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HomeMy WebLinkAboutFood Service Establishment Inspection 76 --'6 Establishment: Inspection Date: Time:�' Oins Einsp ddress/City: - :k 4M f' 45LVb Health Dept: a Class: 1 ;!�94 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 JDNC KEY: C[complies] N10[not observed] NIA[not applicable] III 4dalifted Food Operators r g IONIC[does not comply] 0[other] RTE[ready-to-eat] ` } " 12 Personnel with infection"resfrrcted.> k T 81 Qesignated Alternate 2 A Food workers have no exposed infected lesions!burns Gl I Written documentation of trarnmg program p Personnel with infection restricted 1 Approved source,wholesome,nonatlulterated t C kN10 NIA ;4: C rri unicable disease of worker reported to focal health director A Approved shellfish,finfrsh,meat&poultry USDA approved 13 He dwashtng facrhttes provided!hands washed,clean''.C V 4 B Food cans in good condition(not dented,rusty,bloated,leaking) A andwash facilities in all food prepidispensing&warewash areas C Wholesomelnonadulteratedfoods/safe B Handwash facilities in or immediately adjacent to toilet rooms D Commercialproducts{no homegrownkannedfood) C Handwash facilities access lblelconvenient to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean!Proper handwash procedure an was Ing at appropriate times 3 iPour tralty hazardous food meets temperature 5quiremell . C"NIO 4 0 t duripgrstorag�p1�f reparation,display,servicq and transportation : `. 1 S :Good hygienic practices C NJQ. ]CIA ,2: A Hot holding greater than or equal to 140°F. (whole beeUporkroasls 130°F.) A ❑No eating ❑No smoking while Ill working B Cold holding less than or equal to 45e F. B Wounds covered adequately C Proper Cooling C Proper sink used for handwashing N D Proper re-heating j 0 E Proper internal cooking l consumer advisory posted FIR v. efiltizationlifirise shot waYgr;;.=pheinical}} .,C lJWO;,N1A 2 0 A Approved sanitizerevoilableladequate concentration ofsanitizer X i Adegi�uatedfacgipi�s t{o,mptnt am product } Y h ¢ Nl0 (N1A;N 2: B Food-contact surfaces and utensils used for potentially teiperattrre;thermbi)tteters' To►to hazardous food sanitized at least every 4 hours A Food thermometer available and accurate C Adequate WIshwashersanitizer ❑final rinse temp D Proper sanitizing procedure B Properfood thermometerfor product Ago I E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 '25 'CI "M WI WI *cloths z r ` Food=protect��i°cuing storage;preparation 0 En " rC`Nl .`NJA 2 i '.�- P Ai 9� h t MCA�N10 NIX 1" display, service and transportation i A Cloths and/or sponges in goodrepairandclean B Wiping cloths kept in sanitizer between uses A Produce washed D 13 Raw meats not stored/prepared near ready-to-eat foods �264 Food eatift V61—Hit if' feat tt tJIA 2'' C Food covered properly l.: . _ ,_ W v F i A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards 1 sneeze guard B Single use gloves changed when soiled E No unauthorized personnel IL C Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floor : 0`(liot andscol wateraunder pressure,prtivtd€1'as°requiie` i ! O I A 2< 0 i36 k Hend*ohmg accessories provided C Nl *aN✓� 1 +9' ndirn ofYoaB min'! ize :K x + i :w w g= _ q rr1 c} C Nl igl: 2 A Soap l paper towels l drying device available A No unnecessary handling RTE and/or cooked foods with be 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 1 waste receptacle at handwash sink C Adequate utensil(s)for dispensing food/ice 0 0 71f 1 •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 trot 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 ork 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 s the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foodslequipme 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 Is ers 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 QF01DA read the inspection report? Y N Describe cooling methods: Indicate who answered the an ve questions:Name(print): Indicate the title of above pe o (circle all that apply):QFO DA Mgr Cook Owner FW Is cooling monitored for time&temp? Y N Is the monitori g of cooling recorded? Y N .Obtain sign u e of ers ho received the QFO responsibilities information at the time of the Is there a produce washing policy? Y N *Describe what is washed and inspection: where: Note: This report is a two ge form(total of 62 debitable items) Page 1 of 2 (5 ,Er3FOON14ECTICUT; ,DPPARTMENTOF`PUBL,IC,H-" AVENUE-MS#51FDP-HARTFORD,CT 66134 A F FOC�TSED FOOD S)CRtrIC TNSPFCPIgN REEUR «LAL HEAL1'W DEFT '`GG� � �_ ADDRESSlGITY� r. ov. .` EstablishmentCD®vrt�r Date of Inspection: t ° Address. "3` fft> %7r L'7 Owner or:Opierator':. ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 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 11 Toxic chemicals. 4 4 Proper tvoelinstallation/backflowpreventiondevice/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -San itizerconcentration not to exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pesticides/rodenticides 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-Monitoring in compliance designed,properly installed OTHER ITEMS vz KEY: DNC [DOES NOT COMPLY] ' cz 2 Sources of food: Original container,properly labeled 1 0 Garbage/rubbish storage area/rooms,enclosures-properly con structed,clean 1 5 Potentially haza rd ous food properly thawed 2'; 41 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 1 3 Outer openings protected against entrance ofinsectslrodents 1 Coors: Floorcovering installed,constructed as required,good repair,clean 1 '� 16 Food-contact surfaces designed,constructed,maintained,installed, Floors graded,drained as required located 6 loor, n ure covered _ 17 Nonfood-contact surfaces designed,constructed, maintained, 1` 7 Mats remova e,goad repair,clean installed,located 8 Exterior walking,driving surfaces,good repair,clean 1 18 Single 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 20 Dishwashing facilities approved design,adequately constructed, 2, 50 Dustless cleaning methods used,cleaning equipment properly stored 1° maintained installed located Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required #1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors F 2 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required " 231 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 1 55 Establishment and premises free of litter,noinsectlrodenlharborage, r•;1 28 Equipment/utensils,storage,handling 1 no unnecessary articles x 32 Properdisposalofwastewater 1 56 Complete separation from living/sleeping quartersandlaundry "1 33 Plumbing location,installation,maintenance 1 571 Cleanisoiled linens stored properly M ;; 58 No live birds,turtles,or other animals(except guide dogs) 1 36 Toilet rooms enclosed with self-closing door 1.6 59 Seats 75 ormore: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 garbagelrubbish containers,adequate number,covered, 1' rodent proof,clean outine Inspection ©Reinspection ❑ Preoperational Inspection Other Inspection: 7M Demerit Score: •Include demerits from page 1 4 3 2 1 Total Rating 7natue signature prin name print name f �� R phone number ? title DATE CORRECTIO S DUE: / L 50 Page 2 of 2 plus continuation pages FocusedInspece 1002 Page—/—of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION REMARKS FORM# 422 40 1 r Q. -711 i 1 67 Gam' C.0 -� � !�'•e.---�. INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) . Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Pagq=,)_of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION REMARKS FORM# 1-U -� INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager