Loading...
HomeMy WebLinkAboutFood Service Establishment Inspection 59 Establishment: 6V� Inspection Date: 0.4Time: insp Einsp Address/City: / Health Dept: .� .S Class: 1 2 QP 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 N10 NIA IDNC I KEY: C[complies] NIO[not observed] NIA[not applicable] 60 Quahfled Food Operator, 3 DNC[does not complyl 0[other] RTE[ready-to-eat] 12 Personnel with,infection restricted 61 Desig�ated'Alternate ;. 2 C ;N/0 NIA 4. 62 Written-documentation of training•program 2 A Food workers have no exposed infected lesions!burns B Personnel with infection restricted k 1 rApproved source,:wholesome,nonadutterated' C ;N/0 NIA '''4 C Communicable disease of worker reported to local health director A I Approved shellfish,finfish,meat&poultry USDA approved 13 Handwashing facilities provided,hands washed,clean 'C N10 .NIA` 4 B Food cans in good condition(not dented,rusty,bloated,leaking) 14 A Handwash facilities in all food prep/dispensing&warewash areas C Wholesome/nonadu Iterated foodslsafe P B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grownlcanned food) AC Handwash facilities accessible/convenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure 0 E Handwashing at appropriate times 3 ,Poten`t[all' haiar'dQuhfo6d rneets'temperatu�erequirernents C N/0 NIA 4' I during,sttoragp,.preparation,display,serviceq ci transportation a :15 i Gr od hy.9*nic,practices G: NIO`. A `2 A Hot holding greater than or equal to 1400F. (whole beef/pork roasts 1300 F.) ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 45°F, B Wounds covered adequately k C Proper cooling C Proper sink used for andwashmg D Proper re-heating 0 24 '(h4 cheinical C�fN1© NIA Proper internal cooking lconsumer advisory posted � , 0 A Approved sanitizer availableladequate concentration of sanitizer � 4 Adequatwfacrutil rnaintid,'tlri*� d�gt C=:N10 INlA �,z, g Food contact surfaces and utensils used for potentially reaire� `" ".p >1, b hazardous food sanitized at least every 4 hours � ` p� ,therrnomeeers Tvidecl s 9 e 8 � r..�- I>.s,x=s A Food thermometer availableandaccurate C Adequate ❑dishwashersanitizer ❑final rinse temp L Pro er sanitizing procedure B Proper food thermometer for product X E Sanitizing between raw animal origin&ready-to-eat food �( C Thermometers appropriately placed in cooler units 0 0 25, Clean wiping}cloths „u Cr iN10x NIX 1 7 aod4protecta i uring storage°" re�ajr On nCm N10 NIA+2Y+ y ' A Cloths andlorsponges in good repairand clean ��d d ay,#ejrytp0;�nd.trsnsportatiarr A B Wiping cloths kept in sanitizer between uses Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods I Ae 1264 Fo�d�c r to kopfa Ctean, r C iN10s rNIA 2 ` C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards I 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 30 .Mot and{coldl§wafewunder pressure;prc vrded as�ee4u'l 16,OA 2, 0 es p i a6'; Handv�a;htng accessori rovrded W �� �C tN10, rN1A',.1`: 9" r .endlin of foodirninimtzed Fi- g_. _ r °C. N10:N/AI 2. A Soap 1 paper towels I drying device available A No unnecessary handling RTE and/or cooked foods with bare hands B Dispenser(s)working: ❑Soap ❑Papertowel B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sinks)clean/waste receptacle at handwash sink C Adequate uter l(s}fordispensingfood/ice 0 0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: CFO[quall food operator],DA[designated alternate],PHF[poteMafly hazardous food],FB[foodborne] Pl are hot held at: F. 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 d you cook: Poultry Ground Beef Pork What diseases related to FB Illness are ye equired to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy tha7 +Do ires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foods/equipment? N and diseases to the QFO? Y N you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are lettov s saved? Y N Is there a language barrier betw n inspector&QFO? Y N Iflf ves indicate language spoken List products cooled: by QFOIDA: +Can the QFOIDA read the inspection report? Y N Describe cooling methods: Indicate who answered the bove 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 monllor'h of cooling recorded? Y N .Obtain signatur of the pe on who received the QF sponsibilities information at the time of the Is there a produce washing policy? Y N ♦Describe what is washed and inspection: where: Note; This rep rt is a two page form(total of 62 debitable items) Page 1 of 2 FS ATE OF CQNNECTICUT DEPARTMEINT bF PUBLIC''HEAI,TH 410 CAPITQI.gVENUE MS#57 FDP-HAE7TOD,CT g613d' FOC U ' FOOD SER V t _T2)EYQ 2T ©YCAI HEALTH DEBT: f�" - i4DDRESSICITY Establishment: L.��iA?- Date of. Inspection: l �� w. dtlress Owner or Operator: ADDITIONAL FOUR POINT ITEMS ��. KEY. DNC [DOES NOT COMPLY] m�a 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 I 1 Toxic chemicals, 34 No cross connections,back siphonage,backflow 4 4 Property+pe/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 -Pes#icideslrodenticides properly dispensed Proper drain for: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination Ldesignfedi clities. Adequate,convenient,accessible, 4-Water quality in compliance -Monitoring in compliance ,properly installed OTHER ITEMS ! KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 1`, 0 Garbage/rubbish storage area/rooms,enclosures-properiyconstnrcted,clean 5 Potentially hazardous food properly thawed 41 Garbagelrubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 42 Vermin Control: No insects/rodents present 2, 14 Food worker:Clean outer clothes,effective hair restraints 43 Outeropenings protected againstentrance of insects/rodents 4 Floors: Floor covering installed,constructed as required,good repair,clean =I" 16 Food-contact surfaces designed,constructed,maintained,installed, 2 45 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed, maintained, 1= 47 Mats removable,good repair,clean installed,located 8 Exterior walking,driving surfaces,good repair,clean 1 18 Single seroicearticles,storage,dispensing 2, 19 in reuse of single service article 9 Walls,ceilings attached,ng surfaces ipas required constructed,good 1, repair,clean.Wall&ceiling surfaces as required - 20 Dishwashing facilities approved design,adequately constructed, 2 1s maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 1 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 ihenmometers provided,dish basket,ifused r"f 54 Rooms adequate,clean,adequate lockers provided,facilities clean h 1 27 Nonfood contact surfaces of utensils&equipment clean 1 55 Establishment and premisesfreeof litter,no insect/rodent harborage, 0,14 28 Equipmentlutensils,storage,handling 1 no unnecessary articles 32 Proper disposal of wastewater 1 56 Complete separation from living/sleeping quarters and laundry mid 33 Plumbing location,installation,maintenance 1 571 Cleanisoiled linens stored properly ; 591 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door I ' 59 Seats75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet f xtures provided,good repair,clean entrances,smoking area indicated b sins i - ( ) g Y 9 ( ) i E 39 Approved garbage/rubbish containers,adequate number,covered, 1 - rodent proof,clean poutine Inspection ❑Reinspection ❑ Preoperational Inspection INSPE TOR: PERSON IN CJdA13CE: er Inspection: e e ' r : *Include demerits from page 1 4 3 2 1 Total Rating ignature si nature �. C, print name print name 6 eae � DATE CORRECTIONS DUE: �— phone number r Page 2 of 2 plus 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 INS ECTION INSPECTION REMARKS FORM# U t se -� rA 0 d-s a > a w �r 6 c� -let 100, INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager