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HomeMy WebLinkAboutFood Service Establishment Inspection 65 (3) , tw te: Time: / Establishment: Inspection Da • Oinsp Einsp ddress/City: �dNi�l ,-z/* xU AeZ>_ Health ept: cuss: 1 z Based on an inspection this day,the items marked DNC identify the violations in operation or facilities which must be corrected bythe date specified on page 2. RISK FACTOR ITEMS:Listing is not inclusive of all possible debitable items C NIO NIA JDNC I KEY: C[complies] NIO[not observed] NIA[not applicable] �ltaf(frd FooiOpe[atOr ,R' „'� �,' DNC[does not comply] 0[other] RTE.(ready-to-eat] 3 44 i Personnel vlrttFi infection restricted e ` 61 rDes�gnated Alternate.f y t �.�:3 •r y , l GNft .'WA jq Food workers have no exposed infected lesions!burns 62y;Writtett ocUme�lMdhono„tr8mtrtg�rogramx w >; 2 B rtneI with infection restricted �1 <iA ro ed ot�irce'wtitlesdm�,inbn�dultr:rated 4 * IC N© N/A 4 P. .:�r om nicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved k' .% 13 dvuashmg5facrltties prowd�d,rhandswashed,clearl, C NfO 4 B Food cans in good condition(not dented,rusty,bloated,leaking) tC Handwash facilities in all food prepldispensing&warewash areas C Wholesome/nonadulteratedfoods/safe 9 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 1K D Personnel hands washed,clean I Proper handwash procedure 3 k Al .� E Ha washing at appropriate times (P it J11.1 hazardous food meets emper1lulfe repwlemen s G Il •,,:4 Will storag0 pr6'itlon,dW0Ihy service and«transportadon t �is�•- ; ,. :,, „;,. +wF4V tr t a '.} , i r r: drh Ss,y i ah:'e!5y_, IS w ...-..... o Y9tenrc.practtce 4 " I ' - .... .. - .. ..: :.,. .,,,, rats,JCi "'*;•.b"FiY.,'.'�Vh, A Hot holding greater than or equal to 140aF. (whale besrJpork roasts1300 F.) ❑ No eating ❑No smoking while working B Cold holding less than orequal to 45a F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating 0 �s r anttizatton4rtne(laat waterat1'ei al i` E Proper internal cooking I consumer advisory posted Approved sanitizeravailable/adequate concentration ofsanitizer ii l4 t« �e�alrrsPrtat[�pt, ; �CCI1Q w v2¢ Food-contact surfaces and utensils used for potentially frtperature stheFttt!�irinetere rovEdetl. �w *1 elk, hazardous food sanitized at least every 4 hours i` art= '+s t € t► a s. Adequate Fd•tshwashersanitizer ❑fina]rinse tamp A Food thermometer available and accurate D Proper sanitizin rocedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eatfood C Thermometers appropriately placed in cooler units ii` ONtp�49 �°etwtr hop ( �NlO'; t 'dd rat tFageSrep„�rfion, C ,N1O �N , 2 -�-� m �.W. v.v_s.�._.. # + I r Cloths and/or sponges in good repair and clean jr� ��tye�antl#ranspbrta;ion '�� I � B 384piscloths kept in sanitizer between uses A Produce washed B Raw meats not storedlprepared near ready-lo-eat foods ag u �cdnta #sutFas< leatln �` C f00 Nl ' C Food covered properlyY1 I A F d equipment clean,utensils cle u]pment interiors cl n D Adequate splash guards!sneeze guard Single use gloves changed when i 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 eg D¢; foa[rclw " 0 �`2 .mC,t,tdak .'kt�:#++liixltinVcxr wD,eFz:rl:.Y...,#: %.v.,....,: •"*+ ;.:!""'" l`. 5! 0 x ]3Q' ahlitivi if r ab essones rovtded:*t* �r � IC NIQ� N/,A e;H_a 1—in' '.of� d.{rtflrn z ft"", �]C kll0 IwA E 2 �=l:� �m, : �«�i�i< �o-�: �e� �:.� � w ., -� �°'�y`x .g�may, - r- A Soap 1 paper towels/ drying device available A No unnecessary handling RTE and/or cooked foods with bare hands $ Dispensers)working: ❑Soap ❑Papertowel B Minimize food handling,other than ready-to-eat,with bare hands & C Handwash sink(s)clean/waste receptacle at handwash sink C Adequate ulensil(s)for dispensing foodlice 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 equires the food worker to report specific illness conditions Are temperatures reoordedllogged for cold holding foodslequip ent? 