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HomeMy WebLinkAboutFood Service Establishment Inspection 17 (6) srxt;r�•'o;r Establishment: Dater w Time: R tnsp Eins Address/City: j S Lrj� rJc Health Dept: ;, �� �;��n.5 c; class: 1 2 3r� 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 N10 NIA JONCI KEY: C[complies] MID[not observed] NIA[not applicable] 80' Qtiaflftetl Fao 6perattir 3 DNC[does not comply] 0[other] RTE[ready-to-eat] i ;Ilk 12 Person`neFwith infection restricted 61 10isignated Alternate 2 A Food workers have no exposed infected lesions 1 burns 62 Written documentation of training program 2 B Personnel with infection restricted 1 App onad roved source,wholesome;,nuIte at d' t NLO N/A i4 '. C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA app roved 113 Handwashmg fadiiitres provided, hands washed,clean 'C N10: N1A 14 B Food cans in good condition(not denied,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadulteratedfoodslsafe 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 Personnel hands washed,clean I Proper handwash procedure 0 E Handwashing at appropriate times ' 3.'°'.!PQte...u.9 ly h";z@rdous footl meets temperafure requirements•� iC'0.0.;NIA:'4 0 ti durrng orage preparation,display,sernce an transportation K. 15 Goodshygienicvractices 1C°;N1.0 j 2. i ; , A Hot holding greater than or equal to 140°F. (whole beef/pork roasts 1300F.) A ❑ No eating ❑No smoking while working B Cold holding less than or equal to 45°F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking/consumer advisory posted 12.4 San1tizatton,rinse(hot water-chern[cal} ;�_'td10 WA 2 rA A Approved sanitizeravailableladequateconcentmtionofsanitizer N10 IN1A 2 g Food-contact surfaces and utensils used for potentially teinj�e[rature,therrrtomehazardous food sanitized at least every 4 hours Food thermometer available and accurate C Adequate ❑dishwasher sanitizer nal rinse temp D Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 12 1 Clean` 11 in cloths C 1N10.; NlA� 1 7 Food.protecteddtaringrstora�e� reparatia[n^, �'`; :'� :(d10.INlA l2 >' ,� . L r display,service and transpartatron +..r k r [y r A Cloths and/or sponges in good repairand clean B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods y- 26,.EoQdolaacttstrtaces�clean tis �. . C NCO �UA i2 C Food covered properly r, A a Food equipment clean,utensils clean equipment interiors clean 4. D Adequate splash guards!sneeze guard � g 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 r p r Hot and fold water undlar pre'sure,provided asre airs C't, 3 �f1 :.12 h w:;,: .v.. q .r*." . . .. :.e: .. .: B Handwaihmg accessories=provided w7 tT NO NIA.m, '. . ; .,n tin ,offood.mimmised¢ y y 11 N10 N! x2 g ' - • •- A Soap!paper towels I drying device available ?1 unnecessary handling RTE andlorcooked foods with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel Minimize food handling,other than ready-to-eat,with bare hands CI Handwash sink(s)clean Iwaste receptacle at handwash sink C Adequate utensil(s)for dispensing foodlice LL p 0 Fft_ -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: F. PHFs are cold held at: F. 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 re you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness polic at requires the food worker to report specific illness conditions N and diseases to the QF0? N Are temperatures recordedilogged for cold holding foods/equipment? Y *Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are leftovers ved? Y N Is there a language bar' r between inspector&QFO? Y N If-yes indicate language spoken List products cooled: by QFOIDA:_ +Cart the Qli read the inspection report? Y N Describe cooling methods: Indicate w/aered thehoveuestions: Nam print): Indicate fhabo cle all e):qn�QFO DA Mgr Cook Owner FW Is coding rnonifared far time&temp? Y N Is the monitorin of cooling recorded? Y N •Obtain si the er ibiti'es-iw or n at the time of the Is there a produce washing policy? Y N ♦Describe w at is washed and inspecti where: Note: This report 11 a to page form(total of 62 debitable items) Page 1 of 2 _IPWI,,.. o7 Yam, V S"ii4Tl=OF GONN'ECTICl1,T. DEPNITIIfNT OF PUS LICHEALTk! 416`CAPIT,©LAUMUE.=MS#5 tFDP-HARTEORD,CT.06134 r : 3 • `< >F(XCIJSe7�FpOA SEEj'I E INSPECTION REPORT LO A H AL fH bEpfi Ge lr�✓7.�5�/�` ADORESS[CtTY: Establishment. r�ri` v' �rS T L-i ylwg. Date of Inspection: .� y . ddress. J / r rrr� Owner Operator., of ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] z 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 No cross connections,back siphonage,backflow I Toxic chemicals. .4 Pm per e�rtype/installation/backfiow prevention devicelair gap tor: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines .San itizerconcentration notto exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticides/rodenticides properly dispensed 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, 4 -Water quality in compliance-Monitoring in compliance designed,properly installed OTHER ITEMS 0 KEY: DNC [DOES NOT COMPLY] tz 2 Sources of food: Original container,properly labeled 1 40 Garbageiubbishstoragearea/rooms,enclosures-properly constructed,clean 1 5 Po _tentially hazardous food properly thawed 2 1 Garbage/rubbish disposed of in an approved manner,at approved frequency t0 od dispensing utensils properly stored 42 Vermin Control: No insectslrodents present =2 14 Food worker:Clean outer clothes,effective hair restraints 43 Outer openings protected against entrance of insects/rodents 1`' 4 Floors: Floor covering installed,constructed as required,good repair,clean 1 16 Food-contactsurfaces designed,constructed, maintained,installed, 2 5 Floors graded,drained as required located 6 Floor,wall juncture covered 17 Nonfood-contact surfaces designed,constructed,maintained, 1 7 Mats removable,good repair,clean in tailed,located 18 Ingle service articles,storage,dispensing 2 8 Exterior walking,driving surfaces,good repair,clean No reuse of single service article 9 Walls,ceilings attached,equipment properly constructed,good20 4 repair,clean.Wall&ceiling surfaces as required Dishwashing facilitiesapprovedtlesign,adequafelyconstructed, 2 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored 17 Egtuipment_&Ufensilso Cleanliness 1: 51 Adequate lighting provided as required 1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 1 2 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required rate thermometers provided,dish basket,if used 4 Rooms adequate,clean,adequate lockers provided,facilities clean 1' 27 An food-contact surfaces of utensils&equipment clean 1 55 Establishment and premises free of titter,no insect/rodent harborage, r 1= 28 Equipmentlutensils,storage,handling 17 no unnecessary articles 32 Proper disposal of waste water ; . 56 Complete separation from living/sleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 58 No five birds,turtles,or other animals(except guide dogs) 1 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 sign(s) 3 39 Approved garbage/rubbish containers,adequate number,covered, '1 rodent proof,clean Routine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: TOR: E N E: Demerit Score: *Include demerits from page 1 J � 4 3 2 1 Total Rating --y J � gneture f sl ature ? print name pnnt name ph' ne number tl DATE CORRECTIONS DUE:17-­ Page 2 of 2 plus continuation pages Focusedlnspee[,on V2002 Page of 44 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION 6/a"-)s o77 L�✓l/G/ S INSPECTION REMARKS FORM# �j 40 Az 04 J n c. INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1 st-White-Health Department 2nd-Yellow- Owner/Man e Pa �of g INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN 3 DATE OF IN PECTION INSPECTION REMARKS FORM# F IN f >+� Vd V - ? . C i INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager