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HomeMy WebLinkAboutFood Service Establishment Inspection 85 (8) 3. Y+O CwN EiC"stl 'UIT ♦ AAAT tlPCt r EdIT13 a Establishment: , •�,-�- Inspection Date: Time: Oins REinsp Address/City: VAV, ,�p/t iVU Health ept: : 1 20 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 )NC KEY: C[complies] N10[not observed] NIA[not applicable] DNC does not comply] 0 other RTE 60 r Qualified S.Fora¢"pperator` 3 [ P y] [other] [ready-to-eat] " ;12 Personnel with,infection restricted ;C NlO N!A 4 61 rDesignated Alternate° 2 r A Food workers have no exposed infected lesions!burns t62 `Written documentation of traitifng program 2 B Personnel with infection restricted 1 Approved source,wholesome;nonadulterated C :N10 IVIA;14`j C Communicable disease of worker reported to local health director A Approved shellfish,finfish,meat&poultry USDA approved 13 -Handwashing;facilities provi ed,h rids washed,clean ;C N10 N1A 4- B Food cans in good condition(not dented,rusty,bloated,leaking} A Handwash ilities in all food b! sp &warewash areas C Wholesomelnonadulteratedfoodslsafe m B Hand ecilities in or I 0 ly jacen_LAetoilet rooms " D Commercial products(no home grown/canned food) C H d S far i ace i v i to use E Potentially hazardous foods received at proper temperature D P rsonnel h ed,6229ro9 ndwash procedure ;,. E Han washi g at appropr' ti 3 Potei�tiatly,hazartious?foodrmeets to peraturg requirements C N!0 WA '4' p ' during stcrag e.preparation;•dfs'lay,servlbe and transportation _ . 15 r Good hygienic'practues= C..N10 WA ,2 A Hot holding greater than or equal to 140eF. (whole beef/pork roasts 13coF.) A ' ❑ No eating ❑No smoking while working B Cold holding less than or equal to 450 F. 110B Wounds covered adequately C Proper cooling C Proper sink used for handwashing D Proper re-heating E Proper Iconsumeradviso [24 Satiitiizat]oti'• irrse. hgti:water=cherrfical C ;Nlp:"N!A 2: P 9 advisory r , .,.lL... } t Approved sanitizer evoilableladequate concentration of sanitizer c Adeggate,facurt a §to,m1ir E-11)P'ra",ducts d.* ;$Yr C;;, �N! ,2' B Food-contact surfaces and utensils used for potentially r +rtempstra#ure,�harmometers prbvr�d, d r t _ K, } " hazardous food sanitized at least every 4 hours Food thermometer available and accurate C Adequate ❑dishwashersanitizer ❑final rinse temp D Proper sanitizing procedure B Proper food thermometer for product E Sanitizing between raw animal origin&ready-to-eat food � C Thermometers appropriately placed in cooler units 0 0 5. Clean wi ill tcloths : •, t a ;. P g. C ;NIQ NIA x 7 Ft3po l.protta6tedgdlulth S# 'fage,p relperation,r.a rC � r� :r t `y s I r "`6 s' * +r # A Cloths andlorsponges m cod repairand clean e 05. lap er.0; •ajrfkl#ransportetion * # tom ` s9 'k' `""" " �,sav k "`" s ° # B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats notstored!prepared near ready-to-eat foods {`26• pood=cot5tactrs�grface cfevari 4 ��.s=:•+k I (� NJ7 l k k:3 m k dI11 'S wry S' ,E:. �YC�ox r2 C Food covered properly A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards!sneeze guard B Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean pooling of eggs not cooked immediately 0 8 F d containers stored off the floor rg0 ,.Hot and cold,waterander pressure,provided as required INIA4 i2n 38 °Handwashing acce4 Oles provided °C N(0 i N_ 1 y .�Ni andi]h °of food mimmtzedk° C N!Q iNlA'+:2" r ._ �. r .... - A Soap 1 paper towels 1 drying device available A No unnecessary handling RTE andlor000ked foods with bare hands 6 B Dispensers)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 alternate[,PHF[potentially hazardous food],FB[foodbornel 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 reheating procedures: Is there a written illness policy that requires the food worker to report specific illness conditions Are temperatures recordedilogged for cold holding foods/equipment? 