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Home My WebLink AboutFood Establishment Inspection ReportsTOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name PIA t HCY Date 1(j / /of g/ %3 Type of Operation(s) Type of Inspection y{I Food Service p Retail ❑Residential Kitchen ❑ Mobile EJ Temporary ❑ Caterer ❑ Bed & Breakfast Permit No. )9,Routine U Re -inspection PreviDate: Inspection LJ Pre-operation U Suspect Illness U General Complaint U HACCP ❑ Other Address %3� L/ 1 S Telephone d S _ Owner HACCP Y/N Person in Charge (PIC) �Cw t t Time In: Out: Inspector - f P 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 ❑ 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: Ins pe o ' i` atur Print . ❑ No PIC's Signature Print `-;a i Page of Pages Item Code C -Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date No. Reference - R - Red IN PLEASE PRINT CLEARLY I Verified 0 G k_rt 0 o, Discussion with Person in Charge: Correction Action Required: ❑ No ❑ Yes O VoluntaryCompliance ❑ Employee Restriction/ P Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other TOWN OF i ARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name 1j / C - Critical Item R - Red Item Date 9 „ /// Type of Operation(s) Type of Inspection Food Service U Retail L1 Residential Kitchen ❑Mobile ❑ Temporary ❑ Caterer ❑ Bed & Breakfast Permit No. >,Routine U Re -inspection PreviDate: Inspection ❑ Pre-operation U Suspect Illness U General Complaint ❑ HACCP LI Other _ _X Address �� 9 �/ / � Telephone _ _3 50 �` Owner HACCP Y/N Person in Charge (PIC) % t Time In: 1 Out: - InspectorV,14 Each violation checkeeirequlres 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) ❑ 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 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 C) 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�nd 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)(590.0071 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 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: Inspec cif' Si naturePrint i C - Critical Item R - Red Item PIC's &ignatjre / PriW - Page 1 of _V_ Pages Item No. Code Reference C - Critical Item R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT Verified CLEARLY 0< G 0 a -r r - Gen C r' r% O t� u. cr�fii G/ c; oz �-7 C> L--' J 7 .O G G Discussion with Person in Charge: Correction Action Required: ❑ No ❑ Yes ❑ VoluntaryCompliance ❑ Employee Restriction/ P Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other 1.