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 eftovers saved? Y N Is there a language barrier be een inspector&QF0? Y N If yes indicate language spoken List products cooled: by QFOIDA: A *Can the QFOIDA read the inspection report? Y N Describe cooling methods: Indicate who answered the ve questions:Nam4relbili Indicate the title of abov rson( cle all that a Cook Owner FW Is cooing monitored for time&temp? Y N Is the m nitoring of cooling recorded? Y N .Obtain signature of t n received t CIF i ormatio at the time of the Is there a produce washing policy? Y N ♦Desc be what is washed and inspection: where: Note: This re rt is a two page form(total of 62 debitable items) Page 1 of 2 SA�` OOgNNE"�7� T DEPARTMENTOR RUB�IO',HEALTH 411DAPITQL,4tIENUE MS#51FDP HARTFORD,CT D6134 u T)CUSE]D FOOD SERVI P INSPIECTION REPORT ka"c i III A rl�tol:�r a oREss clTY: F Estabhshmerlt, ..s 57rc Date of.Inspection: ddress ! f> Nii� /TG/f- 1y Owner.or`'0per/ato�. = � u ADDITIONAL FOUR POINT ITEMS o KEY: DNC [DOES NOT COMPLY] 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 No cross connections,back siphonage,backflow 11 Toxic chemicals. 4 4 -Stored properly,labeled properly,used properly PrQ ear typelinstdationlbackflow prevention device/air gapfor: -San itizer concentration notto exceed maximum permitted -Food equipment -Rase connections -Dish machines -No unnecessary toxics on the premises -Soda system carbonator -Beverage dispensers -Toilet tanks -Pesticideslrodenticides properly dispensed -Chemical dispensers -Ice machines Proper drain for: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -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 KEY: DNC [DOES NOT COMPLY] :` S rcesoffood:Originalconta' r,properlyla6d�-"` 0 Garbage/rubbish storagearea/rooms,enclosures-properly constructed,dean I" Potentially hazardous food properlylhawecl 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored `;1 2 Vermin Control: No insects/rodents present rrrr 2 _ 14 Food worker:Clean outer clothes,effective hair restraints l> 43 LLIeroperings protected against entrance of insects/rodents I 4 Fle rs: Floor covering installed,constructed as require ,goad repairer 1 16 o '-contact surfaces designed,constructed, maintained,installed, 2" 5 Floors graded,drained asrequired e ated 6 Floor,wall juncture covered N n ood-contact surfaces designed,constructed,maintained, 7 Mats removable,good repair,clean installed,located S 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 I repair,clean.Wall&ceiling surfaces as required t 20 Dishwashing facilities approved design,adequately constructed, 2'' maintained installed located 50 Dustless cleaning methods used,cleaning equipment property stored Equipment&Utensils: Cleanliness 1 51 Adequate lighting provided as required 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors l 22 Wash water clean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 23 urate thermometers provided,dish basket,if used Rooms adequate,clean,adequate lockers provided,facilities clean 1 7 NoKfood-contact surfaces of utensils&equipment clean Establishment and premises free of litter,no insectlrodentharborage, 1 Equipmentlutensils,storage,handling no unnecessary articles 2 _R�o erdisposalofwastewater 4el 16 Complete separation from living/sleeping quarters and laundry 1 33 Plumbing location,installation,maintenance 57 Clean/sailed linens stored properly 1 58 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 37 Proper toilet fixtures provided,good repair,clean entrance(s),smoking area indicated by signs) 3 39 Approved garbage/rubbish containers,adequate number,covered, I rodent proof,clean Awoutine Inspection OReinspection ❑ Preoperational Inspection I TOR: PERSON mtmuE, Other Inspection: Demerit Score: •Include demerits from page 1 /,,7 4Z ) 4. 3 2 1 Total Rating i nature si et t p��r~~mt name print name `R l` & G`� 52 ��. Z ��� �� DATE CORRECTIONS DUE: f llJ phone number 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 SPECTION i !.0 s7J ©Ir— INSPECTION REMARKS FORM# Cj iF i v cr 4-1 I I eo INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) AM/ , Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Pageof —3— INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION INSPECTION REMARKS FORM# U r lip-Pig G %�Oc'UCH el F 1 ��G - e AM INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager Page-3—of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF IN PECTION INSPECTION REMARKS FORM# t e 4 INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager