HomeMy WebLinkAboutSchool Inspection 949 Avery Street (2) _ l
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Establishment: /.I— Sic/,P� R? Inspection Date: Zr,14 Time: [ RE[nsp
ddress/City: �� Y .S rie9s� Health Dept: 6� G�i UA So class: 1 2�9
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 NIA JONC I KEY; C[compiles] N10[not observed] NIA[not applicable]
60 ;Qual�fed=FOQd OpQr$tOr g DNC[does not comply] 0[other] RTE[ready-to-eat]
12 Persdr nel with infection restricted C:.N10.;:hUA'.4
61 Epgstgnated Alternate 2
A Food workers have no exposed infected lesions I burns
62 r Written documentation of training program 2 B Personnel with infection restricted
t 'A'p:provtfd source,wholesome,'nonatlulterated C iN10 NIA '4' C Communicable disease of worker reported to local health director
A Approved shellfish,frnffsh,meat&poultry USDA approved 13� Handwashit �fa�ilities provided, hands washed,clean C, N10 N1A; 4
B Food cans in good condition(not dented,rusty,bloated,leaking) A I Handwash facilities in all food prepldispensing&warewash areas
C Wholesomelnonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms
D Commercial products(no home grown/canned food) C Handwash facilities accessiblelconvenient to use
E Potentially hazardous foods received at proper temperature D Personae[hands washed,clean!Proper handwash procedure
E andwashing at appropriate times
3 ;P Aeat%pllyy" hazardqus'footCmeets.110 nature i+egultemenfs C �VfO N1A [4;
dunng s,Eorage,:preperatron display,seance and train sporEatron r.
4 . K 15 od hygienid practices C N/041
2 t
A Hot holding greater than or equal to 140eF. (whole beef/pork tomb 1e°F) A 0 No eating ❑ No smoking while working
B Cold holding less than orequal to 45'F. k, B Wounds covered adequately
C Proper cooling /I J,4 I C Proper sink used for handwashing VI
D Proper re-heating 0 <
E Proper internal cooking l consumer advisory posted 24"$anitization rinse(hat'wat`er;-9chern cat);, "C N!0'NIX 2 ;
0 A Approved sanitizeravailableladequateconoentrationofsanitizer
q Aldequate facilities to=maintaln product •8 ,; .2, ;. ;N10 tN1A g Food-contact surfaces and utensils used for potentially
r�teperature,thermometers provided fir �r. Y hazardous food sanitized at least every 4 hours
A Foadthermometeravailableandaccurale C Adequate ❑dishwashersanitizer ❑final rinse temp
D Proper sanitizin rocedure
B Properfood thermometerfor product E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in cooler units C
D *� 25 4 Glean awl in }cloths{ a ,x C iNl Al
F
7 " Pb. of ct d r star e . ration>� !NIO'tNl ' 0 Ni ,
tag eg '�p `� ' '" �, A Cloths and/or sponges in goodirepair and clean
a vtltsptay servtee and tra'nsportati'trin �t t•
*,• ,s 4 z64,4 `s t rR w• `' �a% '" �' k` , ^' B Wiping cloths kept in sanitizer between uses
A Produce washed 0
B Raw meats not storedlprepared near ready-to-eat(cods A' 2gt!F o'l brit ctnsfi" odes ieait W° *'° t C41Nlb ►NIA '2
.si +pae* m ; .q .yF.#xkx ex 'fi� s t i
C Food covered properly K A Food equipment clean,utensils clean,equipment interiors dean
D Adequate splash guards 1 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 kl 0
S Food containers stored off the floor rt a 1A v s x".' u 'I
t30 Hot and:cold water rntlet pressure,proutc(ed as requrr ,r INIA ,2
h :a xt4r a:r7�^ah' # E....5...:x :uaa 0± a. :s ' ,ki •R 'r,
0 `3$"klandwat'slitna a ce t;oXit s groyiiled; w C 0 N/A. 1'
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ig '14 dlrnggo food minimized Y # rx r C kN/G UA i 2: A Soap 1 paperlowefs 1 drying device available
_ _ it .
A No unnecessary handling RTE and/or cooked foods with bare hands B
Dispenser(s)working; IJSoap ❑Paper towel Aq
B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(s)clean Iwaste receptacle at handwash sink
W
C Adequate utensil(s)for dispensing food/ice 0
0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The fallowing information is not debitable and does not affect your score. KEY: 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 FS 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 recordedllogged for cold holding foot/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 If yes indicate language spoken
List products coaled: 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 ''L�ok Owner FW
Is cooling monitored for time&temp? Y N is a monitoring of cooling recorded? Y N *Obtain sign t4rePf3h erso who sceived th r ponslbllltle information at the time of the
Is there a produce washing policy? Y N ♦ escribe what is washed and inspectio .
where: Note: This report is a two page form otal of 62 debitable items) Page t of 2
S T C F DNNECTi UT L3EPaRTMENTQF,PUBLIC'HEALTH 410.CAPfTpLA1�9, UE
'FOOD S NS GiiQhl.�tEl'pRT
�OCALH>rALTH DEPT�' ESSICITY _
EstablishmenlLi �, �? � Data of Inspection: I
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ddress !fr� `,�' s V' S:'T. Owner yor Operator
.:
ADDITIONAL FOUR POINT ITEMS ',��,� 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
11 Toxic chemicals. 34 No cross connections,back siphonage,backflow 4
4 Proper typehnstallationl 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
-Pesticidesfrodenticides properly dispensed Proper drain for:
29 Water source adequate,safe. -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 z Z
KEY: DNC [DOES NOT COMPLY] ,�'
Sourcesoffood: Original container,properly labeled 40 Garbage/rubbish storage arealrooms,enclosures-propedycenstructed,clean
5 Potentially hazardous food properly thawed 41 Garbagelrubbish disposed of in an approved manner,at approved frequency #
10 Food dispensing utensils properly stored 1 2 Vermin Control: No insectslrodents present 2
14 Food worker:Clean outer clothes,effective hair restraints 1" 43 Outeropenings protected againstentrance of insects/rodents 1
4 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
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
18 Single 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
0 Dishwashing facilities approved design,adequately constructed, 2, 1
maintained installed located 50 Dustless cleaning methodsused,cleaning equipment properly stored
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
7 Nonfood contact surfaces of utensils&equipment clean 55 Establishment and premisesfreeof litter,no insect/rodent harborage. I„
8 EquipmenUutensils,storage,handling I ' no unnecessary articles
32 Proper disposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry ,4,
33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly Y
58 No live birds,turtles,orother animals(except guide dogs) 1
36 Toilet rooms enclosed with self-closing door 1
59 Seats 75or more:Nonsmoking area provided,sign(s)pasted at 3
37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered, 1
rodent proof,clean ❑Routine Inspection ❑Reinspection ❑ Preoperational Inspection
ASRECTOR: PERSON IN CHARGE: Other Inspection:
4L ,r emerit Score: *Include demerits from page 1
- a�Ll 1� 4 3 2 1 Total Rating
nature signature _
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riot name _ print name
r f DATE CORRECTIONS DUE: s
p one number title
`/ Page 2 of 2 plus continuation pages Focused MspecNan 112002
Page ` OfL—
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTIOiN
INSPECTION REMARKS
FORM# / ff
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: I st-White-Health Department 2nd-Yellow-Owner/Manager