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Z O �F.. �. z a F O a � � � 000 ' .��� � Ovui � � � aiaio � m���= 9 n � . . - w . > � LL �O w00 � 0000 a00O0 > poz° `o � V ` a TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name r _ Date j Type of Operation(s) Type of Inspection Food Service +1 Routine Disposal Address /� �j� /?/ U Retail LIResidential Kitchen U Re -inspection Previous Inspection Telephone U Mobile U Temporary Date: U Pre-operation Owner HACCP Y/N LJ Caterer ❑Bed &Breakfast U Suspect Illness U Claint GeneralComplaint J HACCP Person in Char PIC p a g () Time In: Inspector �7� �p Out: Permit No. U Other_____ 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) J 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 ❑ 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 J 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 TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) ❑ 16. Cooking Temperatures ❑ 17. Reheating ❑ 18. Cooling Cl 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: Inspec q Si at re Print f� W C - Critical Item R -Red Item PIC's Signature` Prin Ili- A G:n/ Page `_ of Pages J Item No. Code Reference C - Critical Item R -Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified Disposal C'S Y 56C 64Z_ J_� ( rVC��i- G'7 d C1ac� e YS -7�-.,,4 (Svcs atm 1 ce d 7 �"F- - �C- X,. f ch. cC K CA P ) 1 n -- rSH - GOG L.o 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 ❑ 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 V_ Food Service ',:.( Routine Page 1 of� Pages � Address ) kq\ AVS �L� )3 U Retail J Residential Kitchen U Re -inspection Previous Inspection �! �% TelephQ1ie ' l02 - U Mobile U Temporary U Caterer U Bed & Breakfast Permit No. Date: J Pre-operation U Suspect Illness U General Complaint U HACCP U Other__ Owner HACCP Y/N Person in Charge (PIC) �_ r T Y'�E� Time In: Out: InspectorN -7 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) J 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 ❑ 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'saSic(n f Print n `'` j / J DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified PIC's.Signature Print�/" C lL. _ Page 1 of� Pages Item No. Code C - Critical Item Reference R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified Disposal ❑ Other S i � iC, .ti` -a -7- -'L� S s 62 /-1 r �J r E+ f S C_1 L- C) • (L S < G 10 ice rr+ 1'P x C5lf Discussion with Person in Charge: Correction Action Required: ❑ No 11 Yes 13 Employee Restriction / Ll Voluntary Compliance Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension Cl Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other i TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Namej Date ',/, Tvl2e of Operation(s) Type of Inspection � Food Service 4Routine Other Address fP(% '/ /• t,' U Retail ❑ Residential Kitchen U Re -inspection Previous Inspection r Telephone Page of - Pages ❑ Mobile ❑ Temporary Caterer ❑ Bed & Breakfast Date: ❑ Pre-operation U Suspect Illness U General Complaint U HACCP Owner HACCP Y/N -El Person in Charge (PIC) Time In: O Inspector U ((a Out: Permit No. ❑ Other 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 A. (590.009) 1� 30. Other E tom_ ❑ 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 atthe above address within 10 days of receipt of this order. DATE OF RE -INSPECTION: 0 Inspector's Sig ature A _ Print Other PIC's Signature i I Prin \ ` ' r Page of - Pages Item Code No. Reference C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date R - Red Item PLEASE PRINT CLEARLY -. Verified Other OW 4=0 JA/ 11' Wer. .w 4-m c - tL l % C ry 4 l //,(_ J-170 -E- ° t ( 00, �(t W a o lie' A(cS I� F©�( I d.E7 qCr� 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 0 Other