HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF YARMOUTH
FOOD ESTABLISHMENT INSPECTION REPORT
BOARD OF HEALTH
1146 ROUTF,28
SOUTH YARMOUTH, MA 02¢64
Name }
Date.
Type of Operation(s)
Type of Insoectiori%
2CFood Service
CiRetail
❑ Residential Kitchen
outine
U Re -inspection
Previous Inspection`
�S
////
`26i 1/
Address
Telephone
3
❑ Mobile
U Temporary
Date:
❑ Pre-operation
Owner
HACCP Y/N
❑ Caterer
❑Bed &Breakfast
Permit No.
U Suspect Illness
U General Complaint
U HACCP
❑ Other_
Person in Charge PIC
9 (PIC)
Time
In: ))
Out:
Inspector �� -� 0"e
Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated.
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) ❑ 590.009 (F) ❑
corrective action as determined by the Board of Health.
FOOD PROTECTION MANAGEMENT
❑ 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. 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
❑ 12. Prevention of Contamination from Hands
❑ 13. Handwash Facilities
PROTECTION FROM CHEMICALS
❑ 14. Approved Food or Color Additives
❑ 15. Toxic Chemicals
TIMEITEMPERATURE 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):
Official Orderfor Correction: 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:
Inspip gnaturei 1
Print1:1 �
C - Critical Item
R - Red Item
PIC?s Signati're ' f {� :' )
Prat
Page Z of/, Pages
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
Disposal
❑ Other
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Correction Action Required:
❑ No
❑Yes
Cl Employee Restriction /
❑ Voluntary Compliance Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
0 Voluntary
�
Disposal
❑ Other
TOWN OF YARMOUTH
FOOD ESTABLISHMENT INSPECTION REPORT
3 v �a3E
B ARD OF HEALTH
1146 ROUTE 28
SOUTH YARMOUTH, MA 02664
Name ';
Date
Type of Operation(s)
Type of Inspection
Food Service
)k Routine
t ? e
r�
Page / of 7/ Pages
Address
UU Retail
Residential Kitchen
U Re -inspection
Previous Inspection
Telephone C �G
-- a 7
tm
❑ Mobile
❑ Temporary
❑ Caterer
C1Bed & Breakfast
Permit No.
Date:
❑ Pre-operation
U Suspect Illness
U General Complaint
U HACCP
❑ Other _
Owner 11,
HACCPY/N
Person in Charge (PIC)Time
In:
Out:
Inspector f v
e
Each violation checkedkequires an explanation on the narrative page(s) and a citation of specific provision(s) violated.
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) ❑ 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 }
❑ 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 `U;k Atl
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):
Official Order for Correction: 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: ) WCcv-s
Ins <
Print
DESCRIPTIONCode CORRECTION
PIC's Signatur -'
Print ' -
Page / of 7/ Pages
❑ Other
r - -
x ) aLI t
Reference
DESCRIPTIONCode CORRECTION
Disposal
❑ Other
tm
AMD
r
r �
��t ger ►telENRON
Ya
ilk W F.9 i 1
_
011
Win
Discussion with Person in Charge: S L-rA b -
Correction Action Required:
❑ No
LJ Yes
�n �
❑ Voluntary Compliance ❑ Employee Restriction /
Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
0 ® ,
Disposal
❑ Other
G�3 j t�1 r BOA D OFHEALTH
TOWN OF YARMOUTH 1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
Name/
��%
Date
Type of Operation(s)
Type of Inspection
6Food Service
U Retail
❑Residential Kitchen
FRoutine
U Re -inspection
Date:Previous Inspection
PIC s
Address 3 �g �
Telephone , 3c� a / ✓
Print
✓
LlMobile
L1 Temporary
❑ Caterer
Ll Bed & Breakfast
Permit.No.
❑Pre-operation
U Suspect Illness
U General Complaint
p
U HACCP
❑ Other
Owner HACCP Y/N
Person in Charge (PIC) . � I
Time n:
L'_�
,�
Inspector /t'�/7Gt:
Each violation checked requires an explanation on the narrative paUe(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 'Y102. Prevention of Contamination from Hands
❑ 1. PIC Assigned / Knowledgeable / Duties O 13. Handwash Facilities
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
-.vr 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)
fp 27. Physical Facility (FC -6)(590.007)
28. Poisonous or Toxic Materials (FC -7)(590.008)
29. Special Requirements (590.009)
30. QWer J:, \
PROTECTION FROM CHEMICALS
Cl 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):
Official Order for Correction: 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 atthe above
address within 10 days of receipt of this order.
DATE OF RE -INSPECTION:
Ins pec
r' S' natuC
Le
Print gam}
PIC s
1gnat dre
(
Print
1 1
Page of _L_ Pages