HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF i ARMOUTH BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
Name'^ �
C k; -7 n
Date
Y¢/
/ i3
Type of Operation(s)
Type of Inspection
X Food Service
U Retail
_J Residential Kitchen
❑ Mobile
❑ Temporary
❑ Caterer
❑ Bed & Breakfast
Permit No.
Routine
U Re -inspection
Previous Inspection
❑ Pre-operation
U Suspect Illness
U General Complaint
U HACCP
U Other___
Address �� C% L� �
Telephone _
Owner
HACCP WN
Person in Charge (PIC) S
Time
In:
Out:
Inspector �/
Each violation checke(irequires 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
❑ 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):
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'sS'
Print t ) I
C - Critical Item
R - Red Item0�
PIC's Signature-_ ;Prfnt
S
Page of Pages
Item
No.
Code
Reference
C - Critical Item
R - Red Item0�
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
Disposal
-
a,- A, 0- P/A'� GX
A
(S cppC.R
�inf�2 r
aK
S /
/Jv,4 S --
h /
�GGri �1 r -i 0_, G�G�
�r
-P
4'S
1
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
❑ Voluntary Compliance Cl Employee Restriction /
P Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
Disposal
❑ Other
TOWN OF YARMOUTH
FOOD ESTABLISHMENT INSPECTION REPORT
(
BOARD OF HEALTH
1146 ROUTE 28
SOUTH YARMOUTH, MA 02664
Name I
�-�
C -Critical Item
R - Red Item
Date
y` 'f
elf/
(
HACCP Y/N
Time
In:
Out:
Type of Operafion(s)
ood Service
U Retail
❑ Residential Kitchen
LJ Mobile
❑ Temporary
❑ Caterer
❑ Bed & Breakfast
Permit No.
Tyne of Inspection
ne
U Re -rose
U Re -inspection
PreviDate: Inspection
❑ Pre-operation
U Suspect Illness
U General Complaint
U HACCP
LJ Other
Address 1 Seo a
Telephone
Owner'. i
Person in C.1'fharge (PIC) %
r
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 ❑ `f3. 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 (x&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)
Cl 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 Si re
Print
C -Critical Item
R - Red Item
PIC's.Signatur f r
Print r
Paged 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
G G
S
1 Le
J<" ti10P
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
EI Employee Restriction /
❑ 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
Type of Operationfs)
Type of Inspection
.Q Food Service
U Retail
❑ Residential Kitchen
'� {Routine
U Re -inspection
Previous Inspection
! )
lo/
�3
Address
Telephone
❑ Mobile
❑ Temporary
Date:
❑ Pre-operation
Owner
HACCP Y/N
❑ Caterer
U Suspect Illness
Person in Charge (PIC) C'!GS�O/fC-S
Time
In:
❑Bed &Breakfast
enera
U General Complaint
U HACCP
/
Inspector `yI Z T
Out:
Permit No.
U Other
Each violation checked requfres 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
❑ 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):
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:
InsignZe
Print
❑ No
PIGigp4 tur __..
Prin
Page ` of l Pages
Item Code C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION - Date
No. I Reference I R -Red Item PLEASE PRINT CLEARLY I Verified
o? Cotzck \ i�; -- of
Discussion with with Person in Charge:
Correction Action Required:
❑ No
❑ Yes
L1 Voluntary Compliance C3 Employee Restriction /
rY P Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
0 Voluntary Disposal ❑ Other
s
TOWN OF I ARMOUTH BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
NameDate
Print
v
1G�1 iY7�/FOOd
PIC's Signat a
Type of Operation(s)
Type of Inspection
Service
U Retail
❑ Residential Kitchen
❑ Mobile
U Temporary
❑ Caterer
❑ Bed &Breakfast
Permit No.
1I<Routine
U Re -inspection
Previous Inspection
Date:
U Pre-operation
U Suspect Illness
U General Complaint
U HACCP
U Other
Address , �G P
Telephone
Owner
HACCPY/N
Person in PIC Charge
9 (PIC) �G
Time
In.
Out:
Inspector /�'� j ' f
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
Cl 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)(590.000
28. Poisonous or Toxic Materials (FCa)(590.0081
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)
1121. 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 icial 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 aright 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:
Inspec ' Si ature
Print
v
C - Critical Item
R - Red Item
PIC's Signat a
Print
Page o Pages
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
Disposal
O Other
C
sem/ - � U �� /2r •-� t" / �
11 r1
.7 3
E'
C( Pn .
ka
6
" c P O
O O
C s G 6th
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
❑ Voluntary Compliance ❑ Employee Restriction/
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
Print
C - Critical Item
R - Red Item
Date
Type of Operation(s)
Type of Inspection
)Q Food Service
U Retail
❑ Residential Kitchen
<Routine
U Re -inspection
Previous Inspection
` i
Address
Telephone
❑ Mobile
❑ Temporary
❑ Caterer
EJ Bed &Breakfast
Permit No.
Date:
❑ Pre-operation
U Suspect Illness
U General Complaint
U HACCP
U Other
Owner
HACCPY/N
Person in ( Charge (PIC)C!G S
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) ❑ 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
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:
Ins P,111gna� a
Print
C - Critical Item
R - Red Item
PIG�s Sig
Prin
Page ` of l Pages
.r.. t,
/
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
Disposal
/
O
Ci
c
A Ur UP
14
A144-
Discussion with Person in Charge:
Discussion
Correction Action Required:
❑ No
❑Yes
❑ Voluntary Compliance ❑ Employee Restriction /
Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
s
Disposal
❑ Other