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HomeMy WebLinkAboutFood Service Establishment Inspection 57 (5) tL_f� 4 t4 s �/ / . 90 Establishment: -Inspection Date: . _1-41Z6 Time: Oinsp All ddresslCity: L Health Dept: � ,h 1j" k&4,�k Class: 1 2 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 not inclusive of all possible debitable items C NO,NIA DNC I KEY: C[complies] N10[not observed] NIA[not applicable] DNC[does not 60 ]-Quahfred Food Operator 3 w 72 i Personnel vyitN.irtfectio]in restril 61 IDesrgpatedAlternate 2 rea y o-ea A Food workers have no exposed infected lesions I burns 162 )illritten documentation of frarning program 2 B Personnel with infection restricted 1 Approved source,wholesome;nonadulterated C :NlO N/A ''4 C Communicable disease of worker reported to local health director K ;. A A roved shellfish,finfish,meat&poultryUSDA approved 413 Handwashmgfa'cilities provided,:handswashed,dean. C ;N10 NIA i4 B Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadulteratedfoods/safe leB Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grownlcanned food) C Handwash facilities access!blelconvenlent to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean I Proper handwash procedure E Handwashing at appropriate times a3 iPoterdially�haza[d`qus'food m�'e s temperature,requrremer is TC NIO N!ik 14-1 0 r durirfg storage„prepaon displays servicQ and;tranaportatton r rati i1g hY9lenro;;practices ,. :. i, C N10:`NlA 2 A Hot holding greater than or equal to 140oF. (whole beeflporkroasie 130e F.) A ❑ No eating ❑ No smoking while working B Cold holding lesslhanorequalloOF. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 Sitzatioa AE roper internal cooking/consumer advisory posted a n ( waeZ Eq ! 2 Approved sanitizer availableladequate concentration ofsanitizer q(Jal .o�luct o j* ( j, Nj g Food-contact surfaces and utensils used for potentially ' ' * * ' " hazardous food sanitized at least eve 4 hours t �gratyrg,thermometers>pro�nGed H <. �. ..r x•. i F' every IY _... . fibili.wr:k .ak v..y.a.uiti dh aw•= 1 '4+ r y R.: A Food thermometer available and accurate C Adequate Ekishwashersanitizer ❑final rinse temp B Proper food thermometer for product D Proper sanitizinprocedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 i2� r:Clean wi jn dl the `` v , ;. .,..,. P Q;.., s ? � IN)q NIA 1 [ Fb d=proteetedreu? n p9lrege, paratiori; C N10 INjA 2 # fi A Cloths and/orsponges in cod repairand clean � dis lh , �r rr ;arid#ranspatit� ion 1 .,., �- ;s kg [ s k x_ya• a '� at `.rt tug s�` ''�"Y "' ` i '' ` r B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared nearready-to-eat foods + r,w w, ^� r 12 'il 4?;O'or�tec �uH. - Claan r ��� ��� �n � �Cx NIb'�IJa ,2 C I Food covered properly A I Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards/sneeze guard B Single use gloves changed when soiled t E No unauthorized personnel C Food contact surfaces clean F No pooling of eggs not cooked immediately k0 8 Food containers stored offlheiloor e0f yHotn ,cic'�fa$erifn�pr;pres;ir ;prbvide8 aS regGrrdti 4 _f 0'tNIA M2 0 i 3a Handwashing accessories provided N10. WA 7 la Itn' of food rninrmlze� .�.« 4<. iC iN!©IwA 2 r Y :; x g._ .. .u ,.r..0. •....�.a s.: A Soap/papertowels/ 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 sinks)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[foodborne] Pl are hot held at: OF. 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 are you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy that r uires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foodslequipment? Y IJ 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 leftovers sav d? Y N Is there a language barrier be on 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 ar�w rt�ie/� a above questions: Name(print): Indicate the title of� dve persoqAcirele all that apply):QFO DA Mgr Cook Owner FW Is cooling monitored for time&temp? Y N Is the monitoring f cooling recorded? Y N .Obtain signature of th rs received the QFO responsibilities information at the time of the Is there a produce washing policy? Y N *Describe wh is washed and Is where: to: This report is a t o 4ge form(total of 62 debitable items) Page 1 of 2 S1f►TEOFCONKF`TICl1aT 13EPARTME TPVPUBL!C HEALTH 41Q.CAPITOLA11ENIUE-MS#5iPOP HARTPORf],CT 061 FOCUSED FOOD SERVICE INSI+,ECTIO REPORT " r lY P L zQ ADDRESSICIV. Establishments�f/fi19: .`7T�#L1 . au7`- Date of Inspection: r . „ ddress - moo'Fes= �—[rL ->F �1� O+rvn�r or operator T / � ADDITIONAL FOUR POINT ITEMS i o; KEY: DNC [DOES NOT COMPLY] 'k 6 Foods not re-served. ' - 4 31 Sewage disposal approved. Unwrapped foods not re-served 4 -Potentially hazardous foods not re-served -Operating as required 11 Toxic chemicals. No cross connections,back siphonage,backflow 4 4'„ Proper type/installation/backflow prevention device/air gap for: -Stared properly,labeled properly,used properly -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 -Chemical dispensers -Ice machines -Pesticitleslrotlenticides properly dispensed Proper drain for: 29 Water source adequate,safe, 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination Lde acilities. Adequate,convenient,accessible, 4-Water quality in compliance-Monitoring in compliance ed,properly installed OTHER ITEMS z" c. KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 1 0 Garbagelrubbish storage area/rooms,enclosures-properlyoonstructed,clean 5 Potentially hazardous food properly thawed 2 1 Garbage/rubbish disposed of in an approved manner,atapproved frequency 10 Food dispensing utensils properly stored a 'i 2 Vermin Control: No insects/rodents present Z 14 Food worker:Clean outer clothes,effective hair restraints 1-= 3 Outeropenings protected againstenlranceofinsects/rodents too : Floorcovering installed,constructed as require good repair,clean 16 Food-contact surfaces designed,constructed,maintained,installed, 2.F Floors graded,drained as required - sated 6 Floor,wall juncture covered 1 I� nfood-contact surfaces designed,constructed, maintained, - 7 Mats removable,good repair,clean installed,located 8 Exterior walking,dnvingsurfaces,good repair,clean 18 Single service articles,storage,dispensing - 19 No reuse of single service article Prepai s i' attached,equipment pro Orly constructed,good !' ean. iling-surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2= maintained installed located 50 Dustless cleaning methods used,cleaning equipment property stored Equipment&Utensilso Cleanliness 1` 51 Adequate lighting provided as required 1 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors j 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required urate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean I 27 No food-contact surfaces of utensils&equipment clean 55 Establishment and premises free of litter,noinsecflrodentharborage, 1' 28 Equipmenllutensils,storage,handling no unnecessary articles 32 Properdisposal of waste water 1 56 Complete separationtom livinglsleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1 581 No live 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 3 37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,covered, 1: rodent proof,clean AWoutine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: IN OR: PERSON IN CHARGE: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signature signature rint name print name �` P� DATE CORRECTIONS DUE: 8 . i G phone numbers title Page 2 of 2 plus continuation pages Focused Inspection 112002 Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION 12116,4 INSPECTION FORM# REMARKS I AV fl INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) C� p Distribution: 1st-White-Health Department 2nd-Yellow�-Owner/Manager laf 5, c-lj�c� l/-�-j c-t j'im - G /J c err— y /�i J