HomeMy WebLinkAboutFood Service Establishment Inspection 98 (2) r.. •r
Establishment: ; ,.GL �iz 4 Inspection Date: Time: k-LRO!nsp Einsp
Address/City: % �'��,��tVA f ,¢f4 Health Dept: &z4.'?>$' _ class: 1 2
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 NA D KEY: C[complies] N!0[not observed] NIA(not applicable]
60 Quallfteri F6 rator DNC[does not comply] 0[other] RTE[ready-to-eats
:.
61 Designated Afternafe " C ;N o N1A 4
'12 "Personnel it Infection restricted
62 Written documentation bf training ptcgrm. 2 A Food workers have no exposed infected lesions I burns
" B Personnel with infection restricted
1 (Approved source;wholesome,nonaduTterated C N10 NIA '4
i C Communicable disease of worker reported to local health director
A Approved shellfish,finfish,meat&poultry USDA approved 13 'Hand vlrahing facilitles prov[ded,hands washed,clean GI 6N10 N!A 4
B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwas a !ties in all food prep! a sing w h areas
C Wholesomelnonadulleratedfeodslsafe B Handw sh cilities in o imme i e adj nt to toilet rooms
D Commercial products{no home grown/canned food) C Hand act'ti s n of to use
E Potentially hazardous foods received at proper temperature D Perso el ha ash ,teen I Proper handwash procedure
Al
Handwashing at appropriate times
IP .entiallyfiaza dohs food meets'tt:rnperature requirement 'C Wo 0
during s(orage,preparation,display,serVice and transportat-n.. r
Ns :Good',hygi tsic `radices
p C' N/0 .IlA: 2:.
A Hot holding greater than or equal to 140oF. (whole beefrporkroosts 1300 F.) A Q No eating 13 No smoking while working
B I Cold holding less than orequal to 45o F. B Wounds covered adequately A.
C Proper cooling C Proper sink used for handwashing
D Proper re-heating 0
E Proper internal cooking I consumer advisory posted 12 o
., Sanitizatin1r`rif:ee{hot'""'( ch�trti al) tC 3fJ/O aNlA I
0 A Approved sanitizeravailable/adequate concentration ofsanitizer
4� A%dequatefacrlrtfestornarntfn,jrrt�Ucrt a V. N(o NlA 2 g Food-contact surfaces and utensils used for potentially
: , .
j�tempeSat re,thermometers prgvtdad§ hazardous food sanitized at least every 4 hours
A Food thermometeravailableandaccuraie C Adequate ❑dishwashersanitizer ❑final rinse temp
L Proper sanitizin rocedure
B Proper food thermometerforproduct E Sanitizing between raw animal origin ready to eatfood
C Thermometers appropriately placed in cooler units 0
0 25' Mean,ping*cloths _ w ,
7 o d �rotectf dkot�u ring stbrage,ap Qpata lint Oa.Nib MA I V
tslaysigg ar�d��[arspQrtation M i !! ` r�o ( A Cloths andlorsponges in good repair and clean
B Wiping cloths kept in sanitizer between uses
A Produce washed
0
B Raw meats not stored/prepared near ready-to-eatfoods 126 Food=canf fsu fa c n C }N10 'NIA., 2N;
C Food covered properly -
A Food equipment clean,utensils clean,equipment interiors clean_
D Adequate splash guards!sneeze guard
B Single use gloves changed when soiled
E No unauthorized personnel C Food--contact surfaces clean
F i No pooling of eggs not cooked immediately t� 0
8 Food containers stored off the floor 130 Hot and eol8 wader under pressure,provided as7require t 4
4. Im rs n e. ,. a , a x, s
0 t38 Handwas iingaai;cet songs prQvitled` ` . iC::1NIG.eNIA 1
9 ; Handling of food rrimirrilied I C NdO iN(A ;2 A Soap l paper towels I drying device available !
A No unnecessary handling RTE and/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!waste receptacle at handwash sink
C Adequate utensil(s)fordispensing food/ice , 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 requi as
the food worker to report specific illness conditions
Are temperatures reoordedliogged for cold holding foodslequi ment? 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 ♦ leftovers saved? Y N Is there a language barrier betwee inspector&QFO? Y N If yes indicate language spoken
List products cooled: by QFOIDA: *Can the QFOIDA read the inspection report? Y N
Describe cooling methods: Indicate who answered the ove questions: Name(print):
Is cooling monitored for time&temp? Y N Is t monitoring of cooling retarded? Y N Indicate the title of above person(circle all that apply):QFO DA Mgr Cook Owner FW
Obtain signature of the person who r peived the QFO responsibilities information at the time of the
Is there a produce washing policy? Y N ♦ ascribe what is washed and inspection: \4 wir-
where: Note: This r ort is a two page form(total of 62 debitable items) Page 1 of 2
iS t�F CONNECTIG.UT AEI?ARTMENT OFbPU1l3I-IC'HEALTH 00 GAPITQL,AV 1 WE,-MS#51 FDP-HARTFdRD,CT 06134'
y� OCCJS D 0p>3 S> R C INSPECTION � 01tT
Lt •�?DI�ESSICfTY
Establishment:'Ta� Date of Inspection
dress, ' 1 l.=l t✓ ,•c t T �i U Owner oc..0 erator.. ,y�" iv 7v5'
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ADDITIONAL FOUR POINT ITEMS �_. KEY: DNC [DOES NOT COMPLY] Lrrr rrr r`t
6 Foods not re-served.
-Unwrapped foods not re served 4 i 31 Sewage disposal approved. 4`
flatly hazardous foods not re-served -Operating as required
74 No cross connections,back siphonage,backflow
11 Toxic hemicals. 4
9 4' ow revention device air a for:
d pr�Rerly;lobe etl properly,used properly -Food equipment -Hose connections -Dish machines
-sanitize- ncentration not to exceed maximurr permitted -Soda system carbonator -Beverage dispensers -Toilet tanks
-No unnecessary toxics on the premises -Chemical dispensers -Ice machines
-Pesticideslrodenticides properly dispensed Proper drain for:
29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines
4
-Well lwell head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4'
-Water quality in compliance designed,properly installed
-Monitoring in compliance
OTHER ITEMS KEY: DNC [DOES NOT COMPLY] �4`
2 Sources of food:Original container,properly labeled 1 0 Garbage/rabbisInsto rage arealrooms,enclosures-properly constructed,d ea n 1.=
5 Potentially hazardous food properlythawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency
10 Food dispensing utensils properly stored Vermin Control: No insects/rodents present
14 Food worker:Clean outer clothes,effective hair restraints 1. 3 ropenings protected against entrance of insectsfrodents 1
4 Floors: Floor covering installed,constructed as required,good repair,clean 1:
16 Food-contact surfaces designed,constructed,maintained,installed, 2•
5 Floors r`
graded,drained as required
located
6 Floor,wall juncture covered
17 Nonfood-contact surfaces designed,constructed, maintained, 1 W 7 Mats removable,good repair,clean
Iled,located
8 Exterior walking,driving surfaces,good repair,clean 1
$' ' gle 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
0 Dishwashing facilities approved design,adequately constructed, 2`'
maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 1
F4uipment&ttensils: Cleanliness 1 51 Adequate lighting provided as required 1
21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1
22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required
23 curate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1
7 1 onfood-contact surfaces of utensils&equipment clean
771- 55 Establishment and premisesfreeof litter,no insect/rodent harborage, I
Equipmentlutensils,storage,handling 1 no unnecessary articles
32 Proper disposal of wastewater 1„ 56 Complete separation from iivinglsleeping quarters and laundry 1
33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1
36 Toilet rooms enclosed with self-closing door
58 No live birds,turtles,orother animals(except guide dogs) 1
1
59 Seats 75 or more;Nonsmoking area provided,sign(s)posted at
37 Proper toilet fixtures provided,good repair,clean 3
entrance(s),smoking area indicated by sign(s)
39 Approved garbage/rubbish containers,adequate number,covered, 1
rodent proof,clean 04outine Inspection ❑Reinspection ❑ Preoperational Inspection
TOR: PERSON IN CHARGE: Other inspection:
1-4 Demerit Score: +Include demerits from page I
CA,.,,/Ap 4 3 2 1 Total Rating
_15169nature signature
4- J 0 N C L_ S
p mt name print name
J<�w �t )v --- DATE CORRECTIONS
phone number title
L� 11 Page 2 of 2 plus continuation pages Focused lnspe on1r:ooz
Page off""
INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TO DATEc OF SPECTI N
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INSPECTION
FORM## REMARKS
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager
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INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF IN PECTION
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INSPECTION REMARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE)
Distribution: Ist-White-Health Department 2nd-Yellow- Owner/Manager