HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF r ARMOUTH - BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
Name /'v j, , f « p P sem'
Date
6 ////
Type of Opeerationfsl
Type of Inspection
K Food Service
U Routine
u
Address I g%atto
r�
��y
U Retail
U Residential Kitchen
U Re -inspection
Previous Inspection
Telephone
U Mobile
,J Temporary
Date:
U Pre-operation
Owners
HACCPY/N
L fd
U Caterer
U Bed & Breakfast
Permit No.
Suspect Illness
General Complaint
U HACCP
U Other __
Person in Charge (PIC)
Time
In:
Out:
Inspector jy S /��,/�
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) J 590.009 (F) J
corrective action as determined by the Board of Health.
FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands
O 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 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 O 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. Official Orderfor 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
?4. 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)(590005).; , .fines per Yarmouth Board of Health. If aggrieved by this
26. Water, Plumbing and Waste (FC -5)(590 00. , 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 #ie above
28. Poisonous or Toxic Materials (FC -7)(590.00e) address within 10 days of receipt of this
io
.009�rd�er "
29. Special Requirements (590) DATE OF RE -INSPECTION: l 1A1, isl
30. 6threr
Inspector'sat �r�=�'„ , !%
Print
C - Critical Hem
R - Red Item
PIC's Signature - r. /
Print
Page L of .._ Pages
Item
No.
Code
Reference
C - Critical Hem
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
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Disposal
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Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
LJ Voluntary Com liance El Employee Restriction/
P Exclusion
❑ Re -inspection Scheduled U Emergency Suspension
U Embargo U Emergency Closure
❑ Voluntary
Disposal
❑ Other
TOWN OF YARMOUTH BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH. MA 02664
Name�� , , £
Date
Type of Operations)
Type of Inspection
X11 Food Service
U Routine
t
(� 1
❑ 1. PIC Assigned / Knowledgeable / Duties
Address
f jtv
U Retail
U Residential Kitchen
Re -inspection
Previous Inspection
Telephone
❑ 3. Personnel with Infections Restricted/Excluded
❑ 15. Toxic Chemicals
U Mobile
,J Temporary
U Caterer
Date: �j �1,,
U Pre -J do
U Suspect" Illness
Owner ,
HACCP Y/N
❑ 5. Receiving/Condition
❑ 17. Reheating
Person in Charge (PIC)
Time
In:
U Bed &Breakfast
U General Complaint
U HACCP
PROTECTION FROM CONTAMINATION
Inspector S C
Out:
Permit No.
U Other___
Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated.
Violations Related to Foodbome Illness Interventions and
Non-compliance with:
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.
Page +_ of 1._. 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
❑ B. 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 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.
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
?4. 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. 09-mT JZ f & k
inspect or'iipi at ed "^' I
Print , i - n , y
❑ No
PIC's Signature
Print ��!� �.- r
Page +_ of 1._. Pages
Item Code C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
No. Reference R - Red Item PLEASE PRINT CLEARLY Verified
IF Az44,
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L
f.Z CA
F'� carX2 e,,,l E" c-..tt C:( �c�L? (�. � „� ;Q c'_. --c •-•rZ
excp rI _ 0417 4r c4 Ci,1 C"
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑ Yes
❑ Voluntary Compliance ❑ ExcPus on Restriction!
❑ Re -inspection Scheduled U Emergency Suspension
❑ Embargo ❑ Emergency Closure
U Voluntary Disposal ❑ Other