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HomeMy WebLinkAboutFood Service Establishment Inspection 85 (10) f, Establishment: ` � i Inspection Date: Time: R insp Einsp ddresslCify: .5.� yz-�.r �A�tJ f4 Healt Dept: �, 1�ui� : 1 z .� Based on an inspection this day,the items marked DNC identify the violations in operation or faci lities 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 DNC KEY: C[complies] NIO(not observed] N/A[not applicable] ' �uabfied Fi d�OpefalOrn+ 4 t #x .; a q "t;W v " 4 to 3 DNC[does not comply] 0[other] RTE[ready-to-eat] esjgtialed,4lternLL te 4; y "' � " �"�`" fig Perdtelft( 'i�jfeGtion re3ltrtced "�" Ct NIO±N/#1 ',� �„Written{documentatton df'trainin��rt3gt'sm r n � r A Food workers have no exposed infected lesions/burns % - B Personnel with infection restricted A�ppr`oved source,wholesome,rnonatlu $aetltr C N10 NIA .. . C Communicable disease of worker reported to local health director A Approved shellfish,finfishi meat&poultry USDA approved r• B Food cans in good condition(not dented,rusty,bloated,leaking) �13 FlaCtdw�s tng factltties r6v d ,:i] n ls�wasE;e ;dean G_.'L T[! A Handw facilities in all food prep! i ensing& rewash areas { C Wholesomelnonadulterated foods/safe B H d sh facilities in or i ffijtiatlely ad*A&_W_WI91qooms D Commercial products(no home grown/canned food) C a sh fa 'gti a e l �et` ie to use E Potentially hazardous foods received at proper temperature D Personnel; an ed, can I Pro a andw h procedure 0 E HEodwallking at appropriat s 4 r Pptttaf(y hazardous food mdes tetrtpdtirt�u,rments. r l�l!®x NlA!r4# p 9 a ,during storage,�preparatlon,dPsp�y,setvtce.and transportafion e x a z$M •u ux�.,,a yr .., $ v T'Yc, h:ygienicipractices a � Y x.wwr � ' ° C N/O''kIA` 2 _:.k..c x A Hot holding greater than or equal to 140°F. (whole bearrpafkroasts 10 F.) A ❑No eating ❑ No smoking while working B Cold holding less than or equal to45 F. B Wounds covered adequately k C Proper cooling C Proper sink used for handwashing D Proper re-heating E Proper internal cooking l consumer advisory posted , r�ttrzattonrtnse (ho :wattoirplCa c {C ref 110 Approved sanitizer availableladequate concentration of sanitizer + tlequate facilities to maintain product * '" �" C iVlp; �f Food contact surfaces and utensils used for potentially aka`"V `" " x `"" "�-& ��� � �s: hazardous food sanitized at least every hour tsr.. mperature,thermorneters�prov� etl . .... ..... A Food thermometer available and accurate C Adequate ❑dishwashersanitizer U-nal rinse temp D Proper sanitizin rocedure B Proper food fhermometerfor product E Sanitizing between raw animal origin&ready-lo-eatfood C Thermometers appropriately placed in cooler units C _ �8'ti C �h�N Ping s Qtns a ;-e Nib ! 1 le�7Food p during#stora�epafriFi C cl( player-drvice antt transpot4.t4on sv s t; Cloths and/or sponges in good repair and clean B Wiping cloths kept in sanitizer between uses A Produce washed 0 B Raw meats not stored/prepared near ready-to-eat foods 26 Food-contactsurfiaGe Ie sa -'. N1 I� l C Food covered-properly . . A Food equipment clean,utensils clean,equipment interiors clean D Adequate splash guards!sneeze guard g Single use gloves changed when soiled E No unauthorized personnel C Food--contact surfacesclean F o pooling of eggs not cooked immediately 0 8 Vood containers stored off the floor "' °* 0 ,}Jot and colihwa er 'hd&r Ar ss"�r ,�rdv°(afef as.require G f I`k}j t k2 :w :: § .. M z: .n::y a��.:n:.'s,•rG •'firm} .s .. .Y.. : t B 'Haut wa5f to arsceesallrovtded ° �1 f a 5N�Is.M: iffiN/A asson 9 h iwi A T. A Soap paper towels I drying device available'No 1 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)fordispensing 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[potentlally 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 policy th squires the food worker to report specific illness conditions Are temperatures recordedilogged for cold holding foods/equipment?. N and diseases to the QFO? Y *Do you have a paid sick leave policy? Y N Are oads cooked in advance and cooled? Y N *Are leRever saved? Y N Is there a language barrier h6tween inspector&QFO? Y N Iflf ves in ' e language spoken Lfst products cooled: by QFOIDA: ♦Can the QF A read pection report? Y N Describe coaling methods: Indicate who answer the above le '00V questions:N a(pr' Indicate the title of above person(circle all odt a } 0 DA Mgr Cook Owner FW Is cooling monitored for time&temp? Y• N Is the monitori of cooling recorded? Y N •Obtain signature of tia person who rece' d t Q responsibilities information at the time of the Is there a produce washing policy? Y N ♦Describe w t is washed and inspection; where: Note: This report. a o a o p p (tot 6of 62 debitable items) , Page 1 of 2 ''�" 09.' �'��:` � � a;�• k� �ti! as vp � ��.