HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF YARMOUTH BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
Name fhC 00rrA L ®' S,
Date
!!
/
Type of Operation(s)
Type of Inspection
/ 1 Food Service
U Retail
❑Residential Kitchen
❑ Mobile
U Temporary
❑ Caterer
❑ Bed & Breakfast
Permit No.
Routine
Re -inspection
Previousectign
Date:/ Lo�fi/J/
❑ Pre- erati
U Suspect Illness
U General Complaint
U HACCP
U Other
Address i�
Telephone
Owner
HACCP Y/N
Person in Charge (PIC) MG
Time
In:
Out:
Inspector ��/ �!^
Each violation checked4equires 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
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)(590.007)
28. Poisonous or Toxic Materials (FC -7)(590.008)
29. Special Requirements (590.009)
30. Other
❑ 12. Prevention of Contamination from Hands
Print
❑ 13. Handwash Facilities
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
PROTECTION FROM CHEMICALS
❑ 14. Approved Food or Color Additives
Print }( %7
❑ 15. Toxic Chemicals
f4
TIME/TEMPERATURE CONTROLS (Potentially Hazardous Foods)
❑ 16. Cooking Temperatures
Cl 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
p
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:
Inspe to 's i re
Print
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
( l
PIC's gnat a !-•,l,;,'
Print }( %7
Page V of !\- Pages
f4
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
Disposal
❑ Other
Fi SGS C9 C3
p
J cA S 7 Yi/1
01 -IJ AS
C 6a
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
❑ Voluntary Compliance C1 Employee Restriction/
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 �/s
Date
Type of Operation/sl
Type of Inspection
t&ood Service
L) Retail
O Residential Kitchen
.I�Routine
U Re -inspection
Previous Inspection
corrective action as determined by the Board of Health.
Gy/
ci20 a
AddressU �
❑ 12. Prevention of Contamination from Hands
Telephone
ft//
❑ Mobile
❑ Temporary
❑ Caterer
❑ Bed & Breakfast
Date:
❑ Pre-operation y
U Suspect Illness,—
U General Complaint,
U HACCP
Owner
HACCPY/N
Person in Charge (PIC) G� t-_,
1(JtJ
Time
In:
Inspector
L�j
Out:
Permit No.
U Other
Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated.
Correction Action Required:
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.
Page L of Pages
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
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 markeo 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/
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. Special Requirements (590.009)
DATE OF RE -INSPECTION:\
30. Other
Inspecto s n u e 1.
Correction Action Required:
Print
❑ Yes
PIC's Si a urePri
Compliance ❑ Employee Restriction/
❑ Voluntary P Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary Disposal 0 Other
t (
Page L of Pages
Item Code C - critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
No. I Reference R - Red Iter I PLEASE PRINT CLEARLY I Verified
W
F&I
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑ Yes
�r
Compliance ❑ Employee Restriction/
❑ Voluntary P Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary Disposal 0 Other
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