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Food Establishment Inspection Report
TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name (i Date Type of Operation(s) Type of Inspection U Food Service U Retail U Residential Kitchen L h Routine U Re -inspection Previous Inspection FOOD PROTECTION MANAGEMENT 7� // /t Address �� �i EMPLOYEE HEALTH Telephone rrr i U Mobile U Temporary U Caterer U Bed &Breakfast Permit No. Date: U Pre-operation U Suspect Illness U General Complaint U HACCP U Other____ Owner HACCPY/N Person in Charge (PIC.". Time In: ; ;' _ Out: Inspector-�( 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) U 590.009 (F) ❑ corrective action as determined by the Board of Health. Page of Pages FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands J 1. PIC Assigned / Knowledgeable / Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS (Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures ❑ 5. Receiving/Condition ❑ 17. Reheating ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 18. Cooling ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20. Time as a Public Health Control ❑ 8. Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Items) Number of Violated Provisions Related to 4- <>< Critical (C) violations marked must be corrected immediately Foodborne Illnesses Interventions and Risk or within 10 days as determined by the Board of Health. Factors (Red Items 1-22): Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board of Health. Official Order for Correction: Based on an inspection today, C N the items checked indicate violations of 105 CMR 590.000/ federal Food Code. This report, when signed below by a 23. Management and Personnel (FC -2)(590.003) Board of Health member or its agent constitutes an order of 24. Food and Food Protection (FC -3)(590.004) the Board of Health. Violations not corrected are subject to 25. Equipment and Utensils (FC -4)(590.005) fines per Yarmouth Board of Health. If aggrieved by this 26. Water, Plumbing and Waste (FC -5)(590.006) order, you have a right to a hearing. Your request must be 27. Physical Facility (FC -6)(590.007) in writing and submitted to the Board of Health at the above 28. Poisonous or Toxic Materials (FC -7)(590.008) address within 10 days of receipt of this order. 29. Special Requirements (590.009) DATE OF RE -INSPECTION: 30. Other r Inspector's Signature i Print .. - DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified PIC's Signatures Print t Page of Pages Item Code No. Reference C - Critical Item R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified Disposal ❑ Other VI, i,Y� _ I OD (C/ ✓`y I t rq e%A G -.. - �' r nI + k i 1 1 L A 6 f 4- <>< 1A -Le tN /? c ?_0 v 1, r / �� } C ve oo Discussion with Person in Charge: Correction Action Required: ❑ No ❑Yes O Volunta Com liance ❑ Employee Restriction / N P Exclusion Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name �� � � Date 3 �a�/ l3 Type of Operation(sl Type of Inspection Food Service U Retail ❑ Residential Kitchen ❑ Mobile ❑ Temporary ❑ Caterer ❑Bed &Breakfast Permit No. IXRoutine U Re -inspection Previous Inspection Date: U Pre-operation U Suspect Illness U General Complaint P Li HACCP U Other Address )' S )tp(i e� g c� Telephone 5U 3. -77/- %%% Owner HACCP Y/N Person in Charge (PIC) Time In Out: Inspector Eash 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 ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned / Knowledgeable / Duties ❑ 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15. Toxic Chemicals 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 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: WLR& Ins pec Sibriat7 Print( n /� Disposal PIC's i naturell I PrioY Page A- of A_ Pages Item No. Code C - Critical Item Reference R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified ^- 1 S v Disposal O Other lS Ha�-- S l7 51- Wc. s C- tz_ L Lo C1, e...`I l WAS ► f - t U° 2.. 1 ?�� SL- �_2i RA3 �P y Discussion with Person in Charge: Correction Action Required: ❑ No L) Yes ❑ Voluntary Compliance ❑ Employee Restriction / P Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal O Other TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name©. Date Type of Operation(s) Type of Inspection *food Service U Routine - ( ❑ Other LeIft2 f-' /--I n Address I 1:� :;P f U Retail U Residential Kitchen ti, Re -inspection Previous Inspection Telephone _ Lo CI Mobile U Temporary U Caterer ❑Bed &Breakfast Permit No. Date: U Pre-operation U Suspect Illness U General Complaint U HACCP P U Other_ Owner HACCP Y/N Person in Charge (PIC) Time In. Out: Inspectorf f!r L , 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) U 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 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: Inspector's Sign . / Print _ __ C - Critical Item R - Red Item PIC's Signature PH Page ` of Pages Item No. Code Reference C - Critical Item R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION PLEASE PRINT CLEARLY Date Verified Disposal ❑ Other LeIft2 f-' /--I n r { 1-f c SrA -*r-P-A - _ Z a 0 >,4 L62S t -Ce!Jr Discussion with Person in Charge: Correction Action Required: ❑ No LJ Yes LJ Employee Restriction / LI Voluntary Compliance Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name` Date j )1 Type of Operation(sl Type of Inspection Food Service �419'13 U Retail ❑ Residential Kitchen ❑ Mobile U Temporary ❑ Caterer ❑Bed &Breakfast Permit No. ) Routine U Re -inspection Previous Inspection Date: U Pre-operation U Suspect Illness U General Complaint ❑ HACCP U Other Address } Tele Telephone G P QUO 77/-7776 Owner HACCP Y/N Person in PIC Charge CO 9 (PIC) (' Time In: Out: Inspector 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 ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned / Knowledgeable / Duties Yl3. 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/HACCPPlans PROTECTION FROM CONTAMINATION ❑ 8. Separation/Segregation/Protection ❑ 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 0 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; AZ 27. Physical Facility (FC -6)(590.007; 28. Poisonous or Toxic Materials (FCa)(590.008; 29. Special Requirements (590.009) 30. '6tfidT A� r sC \ PROTECTION FROM CHEMICALS ❑ 14. Approved Food or Color Additives ❑ 15. Toxic Chemicals TIME/TEMPERATURE CONTROLS (Potentially Hazardous Foods) Cl 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 1 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: CC,,(\��\ Insp is 'gnat re A Print I�r i� PIC'sX gnature f / ` f .9 /%'i Pr'I�t Page of Pages