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HomeMy WebLinkAboutFood Service Establishment Inspection 98 (3) �T C �)17�_ Establishment: /LL oAJ 7 Inspection Date: Time: /Owe"K!�.o1k_0in9lf_,ftInSP Address/City: //in Health bent- �v,u 2 s Based on an inspection this day,the items marked DNC identify the violations in operation orfacilities 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] N10[not observed] NIA[not applicable] 60:;Quahfted Food Qpe[ator 3 DNC[does not comply] 0[other] RTE[ready-to-eat] w " i12 Personnel wffh infe*rtion restricted .0 ;NIQ NIA 4 d sI I'91n ad Alternate< s 2 X' A Food workers have no exposed infected lesions I burns t6 riften docurnentaftoo of traintin program Z B Personnel with infection restricted Approved st;urce;wholesome;nonatlulteratetl. CN/0 NI :€ om nicable disease of worker reported to local health director .� . . A Approved shellfish finfish,meat&poultry USDA approved -4 13 '..ii dwashmg facthttes provided;hand0. ashed clean ;C N O 4 a B Food cans in good condition(not dented,rusty,bloated,leaking) q Handwash facilities in all food prepldispensing&warewash areas C Wholesomelnonadulteratedfoods!safe a Handwash facilities in or immediately adjacent to toilet rooms D Commercial products(no home grown/canned food) C Handwash facilities access till elconvenisnt to use E Potentially hazardous foods received at proper temperature D Personnel hands washed,clean 1 Proper handwash procedure 0 andwa h's in at appropriate ti p 4 x„ times of in is ly hazardous Qd;tneets hem erature re utrements ..0 N/O VA 4' 0 u]�rtg atoragepFgraton�diaplaytseNrwe and transportat4ori,;. . 15 Good hygiep,, .prae NIA 2; A Hot holdinggreater than ore equal to 140°F. whole beef/pork roasts 130°F.) y g a ( A ❑ No eating ❑ No smoking while working B Cold holding less than or equal to45°F. B Wounds covered adequately C Proper cooling C Proper sink used for handwashing P mer re-heating 014 E Proper internal cooking lconsumer advisory posted 124ry3ijsIN ation ri a (ho1"walter ;chemtcal)� 3,`r C N10 rNA 2 NFV 0 A Approved sanitizeravailableladequate concentration ofsanifizer q Adequate facilities to+m iYt i i:*� duct * # !1&1j [N1A �2> B Food-contact surfaces and utensils used for potentially temperature,thermornetersr hazardous food sanitized at least every 4 hours A 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-eatfood C Thermometers appropriately placed in cooler units 0 0 r an wiping�clbths ,. t dod prrotected during still. e �@p8Pat10 #r t', 'N![7 V' 1 2 A ,C oths andlorsponges in good repair nd cl an tsptay,sewtce and transportation B Wiping cloths kept in sanitizer between uses A Produce washedAll B Raw meats not stored/prepared near ready-to-eat foods 126 Olt conta t uf#aces trliEa"n #' C 'N10 2 . C Food covered properly A Food equipment clean,utensils clean,equfprKnt interio Ilea D Adequate splash guards 1 sneeze guardv IB Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfaces clean F No pooling of eggs not cooked immediately 0 ood containers stored off the floor 30 'H of a ol&watef uni [ "ed as requi.l I s H dvitashtng aceassorlss°pr",ovided x.; . };. , inn It.. :offod"dri'tntmizdr. C, NIO N! �C� ro p A - cap 1 paper towels!drying device available No unnecessary handling RTE and/or cooked foods with bare hand B Dispenser(s)� Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C Hantlw Fink(s)clean-/Avaste receptacle at handwash sink C Adequate uteri l(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 altematel,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 ou required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written illness policy the equines the food worker to report specific illness conditions Are temperatures recordedllogged for cold holding foodslequipment?YN and diseases to the QFO? Y +Do you have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are leftov saved? Y N Is there a language barrier etween inspector&CFO? Y 771 es indicate language spoken List products cooled: by QFOIDA: *Can the QFOIDA read the inspection re 6rt? Y N Describe cooling methods: indicate whoZon, red the above q estions: 162 me(print): Indicate thge tabovPperson(cir I all thep�Ift:,111;FA� gr C ok Owner FwIs cooling monitored for time&temp? Y iV Is them itodng of ccoling recorded? Y N •Obtain si npf the person wh eived tQiC s i forma on at the time of the Is there a produce washing policy? Y N ♦Desc be what is washed and inspecfiop. where: Note: This report is a two page form(total debitable items) Page 1 of 2 Date Hof in�sfpgction: `perator: ADDITIONAL POUR POINT ITEMS a KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. -Unwrapped foods not re-served k 31 Sewage disposal approved. K'4 -Potentially hazardous foods not re-served -Operating as requiredOil No cross connections, back siphonage,backflow 11 Toxic chemicals. 