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HomeMy WebLinkAboutFood Service Establishment Inspection 10 (8) %x W� � FO®D �1" �EGTt4N rY Establishment: 1 Inspection Date: i Time: /D-'3 Elnsp Address/CRY: lO O AM-IAJ -57— Health Dept: 1/0" lie/ b class: t z 3 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 rot inclusive of all possible debitable items C N10 N/A DNCJ KEY: C(complies] N10[not observed] NIA[not applicable] :80x Quah#tad Food Operator r 3 DNC[does not comply] 0[other] RTE[ready-to-eat] Qesignated z :12 Personnel with'!nfection restr[ct 61 Alternateeil, W0 NIA 4 A Food workers have no exposed infected lesions/burns 62 r W-h" documentation of training program4 2 B Personnel with infection restricted t , 'pprovgd source,wholesome,nonadulterated• C NO,NIA 4; C Co municable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 3 ' andwashrng facdPigs pr6►We`d hands wastied,clean .t: V 4 B Food cans in good condition(not dented,rusty,bloated,leaking) Handwash facilities in all food prep/dispensing&warewash areas C WholesomeJnonadulterated foods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grownlcanned food) C Handwash facilities access iblelconven!ant to use ACI- p( E Potentially hazardous foods received al proper temperature D Personnel hands washed, clean 1 Proper handwash procedure , 0 E H dwashing at appropriate times 37 Potentiaily h 'mid oG ;food mt ttfs tetnp r ftYre°i'eq`uf..Me"lit C N[0 NIA 4 during storage,p[eparatron„dreRlay serwc.,and,transportation, 7 od hygienic practices A Hot holding greaterthan orequal to 140 F. (whdabeef1parkroasts130PF) 7 ❑NO eating ❑ No smoking while working B Cold holding lessthanorequallo45aF. B Wounds covered adequately C Proper cooling k C Proper sink used for handwashing D Proper re-heating 0 E Proper internal cooking consumer advisory posted 124 .San itizationsrinsey(hofiwafer cf0rnicakyy C �N/0 N/A 2 0 A Approved sanitizeravailableladequate concentration ofsanitizer .� :�Atlecjua g;fecilttles to maintain.iproduct 4.�� iC"NO N/A 2' g Food-contact surfaces and utensils used for potentially (i, temperature&th rr npfneters provtdec hazardous food sanitized at least every 4 hours � A Food thermometer available and accurate C Adequate ❑dishwashersanitizer �#fnal rinse temp Je B Properfood thermometer for product D Proper sanitizin rocedure AKC E Sanitizing between raw animal origin&ready-to-eat food C Thermometersappropriatelyplacedincoolerunils 0 0 P x w „. 25; jCtean w(pri�grclohs z r , r 7 C [N10s N!A 1== Hk ,�aodvprt�tetC(drling stprage,yprePare�on, t.... ..C.. N10 r r W °� P e a , % w k 3 i A Cloths and/or sponges in good repair and clean d" i B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods ft odocontact4u I acestlean C Food covered properly r �:a• � .�� �� �r � .rrr �.�� �,,�� �,� �..� �i�� �::: ood 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 surfacesclean F No pooling of eggs not cooked immediately 12,, 0 8 Food containers stored off the floor �' *' '' W 4 x 3D, ;Hof�a[tdTcofd water under pressure,provided as.required U&J34:.k.0.::t.`^.a�`'•.'3,: $ }..7... ::.r.r.• }..� 0 SB; HandwasNig a cessones?provided': NO tWF ; !3 a F:angling of fogcE;,f'i�nireizeatlr,�,, :.� ,:: r lVla IwA 2. a "' A Soap./paper towels I drying device available A No unnecessary handling RTE and/or000ked foods with bare hands B Dispenser(s)working: OSoap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C I Handwash sink(s)clean/waste receptacle at handwash sink C Adequate utensil(s)for dispensing 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(foodbcrne] PHFs are hot held at: IF 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 food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foodslequip nt? Y N and diseases to the QF ? Y N +Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are eftovers saved? Y N Is there a longuaVbarrfer between inspector&QF0? Y N if yes indicate language spoken List products cooled: by QFO/DA: *Can the QFOIDA read the inspection report? Y N i Describe coding 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 triltoring of cooling recorded? Y N .Obtain sign ur of the rnoh g received the QFO responsibilities information at the time of the rhere a produce washing policy? Y N ♦De cribe what is washed and inspection:ere: Note: This report is a two page form(total of 62 debitable items) Page 1 of 2 S �kTL OF,CONNECYIC�lT DEPpRTl11ENT OF PUBLIC.HEyp ALTH 410 GAAPITOL AVENUE-MS#5 FQ �Fa�� .Si.alVXC tl�� +l�T1©N REPO2.T DDRE$S1fITY Establishment pry- !6 - .> y' Date of Inspection; ddress k �G ;i S: 7`"' Owner or..;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 44 -Potentially hazardous foods not re-served -Operating as required No cross connections,back siphonage,backflow I 1 Toxic chemicals. 4; 4 P roper lypelinstalIation/backflow payeofIon device/atgap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -5anitizerconceniration notto exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pest!cideslrodent+tides properly dispensed Prover 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 designed,properly installed -Monitoring in compliance OTHER ITEMS z KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 1 0 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,clean 1" 5 Potentially hazardous food properlythawed 2 41 Garbagelrubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properlystored J, 42 Vermin Control: No insects/rodents present 2 14 Food worker:Clean outer clothes,effective hair restraints 1 3 Outer openings protected against entrance of insects/rodents 4 Dots: Floor covering installed,constructed as required,good repair,clean 16 Food-contact surfaces designed,constructed, maintained,installed, 2 5 Floors graded,drained as required located 6 Floor,wall juncture covered No food-contact surfaces designed,constructed, maintained, 1 7 Mats removable,good repair,clean _ --itSstalled,located 18 Single service articles,storage,dispensing Z; 8 Exterior walking,driving surfaces,good repair,clean 19 o reuse ofsingle service article 9 Walls,ceilings attached,equipment properly constructed,good ;1 repair,clean.Wall&ceiling surfaces as required 0 ishwashing facilities approved design,adequately constructed, maintained installed located 50 ustlesscleaning methods used,cleaning equipment properly stored a 1 Equipment&Utensils: Cleanliness (51 Nd"equatelighting provided as required 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 Aqcurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1 7 onfood-contact surfaces of utensils&equipment clean 5,5 Establishment and premises free of litter,no insect/rodent harborage, 1' 28 Equipmentlutensils;storage,handling no unnecessary articles 32 Proper disposal of waste water 56 Complete separation from livinglsleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 1; 57 Clean/soiled linens stored properly 1 1 3 58 No live birds,turtles,orotheranimals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 1 59 Seals 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet Wuresprovided,good repair,clean entrance(s),smoking area indicated by sign(s) 3 39 Approved garbage/rubbish containers,adequate number,covered, "1` rodent proof,clean L AlRoutine Inspection ❑Reinspection ❑ Preoperational Inspection 70TOR: PERSON IN HARGE: her Inspection: C�� /� =� ✓�, Dem+?rit Score: *Include demerits from page 9 4 3 2 1 Total Rating sig a ure signature _ f tint name�� � � print name c� � t� ' / ��,� /� DATE CORRECTIONS DUE: /,¢ C hone number � title ,�u�. Di Z •, U Page 2 of 2 plus continuation pages Focused Inspection 1/2002 Page 4,_ via Date. F.,M INSPECTION REPORT STATE OF CONNECTICUT E"'° EmpRado PASS WHEN BLUE BAR TURNS ORANGE FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET 1600Fmec NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION Z,—//, INSPECTION FORM# REMARKS or ll � l INITIAL(INSPECTOR) j INITIAL(PERSON IN C GE) Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager 1 Pageof INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION REMARKS FORM# a- Cs' �- INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager