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DO00 a 0 � 00 � 3 c ; = i� _ Ci `oz° `o V a TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name Date �` �'I )f_ VV Type of Operations) Type of Inspection /Food Service U R'a 1'I U Residential Kitchen U Mobile ,J Temporary U Caterer U Bed & Breakfast Permit No. ']'Routine U Re -inspection Previous Inspection Date: U Pre-operation >eSuspect Illness U General Complaint U HACCP IU Other__ _ Address Telephone ^� c� Owner^i "" HACCP Y/N Person in Charge (PIC) Time In: Out: Inspector t, -t > 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 ❑ 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 ❑ 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 48. 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. OtAer f 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 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 O 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: Inspec iglure Print _ t C -;Critical Item R - Red Item PIC' ature -- -- -�.� Print Page A_ of _ \ Pages Disposal 0 Item No. ' Code ', Reference; C -;Critical Item R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified Disposal 0 - tICt• )� .+c'7 Ae tL�' .. -6�• 1 A1C. 1 V=.Q- -9 1 1 i �G 73 hi K� r. t" LJ / Discussion with Person in Charge: Correction Action Required: ❑ No ❑' Yes ❑ Voluntary Compliance LJ Employee Restriction / IY Excluson ❑ Re -inspection Scheduled U Emergency Suspension ❑ Embargo ❑ Emergency Closure U Voluntary Disposal ❑ Other TOWN OF YARMOUTH FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 1146 ROUTE 28 SOUTH YARMOUTH, MA 02664 Name i n Date Type of Operation(s) Type of Inspection ;[Food Service +routine PIC' ature Print Address ' ' r U Retail U Residential Kitchen 34 -Re -inspection /15re-vious Inspection + Telephone P r �� U Mobile U Temporary Date: j///I / /& U Pre-oper tion Owner - HACCP Y/N U Caterer U Bed & Breakfast U Suspect Illness U General Complaint U HACCP Person in Charge (PIC) Time In: Inspector Ft ,) , ,� - Out: Permit No. U Other___ _ Each violation chedked 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) 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/Condkion ❑ 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 ❑ 12. Prevention of Contamination from Hands ❑ 13. Handwash Facilities PROTECTION FROM CHEMICALS ❑ 14. Approved Food or Color Additives ❑ 15. Toxic Chemicals TIME/TEMPERATU R E CONTRO LS (Potentially Hazardous Foods) O 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: Inspectof Sid'oaturet;", Print _t ❑ No . n.,.,. 11 ❑ Voluntary Compliance U Exclusion Restriction / ❑ Re -inspection Scheduled U Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal U Other PIC' ature Print Page IJ r t Item Code I C -Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION I Date I No. Reference R - Red Item PLEASE PRINT CLEARLY Verified Discussion with Person in Charge: Correction Action Required: ❑ No ❑ Yes ❑ Voluntary Compliance U Exclusion Restriction / ❑ Re -inspection Scheduled U Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal U Other TOWN OF YARMOUTH �12te - � � ( BOARD OF HEALTH - 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT ,-2± ) SOUTH YARMOUTH. MA 0 664 Name Print - Date / Type of Operation(s) !ype of Inspection ts(Food Service U Retail U Residential Kitchen U Mobile ,J Temporary U Caterer U Bed & Breakfast Permit No. �U�^R-outine -Re-inspection Previous I?spection Date:/f����� U Pre per Ion U Suspect Illness U General Complaint U HACCP U Other___ _ �. Address 1300 ✓0 Rc u- f ;;9 Telephone 6)7 `7 - �� Owner HAC P Y/N Person in Charge (PIC) Time In: Out: / Inspector �. �r� A ".2J: y 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 Foodbome 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) 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 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. either �QA_XA O 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 L117. Reheating ❑ 18. Cooling ❑ 19. Hot and Cold Holding ❑ 20. Time as a Public Health Control REOUIREMENTS 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�rder. DATE OF RE -INSPECTION: Coo 4M 1pp &n5 t(a2 -hl1-r Inspector's Sign �/ f _ Print C -Critical Item R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified PIC's Signat(iree CI Other Print 1 - - -- } ,g= ..- z Pa 9 Patof - -Pages Item No. Code Reference C -Critical Item R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date PLEASE PRINT CLEARLY Verified Disposal CI Other L06 "k" rr c &j c- v -27 Fc- ( (C.3 , tj �- - 1 t� W-51 `- o; r- - rte. S� mak= wa�lS, Discussion with Person in Charge: Correction Action Required: ❑ No 11 Yes LI Voluntary Compliance O Employee Restriction / Exclusion ❑ Re -inspection Scheduled U Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal CI Other TOWN OF YARMOUTH FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 1146 ROUTE 28 SOUTH YARMOUTH, MA 02664 Namei-y Fes,c..7-t,..r ❑ No PIC �5ignatu j .r."r 7 i ✓tel" Date Type of Operationfsl T e of Inspection 111. Food Service B Routine Address `1 y6 U Retail U Residential Kitchen U Re -inspection Previous Inspection Date: Telephone ` G1 2 P -S � 'l � IO 6 � - �° U Mobile U Temporary U Pre-operation Owner -y HACCP YIN r" u Caterer U Bed &Breakfast Permit No. U Suspect Illness U General Complaint U HACCP U Other_ Person in Charge (PIC) Time In: Out: Inspector lr. �� I, r n. % .J o Each violation checked iequires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodbome 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 ❑ 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source ❑ 5. Receiving/Condition O 6. Tags/Records/Accuracy of Ingredient Statements ❑ 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION ❑ 8. Separation/Segregation/Protection O 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) ?4. 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. Gther- ❑ 12. Prevention of Contamination from Hands ❑ 13. Handwash Facilities PROTECTION FROM CHEMICALS ❑ 14. Approved Food or Color Additives ❑ 15. Toxic Chemicals TIME/TEMPERATU RE 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 atthe above address within 10 days of receipt of this order. DATE OF RE-INSPECTION:A� Iv `1a1� V\ Insp s Ign, t e Print ❑ No PIC �5ignatu j .r."r 7 i ✓tel" Print l.� ' j ` C.0-C��_. Page __ of Pages Item Code C -Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date No. Reference R - Red Item PLEASE PRINT CLEARLY Verified S M vs -r WA )Z0, "(vSA- .,d-t-,.:nS �� T-�.skr"� � Y•-%(.+T('M"r.�C.�-� L'_��' Fre etc c1'4'S-t- O ' L -0 U fi5 %� u V'C' f =�g �tal tr-tt iia" - 0 .lIr- _V X Discussion with Person in Charge: Correction Action Required: ❑ No ❑ Yes ❑ Voluntary Com C] Employee Restriction / rY Mance P Exclusion ❑ Re -inspection Scheduled U Emergency Suspension ❑ Embargo ❑ Emergency Closure U Voluntary Disposal ❑ Other Of it ` 4 - lel., "- CA C;'(I S t^1 C -f -s-. Discussion with Person in Charge: Correction Action Required: ❑ No ❑ Yes ❑ Voluntary Com C] Employee Restriction / rY Mance P Exclusion ❑ Re -inspection Scheduled U Emergency Suspension ❑ Embargo ❑ Emergency Closure U Voluntary Disposal ❑ Other Of it ` 4 -