contact surfaces designed, i 58 No live birds,turtles,or other animals 1
constructed,maintained,installed,located GARBAGEJRUBBISH STORAGE&DISPOSAL I(except guide dogs)
1 B Single service articles,storage,dispensing 2 39 Approved containers,adequate number, 1
19 No reuse of single service article covered,rodent proof,clean SMOKING PROHIBITED
20 Dishwashing facilities approved design,adequately 2 40 Storage arealrooms,enclosures- 59 Smoking prohibited,signs posted at each 3
constructed,maintained,installed,located properly constructed,clean entrance -
1 -
41 Garbage disposed of in an approved manner,
at approved frequency QUALIFIED FOOD OPERATOR
DEMERIT SCORE 60 Qualified Food Operator 3
4 3 2 1 RISK FACTOR VIOLATIONS IN RED 61 Designated alternate 2
A� [ ri##en tlocumenta#ion of training program 2- -
7
Signature of Per on in char%
TOTAL RATING Date Corrections Due
SIGN pector)
.:� ,;
a7_ c� DESCRI DEFICIENCIES ON CONTINUA ION SHEETS
ISTRIBUTION:1"-White—Health Department 2"d—Yellow—Owner/Operator
Page_ of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF SPECTION
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INSPECTION REEKS
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INITIAL(INSPECTOR) INITIAL,(PERSON IN CHARGE)
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