44 Propertype/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly m -Food equipment -Hose connections -Dish machines �r -Sanitizer concentration not to exceed maximum permitted -No unnecessary toxics on the premises -Soda system carbonator -Beverage dispensers -Toilet tanks -Pesticides/rodenticides 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 -Water quality in compliance 35 Toilet facilities. Adequate,convenient,accessible, 4'I -Monitoring in compliance designed,properly installed _ OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 5o esoffood: Original container,properly labeled 40 Garbage/rubbish storage arealrooms,enclosures-properly constructed,clean 1 a Potentially hazardous food properly thawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 Food dispensing utensils properly stored ti rmin Control- No insects/rodents present 14 Food worker:Clean outer clothes,effective hair restraints p 43 Outer openings protected against entrance of insectslrodents 1 P'M 4 Floors: Floor covering installed,constructed as required,good repair,clean 1 6 IF od-contactsurfaoes designed,constructed,maintained,installed, 45 Floors graded,drained as required r located 6 Floor,wall juncture covered o food-contactsurfaces designed,constructed,maintained, i a ailed,located 7 Mats removable,good repair,clean �Iaoa� 18 �i gle service articles,storage,dispensing ; 4 xteriorwalking,driving surfaces,good repair,clean No reuse of single service article Is,ceilings attached,equipment properly constructed,good — repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, , k. maintained installed located 50 Dustless cleaning methods used,cleaning equipment properly stored h 1 Fquioment& tensils: Cleanliness > 51 Adequate lighting provided as required lq 21 Preflushed,scraped,soaked and racked 52 Room free of steam,smoke odors 22 Wash water clean,proper temperatures 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 Lit. 27 onfood-contact surfaces of utensils&equipment clean `Y" 55 Establishment and premises freeof litter,no insectlrodentharborage, 8 uipmenvutensils,storage,handling no unnecessary articles 32 Proper disposal of waste water 56 Complete separation from living/sleeping quarters and laundry j r; 33 Plumbing location,installation,maintenance 57 Cleanlsoiled linens stored properly. 1 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door „ 37 Propertoiletfixtures provided,good repair,clean ft* 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at entrance(s),smoking area indicated by sign(s) F 39 Approved garbagelrubbish containers,adequate number,covered, `: rodent proof,clean Routine Inspection 1711einspection ❑ Preoperational Inspection Other Inspection: E T R; / E Demerit Score: *Include demerits from page 1 ��G-•e 4 3 2 1 Total Rating signature sign t e �rL ©LH print name phone number 7 _/„ title DATE CORRECTIONS ` Page 2 of 2 plus— continuation pages Focused Inspecdon 112002 NAME OF • OF • � a � Kim r Lf icy t -... _ -� a-_ ....4�. _✓ o vi -1111M_ . 511. .� _._ J.. � •'_.. � .. - l ! � � � j- y=mot./,_ � JJI� IM �j ....................... -_ _ MEOW. Will INITIAL(INSPECTOR) J IN11fTIAL(PERSON IN CHARGE) l Page of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TO DATE OF INSPECTION TION Ile INSPECTION REMARKS FORM# �/ �� Utz'�✓t� ,i_ � ���%�7Z A � � 3 Z,�& Z5�7-6-L 8 -/A 4_,X Jlt� go' 4-�66� Y� INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) r Distribution: 1st-White-Health Department 2nd-Yellow- Owner/M ag Pag of INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF INSPECTIO INSPECTION 9J REMARKS FORM# 1 �a CO Ile ol C — —Aw— 0000u j r INITIAL(INSPECTOR) J/4 INITIAL(PERSON IN CHARGE Distribution: Ist-White-Health Department 2nd-Yellow-Owner/Manager