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HomeMy WebLinkAboutFood Service Establishment Inspection 40 (3) r/ m,Vx A6.5 Establishment:/.,,o v Inspection Date: Time: 1,4-' ' Roi sp Einsp `Address/City: 6 — Healt ept: ass: 1 z 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 NIO NIA JDNC I KEY: C[complies] NIO[not observed] NIA[not applicable] �i0�a QuallfredrPoodOperitor e 7 3 DNC[does not comply] 0[other] RTE[ready-to-eat] 61 Designated Alternate ' " f2 *Person"net With infadH'os fep 'r}c'tei ti v : C W0 NIA 4 4 �r ad.s sr#,e k 2 r.� r.h fi:p: ',. a x :px 'g .r r...:w ,. .. A Food workers have no exposed infected lesions I burns tit Written documentation of training program r s 2 B Personnel with infection restricted t/ 1 Approved source,wholesome;nonadaife ate&t C Communicable disease of worker reported to local health director A Approved shellfish,finfist meat&poultry,USDA approved 13 '}Ian facrtttre 'r"ov�ded'handswashed,~ciean C N10 NIA 4 B Food cans in good condition(not dented,rusty,bloated,leaking) X A shtn9, �� A Handwash facilities in all food prep/dispensing&warewash areas C Wholesomelnonadulteratedfoods/safe 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 I Proper handwash procedure C E Handwashing at appropriate times 'i?ofenhai]y hi5rotis;footl;mpets:#emlrau`t'eequ�}emends GQ► 0 NIA' 4 0 tiur tg storage!preparafron,display,:sarvrce and;traosportatroro� +* a-_ r ., :. *. t.:. , ,3 r �k.r " Goodrh9Od ti,;;oracjua-w� �2 s' : t'S. .w..0 4.. ...M.A.....r .. y. A Hot holding greater than or equal to 1400F. (whole beetlpork roasts 73oe e) A ❑No eating ❑ No smoking while working B Cold holding less than orequal to 45o F. B Wounds covered adequately C Proper Cooling Vf C Proper sink used for handwashing D Proper re-heating y 0 z4Sir m NA 2E Proper internal cooking/consumer advisory posted r �s e � eca 0 A Approved sanitizeravailableladequateconcentraflonofsenitizer 4 equate facilttfes to ma�ntarn product s `� 'r" Food-contact surfaces and utensils used for potentially F era ure,thermometers.provrderi..: .� ;« A t *V k ,'* hazardous food sanitized at least every 4 hours -i4...t 1...P.. : � rr'..WA.:•.........s, C Adequate ❑dishwashersanitizer 139yral rinse temp A Food thermometer available and accurate B Properfood thermometerfor product. L Proper sanitizin rocedure C Thermometers appropriately placed in cooler units E Sanitizing between raw animal origin&ready-to-eat food 1.10 0 0 � � a k ,ZS. Clean wi�stng ciohs sv p G.=.N/O N1A .T Pogd;protestedsduring storage,preparation, , y.., C Nl9 [�12 - � ° dis la �s rra�eandtransportation A Cloths and/or sponges in good repair and clean B Wi 'a A Produce washed cloths kept insanitizer between uses B Rawmeats notstored/prepared near ready-to-eat foods 01 0 m r M T , V d�i,�a n act su�fao. Vie° 3r� ? _ C ,� 1 C Food covered properly 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 F No pooling of eggs not cooked immediately 0 8 Food containers stored off the floo> t`iiifd af�"r,`..�; �3�. ` b �b�dwtndeF;,p�essure,.proyldedias7require xn. ., 0 8 andwashing ccessorres rovtded': h 'C•..*�'.{au5 a ..0: .. a:.d ., ¢ .�S 7 X, R a..x +. +E fi s 'G x' A; Y , . ciJtng:offoodsmrnimized �/A 2 _ .._-- . _. .�..., _. - • — •--._ _--� Soap 1 paper towels 1 drying device available A No unnecessary handling RTE andlorcooked foods.with bare hands B Dispenser(s)working: ❑Soap ❑Paper towel B Minimize food handling,other than ready-to-eat,with bare hands C H n w sink(s)clean aste receptacle at handwash sink C Adequate utensil(s)for'dispensing foodlice 0 O •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[foodborne] PHFs are hot held at: OF. PHFs are cold held at: IF. 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#o B illness are you required to report to the local health department? Roasts Other Describe re-heating procedures: Is there a written ill s policy that requires the food worker to report specific illness conditions Are temperatures recorded/logged for cold holding foodslequlpme Y N and diseases to th QF0? Y N ♦ y I.have a paid sick leave policy? Y N Are foods cooked in advance and cooled? Y N *Are le vers saved? Y N Is there a langu ge barrier between inspe or& FO? Y N Iflf ves indicate language spoken List products-cooled: by QFOIDA: Ce the QFOIDA read the inspection report? Y N t Describe;cooling methods: Indicate who answered the abov quest Name(print): Indicate the title of above person(cir I t at a ly):QFO DA Mgr Cook Owner FW Is cooling-monitored for time&temp? Y N Is the moni ring of tooling recorded? Y N .Obtain signatu e o the person Ire ed the responsibilities information at the time of the rs there a produce washing policy? Y N ♦Describ whatis washed and inspection:here: Note: This report is a two pag debitable items) Page t of 2 d ear / A �. Date of q.nspection: a��, .