HomeMy WebLinkAboutFood Service Establishment Inspection 93 (2) g `OJFf5': q ; tT�Ta 'FPCTrS> D FOpA +'CILfN REP0�2T „ ' ..P rX
Establishment: /C41-1 Inspection Date: Time: //,'/,&* Ins Binsp
AddresslCify: 7s �L�� �,¢� ,+ fL Heal h Dept: > ,cam,c•Dclass: IT 3ZD
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 Nl0 NIA DNC KEY: C[complies] NIO[not observed] N/A[not applicable]
ti0 g Qu hhed.Food Operator 3 DNC[does not comply] 0[other[ RTE[ready to•eat]
` ; - 2 12,'..Psr orinel with infectEon restricted ;..
.. 61 ' DBig nated Atternate> it A Food workers have no exposed infected lesions r burns
c,,Nro IVIA°,a
i 62 Written doct meritatiow And nipgprogram 2 B Personnel with infection restricted k
1,,A source;who!@some;nonadultenit . C; N!O'NIA, .4 C Communicable disease of worker reported to local health director
A Approved shellfish,finfish,meat&poultry USDA approved 13 .Hansiw*Ang facilities provided,handswashest,,clean. C 77 'N!A 4:,
B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepidispensing&warewash areas
C Wholesomelnonadulteratedfoodsisafe I B Handwash facilities in or immediately adjacent to toilet rooms
D Commercial products(no home grown/canned food) C Handwash faci 11 tieA access! convenient to use
E Potentially hazardous foods received at proper temperature D Personnel hands h n r e ndwash procedure
0 E Handwashing at 5 i es
il:3 ` Po4entiatlyrhaxardous fodPmeets tt m�etature requirements C N10 WA 4' p
during stoagerprapatat]On;display,"service andrtranr }ion` _
hygienic practices C
iN!0 NIA 2:-
A Hot holding greater than or equal to 140°F. (whole beeYpork roas,s 130°F) A ❑ No eating ❑ No smoking while working
B Cold holding less than or equal to 450 F. lei B Wounds covered adequately f�
C Proper cooling k1 C Proper sink used for handwashing
D Proper re-heating
10,
as i Santtiaation rinse(trot water=''cheinica l C N/pa N/A 2
E oper internal cooking 1 consumer advisory posted u _ ,}- , ,. ;. . _ •
Approved sanitizeravailableladequate concentration ofsanitizer
i dequate` rat es:t lnatr�tarn produ t '
C N!0 , 2 Food-contact surfaces and utensils used for potentially°
tertlirature;thermoeterssploic�e G hazardous food sanitized at[east every 4 hours
i.:.ai.A.hiP L,a' , .. a,: I 3f ;
A Food thermometer available and accurate C Adequate Odishwashersanitizer ❑final rinse temp
Proper
B Properfood thermometerfor product D
E Sanitizing between rawanimal origin&ready-to-eat food
C Thermometers appropriately placed in coolerunits 0
0 4 Y r v 25' dean wiping Cloths,
? i oa�iItodr ' ilrin store*A�f�et ! niC NIO NIA 2d ,_ � :.:: x 6
tdi�s ;staFvioe tts ron se°.,e h}m a r _' ' A Cloths and/or sponges in good repairand clean
Y.P. 6 Wiping cloths kept in sanitizer between uses
A Produce washed
0
B Raw meats not storediprepared near ready-to-eat foods 26°;Fa'odifiaiiot+atafoo6fol o C NJb'F��WA 2
Alx.L.-:1'"sc..•:tN4:a ! dr`4�k ; ?te--:�,h x+f< .5t
C Food covered properly '
A Food equipmentclean,utensils clean,equipment interiors clean
D Adequate splash guards 1 sneeze guard B Single use gloves changed when soiled
E No unauthorized personnel j4 C Food--contact surfaces clean
F No pooling of eggs not cooked immediately 0
8 Food containers stored offtheiioor B6P liot andfco r(indt3r pi ss ire,rpmvided as required::
r��(y0p, Han tut o f hcf�my►`it�1mrze�r �. x C ¢NIO�t�I�A I�2. [3p;.Ftant %(t 11�r ,a R ssQriesprovid6d; a �` ' ;,�kWl ;N/A r1:
�....e�a...,�y��. "fi!'S .. ..AY YF:.SM'�°'� :W s> 5.. t" & L .:v IE."' x �
A No unnecessary handling RTE and/or cooked foods with bare hands A Soap!paper towels!drying device available
B Dispenser(s)working: ❑Soap 0Paperfowel
B Minimize food handling,other than ready-to-eat,with bare hands C Handwash sink(5)clean rwaste receptacle at handwash Ts
ink
PAdequate utensil(s)for dispensing foodrice 0
0 •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS
The following 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 FB 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 fo worker to report specific illness conditions
Are temperatures recordedllogged for cold holding foodslequipment? Y and diseases to the QFO? Y N ♦Do have a paid sick leave policy? Y N
