HomeMy WebLinkAbout2016 Food Establishment Inspection ReportTOWN 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
Food Service
Routine
PIC's SPJnatuu e, - -, n�"
Print,",�
of. ._ Pages
Page f/
Address`�
1
U Retail
J Residential Kitchen
U Re -inspection
Previous Inspection
t
Telephone/j(,
_7 QQ3 - -7� O a
U Mobile
U Temporary
Date:
U Pre-operation
ownerHACCP
Y/N
U Caterer
U Bed 8 Breakfast
Permit No.
U Suspect Illness
U General Complaint
U HACCP
U Other___
Person in Charge (PIC)
Time
In:
Out:
Inspector Y "
Each violation checkfd 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
❑ 1. PIC Assigned / Knowledgeable / Duties
EMPLOYEE HEALTH
❑ 2. Reporting of Diseases by Food Employee and PIC
0 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)
Q 30. Other ::Zt-t j
❑ 12. Prevention of Contamination from Hands
❑ 13. Handwash Facilities
PROTECTION FROM CHEMICALS
❑ 14. Approved Food or Color Additives
❑ 15. Toxic Chemicals
TIMEITEMPERATURE 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 atthe above
address within 10 days of receipt of this order.
DATE OF RE -INSPECTION:/, �, I 5
Inspector's Siature (
Print -► _
Code
Reference
n ,f
G
PIC's SPJnatuu e, - -, n�"
Print,",�
of. ._ Pages
Page f/
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1
�5
Item
No.
Code
Reference
C -Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION
R -Red Item PLEASE PRINT CLEARLY
Date
Verified
A=a 42 1
t
I�
0 Other
/
C:ep
-07
-_
j r
<
4,04 4
r
�- i
CA
cLt
Discussion with Person in Charge:
Correction Action Required:
Cl No
C1 Yes
�
� q
� `• 1,
❑ Voluntary Compliance ❑ Employee Restrts iction /
Exclusion
O Re -inspection Scheduled U Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
as�
v �
Disposal
0 Other
TOWN OF YARMOUTH BOARD of HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT -SOUTH YARMOUTH, MA 0266a
Name
i1, „ r
�, . G,.
Date
Type of OReration(sl
Type of Inspection
g Food Service
U Routine
.4111U
Address
��
Retail
U Residential Kitchen
U Mobile
U Temporary
Re inspection
Previous Inspection
Date:V/Z.J j(rj
U Pre-operation
Telephone � J
Owner �,.1�rr
HACCPY/N
��;
U Caterer
U Bed & Breakfast
U Suspect Illness
U General Complaint'
J HACCP
Person in Charge (PIC) �/j t , '--n _
Time
In:
Inspector
/ ��
�/
Out:
Permit No.
U Other__`___.
,1
Each violation checl(ed requires an explanation on the narrative page(s) and a citation of specific provision(s) violated.
Non-compliance with:
Violations Related to Foodbonne 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) J
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 RestrictedlExcluded
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. Separabon/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)(590.006)
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 HazardousFoods)
❑ 16. Cooking Temperatures
E117. 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
Cl 22. Posting of Consumer Advisories
Number of Violated Provisions Related to
Foodborne Illnesses Interventions and Risk
Factors (Red Items 1-22)5
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:
Insp o f Si at rel l
Print _ (/1
PIC Si natpre
Print / �/7 ,/� f
Page _L of _ tPages
Item Code C -Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
No. Reference R - Red Item PLEASE PRINT CLEARLY Verified
e,�{+r
�atz 3
► t I 1
Discussion with Person in Charge: Correction Action Required: ❑ No ❑Yes
❑ Voluntary Compliance L1Employee Restriction /
IY Exclusion.
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
Disposal
[:1 Other