HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF YARMOUTH BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
Nameh�
Print
Date
/)
�/ 7
/ 3
Type of Operation(s)
Type of Inspection
a Food Service
L) Retail
LJ Residential Kitchen
LJ Mobile
❑ Temporary
❑ Caterer
❑Bed &Breakfast
Permit No.
AA Foutine
U Re -inspection
Date Previous Inspection
a Pre-operation
❑ Suspect Illness
L) General Complaint
❑ HACCP
❑ Other _
Address �o'l a
Telephone
s&)7 -75r-7
- % /
Owner De 6e-6, 1 1-
HACCPY/N
Person in Charge (PIC)
Time
In.
Out:
Inspector r, j "'
Each violation checkdd requires an explanation on the narrative page(s) and a citation of specific provision(s) violated.
Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Non-compliance with:
Anti -Choking Tobacco
Violations marked may pose an imminent health hazard and require immediate 590.009 (E) ❑ 590.009 (F) ❑
corrective action as determined by the Board of Health.
FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands
❑ 1. PIC Assigned / Knowledgeable / Duties ❑ 13. Handwash Facilities
EMPLOYEE HEALTH
O 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. Equipment 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)(590.008)
29. Special Requirements (590.009)
30. Other
PROTECTION FROM CHEMICALS
❑ 14. Approved Food or Color Additives
❑ 15. Toxic Chemicals
TIME/TEMPERATURE 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):
Off icialOrderforCorrection: 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:
InspectI .S' nature
Print
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
PIC's-Signatur
Print
Page _i_ of Pages
Disposal
__
Item Code
No. Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
Disposal
❑ Other
S a E
P
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O i
r7 G
�W
GGLfG
S Z11-1 e(A
.moi � GG
rr
(2t7Z, aft 3i V`V
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
El Employee Restriction /
11 Voluntary Compliance Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
0 Voluntary
Disposal
❑ Other
TOWN OF YARMOUTH BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
Name�S
+
Dat
�
Type of Operation(s)
Type of Inspection
4Food Service
^t Routine
Disposal
Address n
2
y
J
U Retail
❑ Residential Kitchen
U Re -inspection
Previous Inspection
Telephone
❑ Mobile
❑ Temporary
❑ Caterer
❑ Bed & Breakfast
Date:
❑ Pre-operation
U Suspect Illness
U General Complaint
U HACCP
Owner
HACCPY/N
Person in Charge (PIC)
Time
In:, `
Inspector 0(
Out:
Permit No.
❑ Other
Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated.
Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Non-compliance with:
Anti -Choking Tobacco
Violations marked may pose an imminent health hazard and require immediate 590.009 (E) ❑ 590.009 (F) ❑
corrective action as determined by the Board of Health.
FOOD PROTECTION MANAGEMENT
Cl 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 T Approved Source
❑ 5. Receiving/Condition'
Cl 6. Tags/Records/Accuracy of Ingredient Statements
❑ 7. Conformance with Approved Procedures/HACCP Plan
PROTECTION FROM CONTAMINATION
❑ 8. Separation/Segregation/Protection
❑ 9. Food Contact Surfaces leaning and Sanitizing
❑ 10. Proper Adequate Handwashing
❑ 11. Good Hygienic Practices
Violations Related to Good Retail Practices (Blue Items)
Critical (C) violationsmarked must be corrected immediate)
or within 10 days as determined by the Board of Health
Non-critical (N) violations must be corrected immediate)
or within 90 days; as determined by the Board of Health.
C N
23. Management and Personnel - (FC -2)(590.00
24. Food and Food Protection (FC -3)(590.00
25. Equipment and Utensils (FC -4)(590.00
26. Water, Plumbing and Waste (FC -5)(590.00
27. Physical Facility- _ (FC -6)(590.00
28. Poisonous or Toxic Materials (FC -0(590.00
29. Special Requirynts (590.00
30. Other 1 i
Ll 12. Prevention of Contamination from Hands
LI 13. Handwash Facilities
PROTECTION FROM CHEMICALS
❑ 14. Approved Food or Color Additives
❑ 15. Toxic Chemicals
TIME/TEMPERATURE CONTROLS (Potentially Hazardous Foods)
LI 16. Cooking Temperatures
LI 17. Reheating
O 18. Cooling
s LJ 19. Hot and Cold Holding
LJ 20. Time as a Public Health Control
REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP)
Ll 21. Food and Food Preparation for HSP
CONSUMER ADVISORY
LI 22. Posting of Consumer Advisories
Number of Violated Provisions Related to
Y Foodborne Illnesses Interventions and' Risk
Factors (Red Items 1-22):
Y
Official Order for Correction: Based on an inspection today,
the items checked indicate violations of 105 CMR 590.000/
3) federal Food Code. This report, when signed below by a
Board of Health member or its agent constitutes an order of
4) the Board of Health. Violations not corrected are subject to
5) fines per Yarmouth Board of Health. If aggrieved by this
s) order, you have a right to a hearing. Your request must be
�) in writing and submitted to the Board of Health at the above
6) address within 10 days of receipt of this order.
s) DATE OF RE -INSPECTION:
,
Inspector's Signatur O Print
oQ iY
PIC's SignatLite -Print
Page _ of _ Pages
.d !
Item Code C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
No. Reference R - Red Item PLEASE PRINT CLEARLY Verified
t t;.
L.P i
JJ
1-4 e- k, I 0a r d
roc
�'A `03/1/1 l'Fitii tN S r !/1 C - tl
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bt +0cC,�1�. IQ0r a
. C• t13E `, �. i,��•• � -
Discussion with Person in Charge: Correction Action Required: �l No ❑ 'Yes
El Voluntary Compliance ❑ Employee Restriction /
P Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
Disposal
❑ Other