� s.i Date of Inspection: k Owner ©T 0 et`atu­A � ADDITIONAL FOUR POINT ITEMS KEY: DNC [DOES NOT COMPLY] 6 Foods not re-served. , 31 Sewage disposal approved. -Unwrapped foods not re-served -Operating as required -Potentially hazardous foods not re-served 37 No cross connections,back siphonage,backflow .a 11 Toxic chemicals. '4 '4 Propertype/installation/backflow prevention device/air ga fjfoor: -Stored properly,labeled properly,used properly ; -Food equipment -Hose connections -Dish machines . -Sanitizer concentration not to 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 for. 29 Water source adequate,safe. 4 -Food equipment -Dish machines -Ice machines -Well 1 well head protected from contamination 35 Toilet facilities. Adequate,convenient,accessible, 4 -Water quality in compliance . w designed,properly installed -Monitoring in compliance OTHER ITEMS KEY: DNC [DOES NOT COMPLY] 2 Sources of food;Original container,properly labeled 40 Garbagelrubbish storagearealrooms,enclosures-properly constructed,clean 5 EAntially hazardous food properly thawed :p 1 Garbage/rubbish disposed of in an approved manner,at approved frequency 10 F d dispensing utensils properly stored 4 ' 2 vermin control: No insectslrodents present2 Food worker:Clean outer clothes,effective hair restraints V, 43 Outeropenings protected against entrance of insects/rodents 3 " 4 Floors: Floor covering installed,constructed as required,good repair,clean 16 F d-contact surfaces designed,constructed,maintained,installed, 5 Floors graded,drained as required ; ted 6 Floor,walljuncture covered 17 nfood-contact surfaces designed,constructed, maintained, t installed,located i ' ats removable,good repair,clean f___148 Exterior walking,driving surfaces,good repair,clean 18 Single service articles,storage,dispensing 2 E 19 No reuse of single service article 49 Walls,ceilings attached,equipment properly constructed,good c 1 repair,clean.Wall&ceiling surfaces as required 20 Dishwashing facilities approved design,adequately constructed, t2 maintained installed located J) stlesscleaning methods used,cleaning equipment properly stored 1 Equipment&Utensils: Cleanliness 51 Adequate lighting provided as required 21 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 Accurate thermometers provided,dish basket,if used 4 Rooms adequate,clean,adequate lockers provided,facilities clean k 1828 nfood-contact surfaces of utensils&equipment clean F 55 Establishment and premises free of litter,no insect/rodent harborage, Equipmentlutensils,storage,handling no unnecessary articles ' per disposal of wastewater b6 Complete separation from livinglsleeping quarters and laundry 57 Cleanlsoiled linens stored properly 33 Plumbing location,installation,maintenance 58 No live birds,turtles,orother animals(except guide dogs) 36 Toilet rooms enclosed with self-closing door 59 Seats 76 or more:Nonsmoking area provided,sign(s)posted at ) 37 Proper toilet fixtures provided,good repair,clean r entrance(s),smoking area indicated by sign(s) 39 Approved garbage/rubbish containers,adequate number,cove d rlt rodent proof,clean 11119outine Inspection ❑Reinspection ❑ Preoperational Inspection /5 Other Inspection: MT . Demerit Score: *Include demerits from page 1 4 3 2 1 Total Rating signature si ure r' t name / pri t name CORRECTIONS hone number title AAt-- s,�t/� �("j `� 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 INSP TION INSPECTION MARKS FORM# r (f YZ ef INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) AL Distribution: I st-White-Health Department 2nd-Yellow- Owner/Manager `-,14. �." - - `- _ r •• i C � . NAME OF 1 'D• WA =W �T �1 W�,,Nrnmwo pp , r , T WA y ' T !' �� 1 (PERSON