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Home My WebLink About2023 Licensing Yrmouth Brd of Health Food Establishment Inspection Report - Town of Yarmouth 11 6 Route.28,South Yarmouth,MA 02664 4.5 C 9U + / Establishment: �/5 Date: 5 13 /. 3 Page 1 of - - Address: 90,F Lea Q? 'S - Time in: / Time out: Telephone: /I 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 to Foodborne Illness Risk Factors Inspector: / ,/// ApP„c� : - and Interventions(Items 1 through 29): Type of Operation s): Type of Inspection: Other Information: Food Service Establishment Routine 0 Retail Food Store 0 Re-inspection 0 Residential:Cottage Foods 0 Pre-operational 0 Residential;Bed& 0 Illness investigation Breakfast 0 General complaint 0 Mobile/Pushcart 0 HACCP --+ 0 Temporary Food Estab. 0 Other 6 Q /,/�� 0 Other �^' FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS 5 POINTS IN=in compliance OUT=out of compliance N =not observed N/A=not applicable COS=corrected on during inspection R=repeat violation Compliance Status IN OUT N/A WO COS R Compliance Status IN IOUT N/A N/O COS R Supervision Protection from Contamination / 1 Person-in-charge present, demonstrates 15 Food separated and protected knowledge, and performs duties 16 Food-contact surfaces; cleaned & //A 2 Certified Food Protection Manager sanitized _ _ Employee Health Proper disposition of returned, / Management, food employee and 17 previously served, reconditioned & !l 3 conditional employee; knowledge, /unsafe food responsibilities and reporting Time/Temperature Control for Safety 4 Proper use of restriction and exclusion if 18 Proper cooking time& temperatures Procedures for responding to vomiting / 19 Proper reheating procedures for hot 5 and diarrheal events (/ holding / Good Hygienic Practices 20 Proper cooling time and temperature Proper eating, tasting, drinking, or 21 Proper hot holding temperature Vz 6 tobacco use 22 Proper cold holding temperature y' No discharge from eyes, nose, and 23 Proper date marking and disposition / mouth Preventing Contamination by Hands !/ 24 Time as a Public Health Control 8 Hands clean & properly washed Consumer Advisory / 9 No bare hand contact with ready-to-eat V 25 Consumer advisory provided for raw/ "` . food undercooked food Adequate handwashing sinks properly Highly Susceptible Populations 10 supplied and accessible 26 Pasteurized foods used; prohibited foods I Approved Source / not offered 11 Food obtained from approved source t` Food/Color Additives and Toxic Substances 12 Food received at proper temperature Lf 27 Food additives: approved & properly used Food received in good condition, safe, & !/ 13 unadulterated 28 Toxic substances properly identified, r Required records available: shellstock stored & used q ✓ Conformance with Approved Procedures 14 tags, par sl a destruction K-Ppr ck) A� 29 Compliance with variance/specialized ft process /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 i Compliance Status I IN I OUT I N/A I N/O ICOSI R Compliance Status IN OUT N/A N/O COS R Safe Food and Water 48 Warewashing facilities: installed, 30 Pasteurized eggs used where V maintained, & used; test strips required 49 Non-food contact surfaces clean 31 Water& ice from approved source Physical Facilities 32 Variance obtained for specialized Hot&cold water available; processing methods 50 adequate pressure Food Temperature Control 51 Plumbing installed; proper backflow i,.._, , _i, Proper cooling methods used; devices 33 adequate equipment for 52 Sewage&waste water properly temperature control disposed Plant food properly cooked for hot 53 Toilet features: properly 34 holding constructed, supplied, &cleaned 35 Approved thawing methods used 54 Garbage& refuse properly 36 Thermometers provided & accurate disposed; faciflties maintained Food Identification 55 Physical facilities installed, Food properly labeled; original - maintained, &clean 37 container 56 Adequate ventilation & lighting; Prevention of Food Contamination designated areas used Insects, rodents, & animals not Additional Requirements listed in 105 CMR 590,011 38 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/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 ( L2 Other --t- -e I �-�\ I 1 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: Signature of Person-In- arg Date: Signature of Inspect MDPH report corm—10//18 version - ', Food Establishment Inspection Report - Town of Yarmouth Establishment: `10S; jl s- ,,. ` 6 ;-. 1 Ccsu d /S`f Date: Lj / 3/.2 3 Page d of f • Temperature Observations Item I Location Temp(°F) Item/Location Temp(°F) Item I 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 Item Section of Code Description of Violation Date to Correct By Number I'q S-Aft3C., — S Jilt', _ ,C-c12p� `Zlt S 1 /427*- --P S /S f' Sz., .--76715 5/ i-� GI,�'9 4- c/�c�-, v Refvey2Actfzsc— `r 36-r L .e)--aS G r c P M C4 C i il1JP -I-- c e— G3Z A ?� �{ZrL. .LyP G, A4.c) .1--- f��ac'�. ,/ S-C-LF —QC,- / Y`-e-P del — CO�7 Z.-CXSU S G�G C'Y:, i-J -.C::9(...0 S G, S - k'_- — s ClCt_,f-- p o irn C l-C.4s 2-, �-i_-,, -S .5/:— 3 ,5---, < 41,4 - / .,- / S ? itp GC)c '--)/5 1--,r4v l-g-, (/ ! A / -) _ ., / 5Z�C)F %� 2. / G� ----'c`- < ' 6 /'''''Z...S21'' s +C- /'t'*:)c,-/ C--Ve :' .c--t C-77--/- K'.6-4-59DP-6z ? -c 1-'CNG- - ii/Vcs�r sect Ile iQ S I C 1--,-e c 1,00c - ' - ,-cam 4., 5"77- - / �// 'G'/ ^,4,42..-, crzs" , aNC_. -* II ;-- - - .._I SrCYve Y\I-E40 - 'ff)... RE' q .ram 1,3 -. ( 2?"-- 3 7 i/VC-- -k- 1 p( .-LP oc k' -/ tv Cpj-ve" L-�/' Signature of Person-in-Charge: VDate: Signature of Inspector: ---)4 /) �/4 J--- i-Date. Z,, MDPH report form—10/5/18 version