HomeMy WebLinkAboutFood Service Establishment Inspection 10 (12) .... -
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Establishment: S;.Ac� .$ , Inspection Date: Time: Ito�nsp Einsp
ddresslCity: � , uLL� .Z Health Dept: '; / s�,, s: lei
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 NIA D KEY: C[complies] N10[not observed] NIA[not applicable]
fi0 Qualified Food Operatorx; , < `• ° DNC[does not comply] 0[other] RTE[ready-to-eat]
' 12 Personnel'wfth.infe:ction restFicted
.C ;N10`MI 4-
fit rDes�gnated Afternate ; y .: .�: :
- Food workers have no exposed infected lesions 1 burns
62 Written3doxgmenta#ton of tramthg program
r B Personnel with infection restricted
1 {Approved source,wh6lesorh6-;nonadulterated C NIO NIA 4 C Communicable disease of worker reported to local health director
A Approved shellfish,finfish,meat&poultryUSDA approved 13 ,liandwabRing facititfes prolvided bnds1was c1 leori'C=,NIO •NIA 4.
B Food cans in good condition(not dented,rusty,bloated,leaking) /C A Handwash facilities in all food prepldispensing& rewash areas
C Wholesomelnonaduiteratedfoodslsafe B HandWagRacilities in or imm y adja t to toilet rooms
D Commercial products(no home gmwnlcannedfood) C He wash facilities cess'� c v ni o use
E Potentially hazardous foods received at proper temperature D Pe el ha we €a p ndwas procedure
0
r .,:,..,,.;..:...:... 4.,::.....: . E Ha drorashthg at appropri t im
3 ,Paten Sally ila�ardus#ood'meets�#efnpezature requirement"s C- NIOJiM,`14" O
durrn xstorag�„p parat lop,display,service and`tranllbdrt tori r
15 ':Good hygienic practIces
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A Hot holding greater than or equal to 1400F. (whore beeflpork maws 1300 F.) A ❑No eating ❑ No smoking while working
B Cold holding less than or equal to450F. B Wounds covered adequately
C Proper cooling I I kol C Proper sink used for handwashing
D Proper re-heating 0
E Proper internal cooking/consumer advisory posted 2 anitizatron ririse;(hp't.water .rch ical)d C; NlQ hN?A
. - ...
0 A Approved sanitizeravailableladequate concentration ofsanitizer
4 �Atleq[�ate#acilrtiestd maltrtaln pdLc�i ,7t' y r ,� rN10 WA r 2 B Foad-contact surfaces and utensils used for potentially
a [temperatuu ,thermomete pralvrtled , r hazardous food sanitized at least every 4 hours
A Food thermometer available and accurateIt C Adequate ❑dishwashersanitizer ❑final rinse temp Ilk
B Proper food thermometer for product D Proper sanitizin rocedure K
E Sanitizing between raw animal origin&ready-to-eat food
C Thermometers appropriately placed in cooler units O
O a p g •`.k, r
.,„n r . e , ;s i25 Clea inr rn clot. J a :f ,0 a ). rt� IW. !:N/A r1
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Foc9d r tra ed dui+ A stt�rage p to Ca Qn, r{ C!!IN
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�� A Clothsandlors on esin oodrepairand clean
se'rvxcatd transportation h- M; P g 9
- e B Wiping cloths kept in sanitizer between uses
A Produce washed
B Raw meats notstoredlprepared near ready-to-eat foods 2 BF�}pdo"�otacurf �es, lean A'•"�,3
C Food covered properly
A Food equipmentclean,utensils clean,equipment interiors clean
D Adequate splash guards I sneeze guard B Single use gloves changed when soiled
E No unauthorized personnel Ae
C Footl--contactsurfaces clean
F No pooling of eggs not cooked immediately
8 Food containers stored off the floor 3o Hot an 1.II ".undi6q:.iure,3provided ;require C iV1O U 2
0 Fdlia 1. NI
p.
z r y �3 � ndwashing aedcessories provided :; tC Nro{; A
rHandligg'of: gd:mrnrmlzed e ¢ k C' )NIA {'2
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A No unnecessary handling RTE and/or cooked foodswith here hands A Soap l paper towels I drying device availableB 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 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 altemate],PHF[potentially hazardous food],FB[foodborne]
PHFs are hot held at: OF. PHFs are cold held at: 7youco-ok:
Describe illness conditions when you would exclude a food worker from working:
Are internal cooking temperatures taken? Y N *To what temperatuPoultry Ground Beef PoWhat 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 p icy that requires the food worker to report specific illness conditions
Are temperatures recordedllogged for cold holding foodslequipment? Y N and diseases to the OF Y N *Do you have a paid sick leave policy? Y N
Are foods cooked in advance and cooled? Y N *Are leftovers saved Y N Is there a language b mar between inspector&QFO? Y N If 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):
Indicate the title of above person(circle all that apply):QFO DA Mgr Cook Owner FW
Is cooling monitored for time&temp? Y N Is the monitoring of co ling recorded? Y N .Obtain signature of person w cerved the QFO responsibilities 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 page form(total of 62 debitable items) Page 1 of 2
OF.CONNECTICUTf=�3EPARTMirNT"z�F PUBLIC" EALTFf 4IU CAPITOLA1/f~h!t!E MS#51 F13P-HA#ZTEORD,CT'Q6134'
FOCUSED FOOD SERVICE TI01 P'(312,Tlx
LOCi4L HEALTH CJEPT: £ v/.,u?a S� " ADDF�ESSICI fY # ,
Establishment " " _(A .4 c � µ Date.of,llnspection: rdo r
ddress:l L�1_1 I.Ael/ rd�mot✓UL-� " Owner or.-Operator:Z3: n
ADDITIONAL FOUR POINT ITEMS o KEY: DNC [DOES NOT COMPLY]
