HomeMy WebLinkAbout2024-6-8 - 150 Nevers Road - Simply Mixx LLC Food Inspection ReportConnecticut Department of Public Health
EHS-106 Rev 2116/23
Risk Category: I
Food Establishment Inspection Report Page 1 of Z
Establishment type: Permanent Temporary Mobile Other
Date:[ 9 +1!'
Establishment SiM& '611)fx t tc,
" Time In AM/PM Time Out AM/PM
DPH LHD S. Wrn86dl
IN Purpose of Inspection: Routine Pre -op
Corof ec tDepartment i �+ ` Public Health Remspection Other
AND PUBLIC HEALTH INTERVENTIONS
Address Sfra4vrl fes Vp
Town/City S- IJInJS;r
Permit Holder
FOODBORNE ILLNESS RISK FACTORS
Risk factors are important practices or procedures identified as the most prevalent contributing factors of foodborne illness or injury. Interventions are control measures to prevent foodborne illness or injury.
Mark designated compliance status (IN, OUT, NIA, NIO) for each numbered item IN=incompliance O T=not in Compliance N/A=not applicable N/O=not observed
P=P iority item Pf=Priority foundation item C=Core item V=violation type Mark in appropriate box for COS a d/or R COS=corrected on -site during inspection R=repeat violation
I
!OUT
N!A MN Supervision
v
cos
a
I OUT
N O Protection from Contamination
v
cos.
R
1 O :� Person/Altemate Person in charge present,
demonstrates kntri_vledge and Lerforms duties
2 O Certified Food Protection Manager for Classes 2,
3, & 4
L.m to ee Health
Pf
O
O
15
r
O A_. ICD Food separated and roteated
P/C
O
O
16
O O Food -contact surfaces: cleaned & sanitized P/pf1C
O
O
C
O
O
17
_
O Proper disposition of returned, previously
served, reconditioned, and unsafe food
P
O
Timelfem erature Control for Safety
3
Management, food employee and conditional employee;
O knovAed e, responsibilities and r artln
@p,_. _g
p/Pf
P
O
O
O
O
O
is
O
O
CD
Proper cooknn time and temperatures IP/PfIC
O
O
19
20
C
O
O
O
.�
�
C?
Rraper reheatlnf} procedures for hot holding
Proper coolin time and temperatures
P O
P O
O
O
4
)
O Proper use of restriction and exclusion
5
O Written procedures for responding to vomiting and
diarrheal events
Pf
21
C)
O
O
Proper hot holdingtent eretura&
P O
O
22
tD
C .0
O
Proper cold holding tem eratures
P
O
Good Hygienic Practices
23
>5
O
Pro er date markin and dis ositionP/Pf
c SO6
1� CDProper eating, tasting, drinking, or tobacco products use P/C C)O
_7_ O No discharge from eyes, nose, and mouth C O c -,
Preventing Contamination by Hands
24
CD
CD;Lj
CD
Time as a public health control: procedures P/Pf/C
and. records
O
C:)
Consumer Adviso
8
9
J4
_
1 s ? C7
CD O r
Hands clean and properly washed P/Pf
No bare hand contact with RTE food or a
pre -approved alternative procedure properly followed P/Pf/C
p p y
O
O
CD
O_
r-
CDFood/Color
25 O CD �*Cunsltmer advisory provided- raw/undercooked food Pf CD t
Highly Suacs table Population
26 C7 O PasleNr1ZW foods used; prohibited foods not offered
Additives and Toxic Substances
10 O Adequate handwashing sinks, properly supp&edfaccessible PVC
Approved Source
27
c'D
CD
Food additives: approved and properl used P O
O
1
O
Food obtained from approved source P/Pf/C
CD
O
CD
Ir
..
.-
Toxic substances properly identified, 1
28 C+ CD stored & used p p y PIPEIc O O
-Conformance with raved Procedures
12
O
r7 Food recelvad at er temperature
p
P/Pf
13
14
O
O
o
Food in good conditlon, safe, and unadulterated P/Pf
OlRequired records avallablw molluscan shellfish p/pf/C
identification, parasite destruction I
CD
•-_ _
29 �::D O
Compliance with varlance/specialized
ProcessIROP criteria/HACCP Plan PipFIC
O
CD
GOOD RETAIL PRACTICES
Good Retail Practices are preventalive measures to control the addition of palhngens, chemicals, and physlcaf objects into foods.
Mark OUT if numbered item is not in compliance V=violation type Mark in appropriate box for COS and/or R COS=corrected on -site during inspection R=repeat violation
zP A N1O SafeFood and Water
v
COS
a
OUT
43 O I0-use
44 O Utensils/equipmenViinens:
Pr�rUse of utensils
utenslIs: rc erl stored
properly stored, dried,& handled Pf/CO
v
cos
a
O
Pasteurized e s used where re uired
t
P
O
O
C
O
Water and ice fromapproved source P/Pf/C O O
Variance obtained for specialized procassrn methods Pf O O
Food Temperature Control
33 O Proper cooling methods used; adequate equipment for Pf/C
temperature control O O
45
O Single-use/single-service
articles: properly stored & used
P/C
O
O
46
O Gloves
used properly
C
O
O
Utensils and Equipment
47
Food
and non-food contact surfaces cleanable, p/pf/C
rl designed, constructed, and used
O
O
34
35
O Plant food properly cooked for hot holding
O � �. Approved thawingmethods used
PF
O
O
PfIC
O
O
48
49
O Warewashing
cleaningagents,
O Non-food
facilities: installed, maintained and used.;
sanitizers, and test strips available Pf/C
contact surfaces clean C
O
O
O
!�
36
� Thermometers provided and accurate
Pf/COO
Food Identification
37 O I Food properly labeled; original container Pf/COO
Phyylcal Facilities
Prevention of Food Contamination
50
O Hot
and cold water available; adequate pressure
Pf O
O
38
O
Insects, rodents, and animals not resent Pf/C
CD
CD51
O Plumbing
installed; proper backflow devices
P/Pf/C
O
O
39
O
Contamination prevented during food preparation, store a &dis la P/Pf/C
C)
O
52
CDSewage
and waste water ro erl dis osed
P/Pf/C
O
O
40
�5
Personal cleanliness
Pf/C
CD
O
53
O Toilet
facilities: properly constructed, su lied & clean Pf/C
O
O
41
42
O JWViping
O
cloths. properly used and stored C
LWashing fruits and ve etables P/PVC
O
O
54
O Garbage
and refuse properly disposed; facilities maintained
C O
O
O
O
55
O Ph
[cal fac[litles Installed, maintained and clean P/PfIC
O
O
Permit Holder shall notify customers that a copy of the most recent inspection report is available.
56
CDAdequate
ventilation and lighting; designated areas used
C cD IcD
O Natural
rubber latex gloves n01 used per CG5 19a-3Bf
Person in Charge (Signature) Date L,,91 1
Violations
documented
Date corrections due
#
Priority Item Violations
I
Person in Charge Printed t�2br
PriorityFoundation Item Violations
—
Core Item Violations
Ins ector (Signal reDate
Risk Factor/Public Health Intervention Violations
Repeat Risk Factor/Public Health Intervention Violations
Good Retail Practices Violations
Inspector Printed
Requires Relns ection - check box if you intend tv reins ecl
Appeal: The owner r pera or a a food establishment aggrieved by this order to correct any inspection violation identified by the food inspector or to hold, destroy,
or dispose of unsafe food, may appeal such order to the Director of Health, not later than forty-eight hours after issuance of such order.
410 Capitol Avenue MS#11 FDP
1st - White: Health Department Hartford, CT 06134 2nd - Yellow: Owner/Operator/Person in Charge
Food Establishment Instaection Resort Page '-,-of-Z—
LHD S. WQ4W Inspection Report Continuation Sheet
Establishment S`^VIiA LIC Town S. Wirho✓
Date
Item/Location/Process
TEMPERATURE OBSERVATIONS
Temp Item/Location/Process Temp
_ _
ItemfLocationlProcess Temp
OBSERVATIONS AND CORRECTIVE ACTIONS
Item
Number
Violations cited in this
report must be corrected within the time frames below, or as stated in sections 8-405.11 & 8-4dfi 11 of the food code.
Person in Charge (Si ng ature)
Date b
,Inspector Si nature
Date fo L
Distribution: 1 st - White - Health Department 2nd - Yellow - Owner/Operator/Person in Charge