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TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOn FSTARLISHMFNT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 -•S Name �) o . a- Date f T Tempe of Ogerationtsl Type of inspection � Food Service U Retail U Residential Kitchen U Mobile ,J Temporary U Caterer U Bed &Breakfast Permit No. ANRoutine U Re -inspection Previous Inspection Date: U Pre-operation U Suspect Illness U General Complaint J HACCP U Other____ Address 17 N +'-'9 af-1J (�Cy, Telephone q _'� Owner HACCP Y/N _ P, /�� g� Person in Charge (PIC) tr 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) J 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 TIME/TEMPERATU RE 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 0 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 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 Orderfor Correction: Based on an inspection today, C N the items checked indicate violations of 105 CMR 590.000) 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 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. Specialequ;rt ements (590.009) DATE OF RE -INSPECTION: 30. -Ocher <-(/`, In r' Si a r Print n _ t s S/yg�r fur r - Print / p(^ (4 iii_- i t f f (' Page of i .. Pages Item No. Code Reference C -Critical Item R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified Disposal ❑ Other ^• �P ry.ti G� f r N Cr* -V G-' . ZeS_ G Lam-'. tG" res -it � G S ✓+PC's g %rI C/ ��.)!'Gc�+f^ .,,.'{/ ] C;'N'd .k3 s em'^ • i� �V! t -3G " 1'Lfls- c� �� 2 0f7C cc' -`<r- '-- 'o = y _ s J Aa,Q 17 FC -Cp !N C--- c- v ' t 117 S r!� 6CJZi:J 5 LAt Discussion with Person in Charge: Correction Action Required: ❑ No ❑Yes Ll Employee Restriction / U Voluntary Compliance Exclusion O Re -inspection Scheduled U Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other