HomeMy WebLinkAbout2023 Licensing Report - Town of Yarmouth Yarmouth Board of Health
Food Establishment Inspection
P 1146 Route.28,South Yarmouth,MA 02664
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Establishment: Vic �G,/j)�' ��s�'}L.„= Date: 1 j Page 1 of
Address: ( 1 03 "Roue' �'K? ' ! Time in: / Time out:
Telephone: Permit No.: Number of Violated Provisions Related
to Foodborne Illness Risk Factors
Owner: and Interventions(Items 1 through 29):
Person-in-charge: Number of Repeat Violations Related
T
to Foodborne Illness Risk Factors
Inspector: -.)H '1.• ("5 1-- kE) and Interventions(Items 1 through 29):
Type of Operation(s): Type of Inspection: Other Information:
l Food Service Establishment Routine
❑ Retail Food Store O Re-inspection
❑ Residential:Cottage Foods 0 Pre-operational
❑ Residential;Bed& 0 Illness investigation
Breakfast ❑ General complaint
❑ Mobile/Pushcart ❑ HACCP
❑ Temporary Food Estab. 0 Other //��/1��'
o OtherJi f.'�'Jr
FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS 5 POINTS
IN=in compliance OUT=out of compliance N/O=not observed N/A=not applicable COS=corrected on-site during inspection R=repeat violation
Compliance Status IN OUT N/A N/O COS R Compliance Status IN OUT N/A N/O COS R
Supervision / Protection from Contamination y
1 Person-in-charge present, demonstrates t.• 15 Food separated and protected
knowledge, and performs duties 16 Food-contact surfaces; cleaned & /'
2 Certified Food Protection Manager !V sanitized s�
Employee Health Proper disposition of returned, 11
Management, food employee and / 17 previously served, reconditioned &
3 conditional employee; knowledge, unsafe food
responsibilities and reporting 1 Time/Temperature Control for Safety/
4 Proper use of restriction and exclusion 18 Proper cooking time &temperatures
5 Procedures for responding to vomiting V 19 Proper reheating procedures for hot
and diarrhea) events holding
Good Hygienic Practices 20 Proper cooling time and temperature /
Proper eating, tasting, drinking, or V 21 Proper hot holding temperature ,!
6 tobacco use 22 Proper cold holding temperature t!.
7 No discharge from eyes, nose, and ! 23 Proper date marking and disposition
mouth 24 Time as a Public Health Control 1
Preventing Contamination by Hands, ` .
8 Hands clean & properly washed Consumer Advisory
-
No bare hand contact with ready-to-eat / 25 Consumer advisory provided for raw I I
9 food undercooked food
Adequate handwashing sinks properly Highly Susceptible Populations
10 Pasteurized foods used; prohibited foods
supplied and accessible 26
Approved Source not offered
11 Food obtained from approved source 4f, Food/Color Additives and Toxic Substances
12 Food received at proper temperature is I 27 Food additives: approved & properly
i!
used
13 Food received in good condition, safe, & �,} Toxic substances properly identified, r
•
unadulterated 28 stored & used '
14 Required records available: shellstock Conformance with Approved Procedures
tags, parasite destruction
29 Compliance with variance I specialized
process I HACCP Plan
GOOD RETAIL PRACTICES AND MASSACHUSETTS-ONLY SECTIONS 2 POINTS
IN=in compliance OUT=out of compliance N/O=not observed N/A=not applicable COS=corrected on-site during inspection R=repeat violation
Compliance Status I IN I OUT I N/A I N/O COS R_ Compliance Status IN OUT N/A N/O COS R
Safe Food and Water 48 Warewashing facilities: installed,
30 Pasteurized eggs used where maintained, & used; test strips
required 49 Non-food contact surfaces clean (J
31 Water& ice from approved source Physical Facilities
32 Variance obtained for specialized I 50 Hot& cold water available;
PI
processing methods adequate pressure •
Food Temperature Control 51 Plumbing installed; proper backflow
Proper cooling methods used; devices
33 adequate equipment for 52 Sewage &waste water properly
temperature control disposed
34 Plant food properly cooked for hot 53 Toilet features: properly
holding constructed, supplied, & cleaned_ __
35 Approved thawing methods used 54 Garbage & refuse properly I
36 Thermometers provided & accurate disposed; facilities maintained
Food Identification 55 Physical facilities installed,
37 Food properly labeled; original maintained, & clean
container ■ 56 Adequate ventilation & lighting;
Prevention of Food Contamination designated areas used
38 Insects, rodents, & animals not Additional Requirements listed In 105 CO 590.011
present M1 Anti-choking procedures in food
Contamination prevented during service establishment
39 food preparation, storage and M2 Food allergy awareness
display Review of Retail Operations listed In 105 CMR 590.010
40 Personal cleanliness - M3 Caterer
41 Wiping cloths: properly used & , M4 Mobile Food Operation
stored M5 Temporary Food Establishment
42 Washing fruits & vegetables M6 Public Market; Farmers Market
Proper Use of Utensils M7 Residential Kitchen; Bed-and-
43 In-use utensils properly stored Breakfast Operation
44 Utensils, equipment& linens: M8 Residential Kitchen: Cottage Food
properly stored, dried, & handled Operation
45 Single-use I single-service articles: M9 School Kitchen; USDA Nutrition
properly stored & used Program
46 Gloves used properly M10 Leased Commercial Kitchen
Utensils,Equipment and Vending M11 Innovative Operation
Food & non-food contact surfaces , ■ Local Requirements
47 cleanable, properly designed, L1 'Local law or regulation
constructed & used *y }
L2 fier
Official Order for Correction: Based on an inspection today,,-the items marked"OUT"indicated violations of 105 CMR' 000 and
applicable sections of the 2013 FDA Food Code. This report, when signed below by a Board of Health member or its agent constitutes
an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food
establishment permit and cessation of food establishment operations. If you are subject to a notice of suspension, revocation, or non-
renewal pursuant to 105 CMR 590.000 you may request a hearing before the board of health in accordance with 105 CMR 590.015(B).
Date of Reinspection: Discussion with Person-in-Charge:
L i _ .\
Signature of Person-in-Charge:-.5( �_, L.`, ,: '`, Date:
Signature of Inspectoft /I �, ~ ` / �aip / ---.0
MDPH report form-1 O/5�,7 3 version / /
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Food Establishment Inspection Report - Town of Yarmouth
Establishment: P; r' c, r r11 y \e (. L Date: S 11 I 02,,, Page of _
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Temperature Observations
Item/Location Temp(°F) Item 1 Location Temp(°F) Item/Location Temp(°F)
Observations and/or Corrective Actions
Violations cited in this report must be corrected within the time frames stated below or in Section 8-405.11 of the Food Code
Number C S3c-
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Section of Code <pescription of Violation Date to Correct By
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Signature of Person-in-Charge: / Date:
Signature of Ins�eCtor � / �1 C~ .
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!MDPH report form-10/5/18 version