�" .. . � 21t- rer�6r"-®pBfByt)r� ADDITIONAL FOUR POINT ITEMS 3a KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. ' 4'. 31 Sewage disposal approved. -Unwrapped foods not re-served tr.4 } -Operating as required -Potentially hazardous foods not re-served ,ta y No cross connections,back siphonage,backflow p I 1 Toxic chemicals. '4 Proper type/installation/backflow prevention device/air gap for: -Stored properly,labeled properly,used properly -Food equipment -Hose connections -Dish machines -Sanitizer concentration notto exceed maximum permitted ° -Soda system carbonator -Beverage dispensers -Toilet tanks -No unnecessary toxics on the premises , -Chemical dispensers -Ice machines -Pesticideslrodenticides properly dispensed " Proper drain foAl r: 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well/well head protected from contamination k 35 Toilet facilities. Adequate,convenient,accessible, : -Water quality in compliance designed,properly installed -Monitoring in compliance ; r, OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food: Original container,properly labeled 40 Garbage/rubbish storage arealrooms,enclosures-properlyconstrucfed,clean i 5 Potentially hazardous food properly thawed 41 Garbage/rubbish disposed of in an approved manner,at approved frequency V 10 Food dispensing utensils properly stored E l a 2 Vermin Control: No insects/rodents present 2 14 Food worker:Clean outer clothes,effective hair restraints P t 43 Outer openings protected against entrance of insectslrodents1 4 Floors:Floor covering installed,constructed as required,good repair,clean :. 16 F od-contactsurfaces designed,constructed,maintained,installed, ', 5 Floors graded,drained as required tetl , 6 Floor,wall juncture covered 7 o food-contactsurfaces designed,constructed, maintained, 1 7 Mats removable,good repair,clean nstalled,located ` 4 erior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing � � 19 No reuse of single service article 4 W II attached,equipment properly constructed,good ' re ir,clean. II&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, 14 maintained installed located 50 Dustless cleaning methods used,cleaning equipment properlystored i 51 Adequate lighting provided as required 1 Preflushed,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 AQqurate thermometers provided,dish basket,if used 54 Rooms adequate,clean,adequate lockers provided,facilities clean 1 27 food-contact surfaces of utensils&equipment clean 55 Establishment and premisesfreeof lifter,noinsecllrodentharborage, 29 Equipmentlutensils,storage,handling 1` no unnecessary articles 32 Proper disposal of waste water s 56 Complete separation from living/sleeping quarters and laundry f � 57 Clean/soiled linens stored properly 1 33 Plumbing location,installation,maintenance � 58 No live birds,turtles,or other animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door a � 59 Seats 75 or more:Nonsmoking area provided,sign(s)posted at 37 Proper toilet fixtures provided,good repair,clean entrances),smoking area indicated by sign(s) 39 1 Approved garbage/rubbish containers,adequate num er,co ered, [[ ' rodent proof,clean ; outine Inspection DReinspection © Preoperational Inspection T R: ER I RG : 0 her Inspection: Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating i nature sign re ri me144 Ofi one number title DATE CORRECTIONS DUE: � title Page 2 of 2 plus continuation pages Focused Inspection 112002 --- Page ok�)_ INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT L DATE OF SP�EtCTIO INSPECTION FORM# REMARKS 3; .� l INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager Pagea .,,, INSPECTION REPORT STATE OF CONNECTICUT FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH CONTINUATION SHEET NAME OF ESTABLISHMENT TOWN DATE OF 1NSP CTION INSPECTION REMARKS FORM# �. y K 19 i INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Distribution: 1st-White-Health Department 2nd-Yellow-Owner/Manager