HomeMy WebLinkAboutFood Establishment Inspection ReportTOWN OF YARMOUTH
FOOD ESTABLISHMENT INSPECTION REPORT
BOARD OF HEALTH
1146 ROUTE 28
SOUTH YARMOUTH, M40266
Nameh61
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C - Critical Item
R - Red Item
Date
Type of Operation(s)
Type of Inspection
N Food Service
+SRoutine
ticCt S (!C f
/!
Disposal
Address
1 � • Rk _- a
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U Retail
U Residential Kitchen
U Re -inspection
Previous Inspection
Telephone
p
5. _
U Mobile
U Temporary
Date:
U Pre-operation
Owner
HACCP Y/N
U Caterer
U Bed & Breakfast
Permit No.
U Suspect Illness
U General Complaint
U HACCP
I U Other____ _
Person in Charge (PIC)
Time
In:
Out:
Inspector Chi , 1 t "K� <R_1llco_�
N.
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
Violptions marked may pose an imminent health hazard and require immediate 590.009 (E) U 590.009 (F) J
coprectiV action as determined by the Board of Health.
,X0OD PROTECTION MANAGEMENT 0 12. Prevention of Contamination from Hands
❑ 1. PIC Assigned / Knowledgeable / Duties 0 13. Handwash Facilities
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS
O 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additives
0 3. Personnel with Infections Restricted/Excluded ❑ 15. Toxic Chemicals
FOOD FROM APPROVED SOURCE TIME/TEMPERATUR E CONTRO LS (Potentially Hazardous Foods)
0 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures
0 5. Receiving/Condition ❑ 17. Reheating
❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 18. Cooling
❑ 7. Conformance with Approved Procedures/HACCP Plans O 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)
0 9. Food Contact Surfaces Cleaning and Sanitizing 0 21. Food and Food Preparation for HSP
❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY
0 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. Off icial 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
.ml.. 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
I 25. Equipment and Utensils IFC -4)(590.005) fines per Yarmouth Board of Health. If aggrieved by this
26. Water, Plumbing and Waste IFC -5)1590.006) order, you have a right to a hearing. Your request must be
'5' 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 Requirepprits (590.009) DATE OF RE -INSPECTION:
30. Oftr 1-04r /
Ins actor*,
"AM
Print Pto a,, Ra
C - Critical Item
R - Red Item
rv^ .��
Date
Verified
PIC's Signature -1
Print
Page �_ of %___, Pages
Disposal
❑ Other
I
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION
PLEASE PRINT CLEARLY
Date
Verified
Disposal
❑ Other
5. _
N.
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Discussion with Person in Charge:
Correction Action Required:
O No
❑Yes
.�?� r• z t�fi1�1' - n "c
Ll mlCompliance ❑ ExcpiisYon Restriction /
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo U Emergency Closure
❑ Voluntary
Disposal
❑ Other