HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF YARMOUTH BOARD s ROUTE28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
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C-�•- a
1C F rr``Q�1f Date
PIC's Signature `
Type of Operation(s)
Type of Inspection
Food Service
U Retail
U Residential Kitchen
Routine
U Re -inspection
Previous Inspection
Name ti, i'i:� i► to �" "° ��
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)11 i s
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Address. , (} r �.;'p
Telephone
U Mobile
U Temporary
Date:
U Pre-operation
HACCP YIN
Owner
U Caterer
U Bed 8 Breakfast
U Suspect Illness
U General Complaint
Person in Charge (PIC)
Time
In:
Out:
Permit No.
U HACCP
U Other
Inspector��;` ` �V„�;
Each violation checked requires an explanation on the narrative page(s) and a citation of specific provisivntsl vrvlaLeu.
Non-compliance with:
Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti -Choking Tobacco
Violations marked may pose an imminent health hazard and require immediate 590.009 (E) U 590.009 (F) U
corrective action as determined by the Board of Health.
FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands
❑ 1. PIC Assigned / Knowledgeable / Duties
EMPLOYEE HEALTH
❑ 2. Reporting of Diseases by Food Employee and PIC
❑ 3. Personnel with Infections Restricted/Excluded
FOOD FROM APPROVED SOURCE
❑ 4. Food and Water from Approved Source
❑ 5. Receiving/Condition
❑ 6. Tags/Records/Accuracy of Ingredient Statements
❑ 7. Conformance with Approved Procedures/HACCP Plans
PROTECTION FROM CONTAMINATION
❑ 8. Separation/Segregation/Protection
❑ 9. Food Contact Surfaces Cleaning and Sanitizing
❑ 10. Proper Adequate Handwashing
❑ 11. Good Hygienic Practices
Violations Related to Good Retail Practices (Blue Items)
Critical (C) violations marked must be corrected immediately
or within 10 days as determined by the Board of Health.
Non-critical (N) violations must be corrected immediately
or within 90 days as determined by the Board of Health.
C N
23. Management and Personnel (FC -2)(590.003)
24. Food and Food Protection (FC -3)(590.004)
25. FEquipment and Utensils (FC -4)(590.005)
26. `Water, Plumbing and Waste (FC -5)(590.006)
27. Physical Facility (FC -6)(590.007;
28. Poisonous or Toxic Materials (FC -7)(590.006,
29. Special Requirements (590.009)
30. Other
❑ 13. Handwash Facilities
PROTECTION FROM CHEMICALS
❑ 14. Approved Food or Color Additives
❑ 15. Toxic Chemicals
TIMEITEMPERATUR E CONTROLS (Potentially Hazardous Foods)
❑ 16. Cooking Temperatures
❑ 17. Reheating
❑ 18. Cooling
❑ 19. Hot and Cold Holding
❑ 20. Time as a Public Health Control
REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP)
❑ 21. Food and Food Preparation for HSP
CONSUMER ADVISORY
❑ 22. Posting of Consumer Advisories
Number of Violated Provisions Related to
Foodborne Illnesses Interventions and Risk
Factors (Red Items 1-22):
officialOrderforCorrection: Based on an inspection today,
the items checked indicate violations of 105 CMR 590.000/
federal Food Code. This report, when signed below by a
Board of Health member or its agent constitutes an order of
the Board of Health. Violations not corrected are subject to
fines per Yarmouth Board of Health. If aggrieved by this
order, you have a right to a hearing. Your request must be
in writing and submitted to the Board of Health at the above
address within 10 days of receipt of this order.
DATE OF RE -INSPECTION:
Inspector's Signature :=� -
.°^C
Print
PIC's Signature `
Print U p{ (4
Page _ of __---- Pages
U Voluntary Disposal U Other
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