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 leftovers saved? Y N Is there a language barrier between inspector&QFO? Y N lfyes indicate language spoken List products cooled: by QFOIDA: *Can the QFO/DA read the inspection report? Y N Describe cooling methods: Indicate who answered the above questions: Name(print): Indicate the fill bove person(circle all that apply):QFO DA Mgr Cook Owner FW Is cooling monitored for time&temp? Y N Is the monitoring of cooling recorded? Y N .Obtain si inatu of a perso who receiv t e Q 0 responsibilitles information 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 t of 2 ATE QF I:QNNECTICU t QE'ARTMENT QE PUBLIC HEALTH 410.CAPITOL AVENU!=_MS#51 FDP-HARTFQRD,QT 061,34' FOG�CTSEDF©QD SERVIt✓E INSPECTIUN REPORT Estatiiishment. ' inspection: ., ddress� .,�SS- �'U 1 u ii�i4sr./. ;._.. .Lb,��,J�:; Owner:olr .Operator.:: �v�t7� � >u� •. ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] k 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 4° Proper type/installation/backflow prevention devicel air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration not to exceed maximum permitted -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. 4 -Food equipment -Dish machines -Ice machines -Well lwell head protected from contamination 35 Toilet facilities, Adequate,convenient,accessible, 4 -Water quality in compliance -Monitoring in compliance designed,properly installed OTHER ITEMS KEY: DNC [DOES NOT COMPLY] ` 2 Sources of food; Original container,properly labeled 0 Garbage/rubbish storagearealrooms,enclosures-propedyconstructed,clean 1 S Potentially hazardous food property thawed 2' 1 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored 42 Vermin Control: No insectsirodents present 2' 14 Food worker:Clean outer clothes,effective hair restraints 1 43 Outer openings protected against entrance of insectslredents 1` lours: Floor covering installed,constructed as required,9_6d•r$ air,clean 16 Food-contact surfaces designed,constructed, maintained,installed, 2 45 Floorsgraded,tlrainetlasrequired located 6 Floor,wall juncture covered 17 Nonfood-contactsurfaces designed,constructed,maintained, 1 . 7 Mats removable,good repair,clean [led,located 48 Exterior walking,driving surfaces,good repair,clean 1 1Single service articles,storage,dispensing 2` 19 No reuse of single service article - 9 Walls,ceilings attached,equipment property constructed,good €1. repair,clean.Wall&ceiling surfaces as required 0 Dishwashing facilities approved design,adequately constructed, 2 1' maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored Equipment&Utensils: Cleanliness 51 Adequate lighting provided as required 1: 21 Preflushed,scraped,soaked and racked p 52 Room free of steam,smoke odors 22 Washwaterclean,proper temperature 53 Rooms&equipment hoods,ducts,vented as required 231 Accurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 7 Nonfood-contact surfaces of utensils&equipment clean 1 55 Establishment and premisesfreeof Her,no insect/rodent harborage, 1, 28 Equipmentlulensils,storage,handling 1 no unnecessary articles 4:, 32 Properdisposal ofwastewater Z 56 Complete separation from livinglsleeping quarters and laundry 33 Plumbing location,installation,maintenance 1 57 Clean/soiled linens stored properly ; 58 No live birds,turtles,orother 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 sign(s) 39 Approved garbagelrubbish containers,adequate number,covered, 1 rodent proof,clean Routine Inspection 13Reinspection 13 Preoperational Inspection INSPECTOR: PERSON IN E: ther Inspection: Demerit Score: *Include demerits from page 1 ,.* 1A 4 3 2 1 Total Rating signature n$ture / p'9 nam e me l print name e DATE CORRECTIONS DUE: ZZ phone number title , Page 2 of 2 plus continuation pages Focused Inspection 1l2002 Page4— of w INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF IN. PECTI N vA-) o u 7 L S INSPECTION REMARKS FORM# 22 qV i G - ° INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow- Owner/Manager Page ofL INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF SPECTION INSPECTION REMARKS FORM# INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager