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Home My WebLink AboutFood Service Establishment Inspection 69 �rJG BS i t✓ 9�-t , r�- � 711,PTUe',T OC 1 D FA®TSB. . amptii"F"! 1wPAIt � iIF P�1 Y1t` r Establishment: AJ Inspection Date: Time: Roins �insp Address/City: �' ;C/r—"y A �� Health Dept: v �� r�„<� `Class: 1 2 't 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 NIO WA DNC KEY: C[complies] N1O[not observed] NIA[not applicable] 3 DNC does not comply] 0 other] RTE[read-to-eat] @0:t.Qualif[edoo jib P yl t y No :12 'Personnel with infection restricted 61 §1DeslgnatedAlt�rnate 2 C ` NIA ,A A Food workers have no exposed infected lesions!burns 62 Written dooumentatton oft mining•pragram 2 B Personnel with infection restricted �4pproved source,whdesome,nonadulferated rC 'N/0 NIA .4,. • C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat& cult USDA approved 73 l-landwashill facilities providld hall washed,clean C NIQ, N1A: 4 8 Food cans in good condition(not dented,rusty,bloated,leaking) A Handwash facilities in all food prepldispensing&warewash areas C Wholesomelnonadulteratedfoods/safe B Handwash facilities in or immediately ad' cent to toilet rooms D Commercial products(no home grownicanned food) C Handwash facilities access!blelconven' t to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean 1 Pradwash procedure E Handwashing at appropriate times $ ;Potentially iazardous'iood meefs.femperatu fe reyuireinnts C Nil hVA:•4 O I during storage;prapar#ion:disptay,service and tie's citation RP r Good hygrem>v pratTces C 00`i N1A 2= r A Hot holding greaterthan or equal to 140°F. (whole beeffporkroasts 130e F.) A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to 450 F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating - E Proper consumer 4 S nibzatlr;ri Arise hot'Water<�oh mtcal • ": P 9 advisory Posted i e ( ) C Nlo: ' 2" proved sanitizeravailable/adequate concentration ofsanitizer � dequate;facillt}esAWnriatnfain product s -. � i[Wpv' B Food contact surfaces and utensils used for potentially mpe'ature thprmori�eters providet r' every v h hazardous food sanitized at least eve 4 hours A Food thermometeravailableandaccurate C Adequate ❑dishwashersanitizer ❑final rinse temp B Proper food thermometer for product D Proper sanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 0* lop R �.x..r„ .,,, .� loan wtprng"cloths Food protc�tpdrdpnn r�e,�prepard�tlon; .N1O N 12 ig� [I{ is�play, rvrd�e a tSr nsport tone H 4 ,"� lothsandlarspongesingoodrepairandclean B Wiping cloths kept in sanitizer between uses A Produce washed B Raw meats not storedlprepared near ready-to-eatfoods tF d c6trft�ac u cos efeah ' r v NJQ 2 C Food covered properly v �+ ,� .u , .n.r. .4 cod equipment clean,utensils clean,equipment interiors clean D Adequate splash guards/sneeze guard B Single use gloves changed when soiled E No unauthorized personnel k0o, C Food--contact surfaces clean No pooling of eggs not cooked immediately 8 Food containers stored off the floor {" ' N1A i30 Hot and told ws�eU114060.4ssure;provided as:rdgiiired k } . '§. . H„ Hal cashing accessories provlde'd, xr G VI iN/A 1 .alndpn off ad mrrtimized 4 t t �,.w, k r� N!(J IN :>: :. ... .; x Soap 1 paper towels/ drying device available 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)for dis ing food/ice 0 0 l S *DESCRIBE DEFICIENCIES ON CONTINUATION SHEETS The following firformation 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: 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 pol' that requires the food worker to report specific illness conditions Are temperatures recordedllogged for cold holding foods/equipment? Y 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 s ed? Y N Is there a language biffrier between inspector&QFO? Y N If ves indicate language spoken List products cooled: by QFOIDA: *Can the QFOIDA read the inspection report? Y N Describe cooling methods: Indicate who answered the above questions: Name(print): Is cooling monitored for time&temp? Y N Is the monitoring