HomeMy WebLinkAbout2024-6-8 - 150 Nevers Road - Villa of Lebanon Food Inspection ReportConnecticut Department of Public Health EHS-108 Rev 211623
Risk Category: 3 Food Establishment Inspection Report Page 1 of
Establishment type: Permanent ors Other
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[Date:Establishment
ime In AM/PM Time Out AM/PM
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Purpose of Inspection: Routine Pre -op
Reinspection Other
Permit Holder Ali A uAs6ni
FOODBORNE ILLNESS RISK FACTORS
AND PUBLIC HEALTH INTERVENTIONS
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, N/A, N/O) for each numbered item IN=in compliance OUT=not in compliance NIA=not applicable N/O=not observed
P=Priority item Pf=Priority foundation item C=Core item V=violation type Mark in appropriate box for COS and/or R COS=corrected on -site during inspection R=repeat violation
IN JOUTINIAIN101
Supervision
v
cos
a
IN
OUTINIAIN1.01
Protection from Contamination
v cos
R
1
O
G Person/Alternate Person in charge present,
demonstrates knowledge and performs duties
Pf
CD
L_�
15
16
17
U
C)C7
O
O
Food separated and rotected
Food -contact surfaces: cleaned & sanitized �P/Pf/C
Proper disposition of returned, previously
served, reconditioned, and unsafe food
PC CD CD..���
CD C-)2
P C-)3,
Certified
O O Certified Food Protection Manager for Classes 2, C
& 4
Em la ee Health
CD
Timai Tem erature. Control for Saferty
_
3
[ _
O Management, food employee and conditional employee;
e, responsibilities and reporting
P/Pf
CD
CD18
CD
CJ
C:i
Proper cookIng time and temperatures IP/Pf/C
CD
CDknowled
19
O
O
0
(!D
Proper reheating procedures for hot holding
P
CD
CD4.
5
CDProper use of restriction and exclusion
Written procedures for responding to vomiting and
CD events
P
Pf
C)
CD
C3
-'
20
[11k
CDCD
Pro er cociing time and temperatures
P
C)
CD
21
CD
c-D
C)
Proper hot hD€dln lam efatutes
P
CD
O
22
O
CD
C-)
Proper cold holdingtemperatures
P
CD
CD
Good Hygienic Practices
.+D
23
O
O
r
O
Proper date markingand disposition PIPE
O
CD
6
_
Proper eating, lasting, drinking, or tobacco roduiats use PIC
O
FD
24
`�
O
O
Time as a public health control: procedures P/PfIC
and records
O
O
�_�
7 O — No clischar�e from a s, nose, and mouth C O C3
Preventing Contamination is Hands f
_
Consumer Advisory
B
jW-4
CD
O
Hands clean and properiy washed I P/Pf
O
O
25 C= = O Eonsumeradvlsa ry provhled: raw/undercooked food Pf L=>
9 CD O No bare hand contact with RTE food or a P/Pf/C O r:�
pre -approved alternative pr6mdtlre prA err followed
10 O 11111111I.Adequate handwa_shing sinks, properly supplled/aeeessible I PfIC O O
vest Source
Highly Susceptible Population
26 C� O Pasteurized foods used; prohibited foods not offered Pic O
oo&Calor Additives and Toxic Sub6tanCas
27
ICD
O
Food additives: approved and properly used
P O
O
11
12
�lC:)
O
dad obtained from approved source P/Pf/C
Food received at ro ertem erature. P/Pf
O
O
O
O
28
?
O
'
Toxic substances properly identified,
stored & used
IP/P13
Food in boa condition, safe, and unadulterated P/Pf O O Conformance with Ap roved Procedures
14 O Required records available: molluscan shellfish p/Pf/C O O 2g O O Compliance with variance/specialized P/Pf/C O r�7
identification, parasite destruction pracesslROP criteria/HACCP Plan
GOOD RETAIL PRACTICES
Good Retail Practices are preventative measures to control the addition of pathogens, chemicals, and physical 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
OUT`NIA NIO Safe Food and Water
v
cos
R
oUT
Proper Use of Utensils
v
_
O Pasteurized e s used where re uired
P
O
O
43
O In
-use utensils: ro err stored
C
Water and ice from a roved source
P/Pf/C
O
O
44
O Utensilslequipmentllinens:
properly stored, dried, & handled PfIC
tSR30
D Variance obtained fors ecialized rocessin methods
Pf
O
O
45
O Single-use/single-service
articles: properly stored & usedP/C
Food Temperature Control
46
O Gloves
used properly
C
O
O
33
34
Proper cooling methods used; adequate equipment for
O temperature control
O CD, O Plant food properly erly cooked for hot holdingPf
Pf/C
O
O
Utensils and E Ui ment
. 47
__ Food
r- , 1properl
and non-food contact surfaces cleanable,
designed, constructed, and used P/Pf/C
O
O
O
O
35
O iD Approved thawingmethods used
PfIC
O
O
48
Warewashing
O cleanin
facilities: installed, maintained and used;
a ants, sanitizers, and test stri .s available PfIC
O
O
36
O Thermometers provided and accurate
PfIC
O
O
Food Identification
49
O Non-food
contact surfaces clean C
O
O
37 O_ Food property labeled; original container PfIC O O
Ph sicel Facilities
Prevention of Food Contamination
50
O Hot
and cold water available; ade Uate resslire
Pf O
O
38
O
Insects, rodents, and animals not present Pf/C
O
CD
51
O Plumbing
installed; proper backflow devices
P/Pf/C
O
O
39
O
Contamination prevented during food prparation, storage & display _ P/Pf/C
O
O
52
O Sewage
and waste water properly disposed
P/PfIC
O
O
40
O
Personal cleanliness
Pf/C
O
O
53
O Toilet
facilities: properly constructed, supplied, & clean I Pf/C
O
O
41
C� lWiping cloths: roperl�used and stored L C
C),Washing fruits and Vegetables A P/PfIC
O
O
54
O Garba
a and refuse ro err dis osed; facilities maintained
C O
CD
42
O
O
55
O Physical
facilities installed, maintained, and clean P/Pf/C
O
O
Permit Holder shall notify customers that of a oat recent insperhn report is available.
56
O Adequate
ventilation and lighting; designated areas used I
C I O ICD
O Natural
rubber latex gloves not used per CGS §19a-36f
Person in Char a Si nature Date
Violations documented
,gate corrections due
#
Priority Item Violations
Person in Charge (Printed)
Prto ro Foundation Item VWativns
I^
Core Item Violations
I
--
/
Inspector (Signature Date ,�/ 'I
Risk FactortPublic Health Intervention Vioietlans
_
Repeat Risk Factor Publle Health Intervention Violatlons
'
�} rr
Inspector Printed 114--c-
Good Retail Practices Violations
Requires. Reins ction - check box if you intend to reins ct
Appeal: The owner or operator of a fr]od 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 Inspection Report Page Z of z
LHD S• UMJSef Inspection Report Continuation Sheet Date
Establishment Ui11u oi K375OV Town S. WAJSO?(
TEMPERATURE OBSERVATIONS
Temp ItemfLocationlProcess Temp ItemlLocationlProcess
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Temp
Item/Location/Process
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❑BSERVATIONS AND CORRECTIVE ACTIONS
Item
Number
Mons cited in this report must be corrected within the time frames below, or as stated in sections 8-405.11 & 8-408.11 of the food code,
T
Person in Charge (Signature) _ _ Date
Inspector Si nature Date 0�
Distribution: 1st - W - eaith Department 2nd - Yellow - Owner/Operator/Person in Charge