6 Foods not re-served.
-Unwrapped foods not re-served 4 31 Sewage disposal approved.-Operating as required 4
-Potentially hazardous foods not re-served
No cross connections,back siphonage,backflow
11 Toxic chemicals. 4 4
-Stored properly,labeled properly,used properly Propertynehnstallation/backflow prevention device/air gap for:
-Sanitizer concentration not to exceed maximum permitted -Food equipment -Hose connections -Dish machines
-No unnecessary toxics on the premises -Soda system carbonator -Beverage dispensers -Toilet tanks
-Chemical dispensers -Ice machines
-Pesticideslrodenticides properly dispensed Proper drain for:
29 Water source adequate,safe. -Food equipment -Dish machines -Ice machines
4
-Well 1 well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, '.4=
-Waterquality in compliance
-Monitoring in compliance designed,properly installed
OTHER ITEMS z
KEY: DNC [DOES NOT COMPLY]
2 Sources of food: Original container,properly labeled 40 Garbagelrubbishstoragearea/rooms,enclosures-property constructed,dean
5 Potentially hazardousfood properlythawed 41 Garbage/rubbish disposed of in an approved manner,atapproved frequency
10 Food dispensing utensils properly stored 1 42 Vermin Control: No insectslrodents present 2
14 Food worker:Clean outer clothes,effective hair restraints k 43 Outeropenings protected against entrance of insects/rodents =1 j
4 Flo s: Floor covering installed,constructed as required good rep ir,clean
16 Food-contact surfaces designed,constructed,maintained,installed, 2 Floors graded,drained as required
located `` "
6 Floor,wall juncture covered
17 Nonfood-contact surfaces designed,constructed,maintained, 1 ' 7 Mats removable,good 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 al§ lingattached,equipment properly constructed,good 1
eLClean.]II111&ceiling surfaces as required
20 Dishwashing facilities approved design,adequately constructed, 2r`
maintained installed located ti 50 Dustless cleaning methods used,cleaning equipment properly stored
Equipment&tJtensils:_Cleanliness °t ' 51 Adequate lighting provided as required
1
1 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors Z'
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 1
27 Nonfood-contact surfaces of utensils&equipment clean 1"`
55 Establishment and premisesfree of litter,no insect/rodent harborage, 1
28 Equipment/utensils,storage,handling 1 no unnecessaryarticles
32 Proper disposal of wastewater 1: 56 Complete separation from living/sleeping quarters and laundry 1
33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly 1
F
58 No live birds,turtles,orother animals(except guide dogs) 1
36 Toilet rooms enclosed with self-closing door -'
59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at
37 Propertoilet fixtures provided,good repair,clean entrance(s),smoking area indicated by sign(s)
3
39 Approved garbage/rubbish containers,adequate number,covered, �^
rodent proof,clean R3Routine Inspection ❑Reinspection ❑ Preoperational Inspection
INSPECTOR: PERSON IN CHARGE: Other Inspection:
Demerit Score: *Include demerits from page I
4 3 2 1 'Total Rating
IfIgnefure signatur �
print name print name -� -
phone number title DATE CORRECTIONS DUE:11r
Page 2 of 2 plus— ! - -continuation pages Focused lnspe0on 112002
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#
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INITIAL(INSPECTOR) k4 INITIAL(PERSON IN CHARGE)--- I �,R
Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager
Collelo, Diane
From: Collelo, Diane
Sent: Thursday,June 16, 2016 1:14 PM
To: 'jennifersc@comcast.net'
Cc: Oatis, Heather
Subject: Subway Store#2397, Compliance
Good Afternoon,
Thank you for reaching out to our department concerning the Food Establishment Inspection performed by me today
at the above subject store.At the time of inspection,a Qualified Food Operator was not on site, and the certificate on
the wall in the office was from a worker no longer employed at your establishment. The food worker present at the
time did not know who the Designated Alternate was,and could not locate the paperwork.A sixty(60)day notice was
written on the continuation sheet to comply with the CT Public Health Code.
Per our phone conversation, I am writing to inform you that you are now in compliance with the violations concerning
the Qualified Food Operator and Designated Alternate. Your ServSafe is on file in our office,and the staff on duty today
also have DA paperwork on file. You also stated that your staff was coached on where to find the documents should we
request them during your next inspection.Therefore,the sixty day notice is hereby nullified.
Thank you for your quick response and compliance with the CT Public Health Code. Should you have any further
questions, please do not hesitate to contact me.
Regards,
Diane L.Collelo
Environmental Health Inspector
Town of Windsor, Health Department
1540 Sullivan Avenue
South Windsor,CT 06074
Ph.860-644-2511 ext.248
Fax 860-644-7280 ( j�ZA.r
TIME AM
DAT / <'� ,/
Website: www.southwindsor.org TO
PHONE( 1
P FRO N D C CELL' 71&6
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CALL 'RETURNED;❑ S E YOU❑ AG IN ALL❑ WAS IN ❑ URGEN mOz
AHONED❑ OB, K CALL"
®Blueline Rwr<)RM.
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