Are foods cooked in advance and cooled? Y N +Are leftovers d? Y N Is there a language barrier between inspect &QFO? Y N If yes indicate language spoken
sa
List products cooled: by QFOIDA: Tan 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 Cook Owner FW
Is cooling monitored for time&temp? Y N Is the monitoring o cooling recorded? Y N .Obtain signature of the person who received the QFO responsibilities information at the time of the
r1sthe-re aproduce washing policy? Y N ♦Describe what's washed andinspection: bgae: N.W. This report is a two page form(total of 62 debitable items) Page f of Y
SATE OF C0114kdTIC6 DEPARTIUIENT OP PUBLIC HEALTfi 41 0CAF�ITOL A�IENtJE MS#S7 FpP-H/11RTFORD,CT Q6134
IOCCTSETI FOQD SER�IC INSPOCT16 iPQ 2T
LOCAL HEALTW bEPT.� G-u � � .` �' AI�w��ICiTY
_ ... ,
Establishment:' `.
., . Date ofi inspection; .
ddress° Owner or Operator: .
ADDITIONAL FOUR POINT ITEMS
KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served. '
-Unwrapped foods not re-served 4 i 31 Sewage disposal approved. 4
-Potentially hazardous foods not re-served -Operating as required
No cross connections,back siphonage,backflow
11 Toxic chemicals. 4` 4
-Stored properly,labeled properly,used properly roper ypelinstallation/backflow prevention device/air gap for:
-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
-Pesticitleslradenticides properly dispensed -Chemical dispensers -Ice machines
Proper drain for:
29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines
4
-Well/well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible,
-Water quality in compliance
-Monitoring in compliance designed,properly installed
OTHER ITEMS KEY: DNC [DOES NOT COMPLY]
c�
2 Sources offood: Original container,properly labeled 1 0 Gatagelrubbish storage area/rooms,enclosures property constructed,clean
5 Potentially hazardousfODd properlythawed 2 1 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 1
4 Floors: Floor covering installed,constructed as required,good repair,clean =1
16 Food-contactsurfaces designed,constructed,maintained,installed, 45 Floors graded,drained as required
aced
6 Floor,wall juncture covered
A nfood-wntaclsurfacesdesigned,constructed,maintained,
installed,located 7 Mats removable,good repair,clean
18 Single service articles,storage,dispensing 2
481 Exterior walking,driving surfaces,good repair,clean `1
19 No reuse of single service article 9 Wails,ceilings attached,equipment properly constructed,good 1;
20 Dishwashing facilities approved design,adequately constructed,
repair,clean.Wall&ceiling surfaces as required
2
maintained installed located 50 Dustless cleaning methods used,cleaning equipment properiystored
Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required l
1 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors
2 Wash water clean,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
27 Nonfood-contact surfaces of utensils&equipment clean l' 55 Establishment and remises free of litter,no insect/rodent harborage, w.
$ Equipment/utensils,stora e,handlin p g r1..
g g 1 , no unnecessary articles ,
32 Proper disposal of wastewater :: 56 Complete separation from living/sleeping quarters and laundry
33 Plumbing location,installation,maintenance 1'' 57 Cleanlsoiled linens stored properly t .
58 No live birds,turtles,orotheranimals(except guide dogs) i)l
36 Toilet rooms enclosed with self-closing door
1 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at ;
37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by signs) B39 Approved garbagelrubbish containers,adequate number,covered, l:
rodent proof,clean '� outine Inspection ❑Reinspection ❑ Preoperational inspection
INSP R: PERSON INCHARGE: Other Inspection:
Demerit Score: +Include demerits from page 1
4 3 2 1 Total Rating
)i ature I signature Z ++
pr` name print name _-
�� �� DATE CORRECTIONS DUE: 4L
p �_ : 7 4--
honehone n���` title
Page 2 of 2 plus continuation pages Focused hued/n 112002
Page / of
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
J* 1 '5;4) zo/,.0 1&2p, 6//,
I 'f Xg
INSPECTION
FORM# REMARKS
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CAa r r
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) ;i� 7-
Distribution: I st-White-Health Department 2nd-Yellow-Owner/Manager