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HomeMy WebLinkAboutFood Service Establishment Inspection 21 ; STATE;OTi C01!1NECFIi7L • O S OOD SERVICE ]'. a Establishment: ( ) nspection Date: Time: R insp Einsp Address/City: �� � �Uyr �?" Heath Dept: S 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 N10 NIA JDNC I KEY: C[complies] NIO[not observed] NIA[not applicable] t60 r Quatlfied Food Operator 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 12: c nuo NIA. 4 b9 Designated Alternafe 2 Personnel with infection restricted A Food workers have no exposed infected lesions!burns 62 Written documentation of training prRgram 2 B Personnel with infection restricted ,. Approved source,wholesome;,nonadulterated C .N10 NIA 4 C Communicable disease of worker reported to local health director A I AoProved shellfish,finfish,meat&poultry USDA approved 13 IHandwaehing;fadi[ities prov[ded,hands washed,clean ,C NI0 NIA +4 B Food cans in good condition(not dented,rusty,bloated,leaking) ` A Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadulteratedfoods/safe A 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/Proper handwash procedure 14 0 E Handwashing at appropriate times V. 3. IPtttefitiatl`.Haafdotsfor3d'inpet .terrlperaturere u[irenents';," N/0',hlfA.f4 0 durng`,s]orage,prepa�atlon,iilsplay,serviee and transportation, l i 15 =Good hygienic practices l C N6 NIA 2 :. a A Hot holding greater than or equal to 14D F. (whole beef/park roasts 1300 F.) A ❑ No eating ❑ No smoking while working B Cold holding less thano eequalto45 F. B Wounds covered adequately C Propercooling w C Proper sink used for handwashing D Proper re-heating o E Properinternalcookinglconsumeradvisoryposted 24� Semtization�rinse;(hot water=cheolcal) C N10 VIA 12 0 A Approvedsanitizeravailableladequateconcentrationofsanitizer }. 1=,Adequate-facitttfes takmaintainwprotluct * ;s' <>: C;' ° WA;`.:2 g Food-contact surfaces and utensils used for potentially 4..t*3 2 :E. i r. tart 1perafure, het9rtometers4provided� I l [ hazardous food sanitized at least every 4 hours .L; .�:�..:,A a 3. r, t t t• Y A F C Adequate ❑dishwasher sanitizer Anal rinse temp A Food thermometer available and accurate B Proper food thermometerfor product D Propersanitizin procedure E Sanitizing between raw animal origin&ready-to-eat food C Thermometers appropriately placed in cooler units 0 0 2fl>Clean wiping cloths C �N/0,'N1A 1 it I ed9rotected dt storage it brstion; w 1, C Nl0' NIA V 2; } w * x. °�' '� 1 'r t A Cloths and/or sponges in good repair clean � �I Y�isony ®,arid tr�atisP4rta ion: # �: •, I A ,�• ._.: _�..t_...i x..st:Sx v A Il...::.a.'.a at '4x. 3f'::h b!'.:x•.•.1R�•5t Aa,. ■• Y r+tr.i W i }m A Produce washed B Wiping cloths kept in sanitizer between uses 0 B Raw meats not stored/prepared near ready-to-eat foods dC I B`IF"ood'do Yactrs"u9rfia/"e,'` `teS��yr�"v k' "' `" ' C IW®+ ILIA 2 +,Nr t y";aA•^f `rY SFr M-Tir. `, •f%wTf°e{Vt K` 7-"45Y'�'M a 4:1'4.Sp. J :c t C Food covered properly - A Food equip 11 meniclean,utensils clean,equipment interiors clean Ael D Adequate splash guards!sneeze guard B 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 stared off lheiloor .30 ;Hot and coldfwate.r under p essure,,provided as'requ'ire t 0',PUA Z d.c l V:h ri � I 138"�..Handidashing aGcessories�provtded f• „''IWA. 1 9c s`KHandtin of=food NO himtz�mi . ' i:G INIA 12 �.. .._.......S_� ._._...__. ��.:.„ . s: t.:� , k. «.. A Soap 1 paper towels I 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 sink(s)clean/waste receptacle at handwash sink C Adequate utensil(s)fordispensing foodlice p D •DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following information is not debitable and does not affect your score. KEY: QFO[qualified food operator],DA[designated altemate],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 ar you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy Pit requires the food worker to report specific illness conditions Are temperatures recordedllogged for cold holding foodsleq ' ment? 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 ♦ re le overs saved? Y N Is there a language barrier etween spec or&QF0? Y N If yes indicate language spoken List products cooled: by QFOIDA: ♦ an the QFOIDA read the inspection report? Y N Describe cooling methods: Indicate who answ the above qu tions:Name(pri Indicate the title above on rc all 1 9t app QFO A Mgr Cook Owner FW Is cooling monitored for time&temp? Y N Is a monitoring of cooling recorded? Y N .Obtain sign e f t p r cei he resoo ilities informat' -af 1he time of the Is there a produce washing policy? Y N Describe what is washed and inspection: ,. where Note: This re ort' a two page form(total of la items) Page f of 2 S lA"1SE CIF CONNECT ICUT,DERa►RTM15[dT OF PUBLIC;HEALTH 410 CAPITOLAVENUE-MS#51 FDP-.HARTFORD,Ct 06134: #- T+UCUSE F(5db 15�R,t+ICE s �pGALHEALTM bEprt; A4RRE5SICITY; Establishment;7'ff 7,,fAlerLs Date of;irispectiort:; adrss r `' or Qperator. 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. -Potentially hazardous foods not re-served -Operating as required No cross connections,back siphonage,backflow 11 Toxic chemicals. ;4 4 Proper type/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizes concentration 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 designed,properly installed -Monitoring in compliance OTHER ITEMS z' c' - KEY: DNC [DOES NOT COMPLY] ; 2 Sources of food: Original container,properly labeled 1 0 Garbage/rubbish storage arealrooms,enclosures property constructed,dean 1: 5 Potentially hazardous food properly thawed 2 41 Garbage/rubbish disposed of in an approved manner,atapproved frequency 10 Food dispensing utensils property stored 1 42 Vermin Control: No insects/rodents present 2 14 Food worker:Clean outer clothes,effective hair restraints .1: 43 Outeropenings protected against entrance of insects/rodents 4 Floors: 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 17 Nonfood-contactsurfaces designed,constructed,maintained, 47 Mats removable,good repair,clean installed,located 2 8 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 1 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, r2; a maintained installed located 0 Dus ess cleaning methods used,cleaning equipment properly stored Equipment&Jtensil& Cleanliness 51 Adequate lighting provided as required 1` 21 Preftushed,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 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 27 Nonfood contact surfaces of utensils&equipment clean 55 Establishment and premisesfree of litter,no insectlrodent harborage, 1= 8 Equipmentlutensils,storage,handling 1; no unnecessary articles 32 Proper disposal of waste water 1 . 56 Complete separation from living/sleeping quarters and laundry ; 57 Clean/soiled linens stored properly 33 Plumbing location,installation,maintenance 1' 1 58 No live birds,turtles,or other animals(except guide dogs) 1 36 Toilet rooms enclosed with self-closing door 1 37 Pfopertoilet fixtures provided,good repair,clean 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 3,, entrance(s),smoking area indicated by sign(s) 39 Approved garbagelrubbish containers,adequate number,covered, _ rodent proof,clean outine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPECTOR: PERSON IN CHARGE: C Demerit Score: *Include demerits from page 1 / ,::, iL ,11_' 4 3 2 1 Total Rating nature sl natu e prints me `ntname —� - phone number tine DATE CORRECTIONS DUE: 6' Page 2 of 2 plus,�continuation pages nao uzoo: 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# Aj v C� Dxhar— Emp: Empl' WH PASS EN BLUE �� l � gAR TURNS ORANGE Xt,&,4 (VIP—T �UMBUA��WA0.WA INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) lyk— Distribution: Ist-White-Health Department 2nd-Yellow-Owner er