o cooling recorded? Y N Indicate the title of above person(circle,�arl that apply);QFO DA Mgr Cook Owner FW Obtain signature aftI;i wed the 6 ,rss nsibilities information at the time of the Is there a produce washing policy? Y N *Describe what is ashed and ins sti0`i � where: Note: Fhis repo two p rm{totarof 62 debitable items) Page 1 of 2 STAfE OF CONf\IIECTICIiT; DE ,I'ARMENT�F PUBLIC';HEALTH 410 CAPITOL AilENl1E-MS#51 FDP-HARTFORD,GT 06134 kOC�JSEDF00D;SER"V1iC MINNPECT10N REPORT LOCAL HEALTHbERT U�y�/ 12 AbDRESS/CITY t s � Establishment Date of Inspection; i Owner or;Operator; 4;A& Lc� ADDITIONAL FOUR POINT ITEMS i. 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 Proper typelinstallationl backflow prevention device/air gap for; 4 -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration not to exceed maximum permitted -Soda system carbonator -Beverage dispensers -Toilettanks -No unnecessary toxics on the premises -Chemical dispensers -Ice machines -Pest icideslrodenticides 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 KEY: DNC [DOES NOT COMPLY] 2 Sources of food:Original container,properly labeled 1 0 Garbagelrubbishstoragearealrooms,enclosures-properly constructed,clean ntially hazardous food properly thawed 1` rbage/rubbish disposed of in an approved manner,at approved frequency 0 F d dispensing utensils properly stored uJ 1; 2 lVermin Control: No insects/rodents present 4 Food worker:Clean outer clothes,effective hair restraints 1 43 Outer openings protected againstentrance of insecfslrodents { Ibors: Floor covering installed,constructed as required,good rep cl n d-contact surfaces designed,constructed,maintained,installed, 5 Floors graded,drained as required located 6 Floor,wall juncture covered PT—No'nfood-contact surfaces designed,constructed,maintained, installed,located 7 Mats removable,good repair,clean 8 Exterior walking,driving surfaces,good repair,clean . jshle service articles,storage,dispensing 2 11 No reuse of single service article - 9 a Is,ceilings attached,equipment properly constructed,good r 1< repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 2 maintained installed located 50 ustlesscleaning methods used,cleaning equipment properly stored 1 Egtupmeat&Utensils Cleanliness t: 51 d�quate lighting provided as required 1 1' +} 21 Preflushed,scraped,soaked and racked 52 Room free ofsteam,smoke odors ,1< 22 Wash waterclean,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 . 271 Nonfood-contact surfaces of utensils&equipment clean 1 55 Establishment and premises free of lifter,no insect/rodent harborage, 28 Equipmentlutensils,storage,handling 1" no unnecessary articles 32 Properdisposal of waste water 1 56 Complete separation from living/sleeping quarters and laundry 1 33 Plumbing location,installation,maintenance it 57 Clean/soiled linens stored properly 1' 58 No live birds,turtles,or other animals(except guide dogs) 1 36 Toilet rooms enclosed with sclosin door �� 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 opertoilet fi u s provided,good repair,cea ,A 3 _./� entrance(s),smoking area indicated by sign(s) 39 Approved`garbage/rubbish containers,adequate number,covered, 1' rodent proof,clean 1011outine Inspection ❑Reinspection ❑ Preoperational Inspection Other Inspection: INSPE T PERSON IN GE: Demerit Score: *Include demerits from page 1 y 4 3 2 1 Total Rating si nature s Mature �� ppr. t name print name -phone number title DATE CORRECTIONS DUE: C �b�t� 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 INS ECT ON INSPECTION MAKK.S FORM# CZ �J 'v INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION &FA- 5 7-Z%jz-� 1 �(, //, /-,7 INSPECTION REMARKS FORM# �� f� i � / ( 94 INITI (INSPECTOR) 110, INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager Page of 3 INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF SPECTION INSPECTION REMARKS FORM# 1-21 Z14 'er�. C� 4---A I V�i� GGJ INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) �- Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager