HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF YARMOUTH BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
NameDate
U1t - Tcver, "
117j
Type of Operation(s)
Type of Inspection
Food Service
U Retail
❑ Residential Kitchen
❑ Mobile
❑ Temporary
❑ Caterer
❑ Bed & Breakfast
Permit No.
Routine
U Re -inspection
Previous Inspection
Date:
❑ Pre-operation
U Suspect Illness
U General Complaint
U HACCP
U Other
Address d{1,
f`QJ
Telephone Z - Z�
Owner
HACCP Y/N
Person in Charge (PIC) Y,, 2 ;'�' i I
Time
In:
Out:
Inspector' )
Each viglation check d requires an explanation on the narrative page(s) and a citation of specific provision(s) violated.
rRelated to Foodborne Illness Interventions and Risk Factors (Red Items) Non-compliance with:
Violations
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 atthe above
address within 10 days of receipt of this order.
DATE OF RE -INSPECTION:
Inspector'
Print
PIC's Signatll6e L., n -
Print
Page of A- Pages
ti-
Item Code C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
No. Reference R - Red Item PLEASE PRINT CLEARLY Verified
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cusston e: Correction Action Required: ❑ No C3 Yes
❑ Voluntary Compliance ❑ Employee Restriction /
P Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
1
Disposal
❑ Other
TOWN OF YARMOUTH
FOOD ESTABLISHMENT INSPFCTInN RFpnRT
BOARD OF HEALTH
1146 ROUTE 28
0n11ru UAMRA rru
Name j V P CG yr ^
Date
13
Type of Operation(s)
Type of Inspection
/
Address l� (oA
6
�" Food Service
❑ Retail
❑ Residential Kitchen
❑ Mobile
❑ Temporary
❑ Caterer
O Bed &Breakfast
Permit No.
kd Routine
U Re -inspection
Previous Inspection
Date:
❑ Pre-operation
U Suspect Illness
U General Complaint
U HACCP
❑ Other
Telephone
Owner
HACCP Y/N
Person in Char PIC
Charge (PIC)
a
Time
In: 1.3(�
Out:
Inspector �� �{
�0�11 vwiaiwn cnecKeO requires an expianatton 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) I7
corrective action as determined by the Board of Health.
Prim / /r!
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
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
❑ 11. Good Hygienic Practices
CONSUMER ADVISORY
J, 4-e
❑ 22. Posting of Consumer Advisories
Violations Related to Good Retail Practices (Blue Items)
Number of Violated Provisions Related to
Svc S Jot, �
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/
- J
23. Management and Personnel (FC -2)(590.003)
federal Food Code. This report, when signed below by a
24. Food and Food Protection (FC -3)(590.004)
Board of Health member or its agent constitutes an order of
Correction Action Required:
No
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)
30. Other ` ,
DATE OF RE -INSPECTION:
Inspector's Signature y )\
Print r 0
PIC's Signatur;
lv
Prim / /r!
Page of , Pages
Item
No.
Code C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
Reference R - Red Item PLEASE PRINT CLEARLY Verified
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Discussion with Person in Charge:
Correction Action Required:
No
Ll Yes
❑ Voluntary Compliance ❑ Employee Restriction /
p Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
0 Voluntary Disposal 0
Other