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2023 Licensing
oard of Health Food Establishment Inspection Report - Town of Yarmouth Yarmouth te 2/8,South Yarmouth,MA 02664 Establishment: 6i i'Gyf�on REFS let;...4 an-r Date: �j/) /a3 Page 1 of c� • Address: }QIl�I 07 Rake ,J Lo Time in: / Time out: J 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 to Foodborne Illness Risk Factors Inspector: 01 I "lii0 and Interventions(Items 1 through 29): Type of Operation(s): Type of Inspection: Other Information: dt e Food Service Establishment ..Routine O Retail Food Store 0 Re-inspection o Residential:Cottage Foods 0 Pre-operational o Residential;Bed& 0 Illness investigation Breakfast 0 General complaint o Mobile/Pushcart 0 HACCP 7.".. , O Temporary Food Estab. O Other 0 Other '�� '.�� 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 OUTI N/A N/O COS R Supervision Protection from Contamination �1 1 Person-in-charge present, demonstrates y 15 Food separated and protected knowledge, and performs duties / 16 Food-contact surfaces; cleaned & J 2 Certified Food Protection Manager sanitized Employee Health _ Proper disposition of returned, I Management, food employee and 17 previously served, reconditioned & 3 conditional employee; knowledge, k unsafe food responsibilities and reporting Timelfemperature Control for Safety 4 Proper use of restriction and exclusion ✓ '. 18_Proper cooking time & temperatures 5 Procedures for responding to vomiting 1// 19 Proper reheating procedures for hot ✓- and diarrhea!events holding Good Hygienic Practices 20 Proper cooling time and temperature 6 Proper eating. tasting, drinking, or 21 Proper hot holding temperature of tobacco use 41, . 22 Proper cold holding temperature No discharge from eyes, nose, and 7 23 Proper date marking and disposition mouth Preventing Contamination by Hands 24 Time as a Public Health Control ,/ Consumer Advisory Fiiiiii 8 Hands clean & properly washed Consumer advisory provided for raw/ V`I{r II No bare hand contact with ready-to-eat V 25 undercooked food 9 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 / Food/Color Additives and Toxic Substances 12 Food received at proper temperature ✓ 27 Food additives: approved & properly . , F. used 13 Food received in good condition, safe, & Toxic substances properly identified, unadulterated 28 stored & used 14 Required records available: shetlstock (/ Conformance with Approved Procedures tags, parasite destruction 29 Compliance with variance / specialized ! ll 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 Compliance Status I IN I OUT N/A I N/O I COS l R Compliance Status IN OUT N/A N/O cos R Safe Food and Water 48 Warewashing facilities: installed, Pasteurized eggs used where maintained, & used; test strips 30 required 49 Non-food contact surfaces clean 31 Water& ice from approved source Physical Facilities 32 Variance obtained for specialized 50 Hot & cold water available; 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 21 35 Approved thawing methods used 54 Garbage& refuse properly 36 Thermometers provided & accurate IIIIIIIIIIIIIII- disposed; facilities maintained Food Identification 55 Physical facilities installed, Food properly labeled; original 37 , ` 1- maintained, &clean container I 56 Adequate ventilation & lighting; Prevention of Food Contamination designated areas used 38 Insects, rodents, & animals not Additional Requirements listed In 105 CM(590.011 present M1 Anti-choking procedures in food Contamination prevented during service establishment .. 39 food preparation, storage and M2 Food allergy awareness b display Review of Retail Operations listed In 105 CMR 590.010 1 40 Personal cleanliness M3 Caterer 41 Wiping cloths: properly used & WM M4 Mobile Food Operation stored M5 Temporary Food Establishment 42 Washing fruits & vegetables 7_.4 M6 Public Market; Farmers Market Proper Use of Utensils Residential Kitchen; Bed-and- 43 In-use utensils properly stored M7 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 I 46 Gloves used properly M10 Leased Commercial KitchenUtensils,Equipment and Vending M11 Innovative Operation Food & non-food contact surfaces Local Requirements, 47 cleanable, properly designed, L1 Local law or regulati _ constructed & used L2 Other ' . ,4 k: / 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 Reinspeotion: Discussion with Person-in-Charge: Signature of Person-In-Charge .( --- ..j Date: / . .._ Y......_.___� Signature of Inspector 4 �. �'', ,,,f a / MDPH report form—10/ s version ..'` � Food Establishment Inspection Report - Town of Yarmouth Establishment: (,- t c v-mil•,. }S -��_1c- --7 s;(t.�,., ft3.1:, A,te: /i--f/ 23 Page of Temperature Observations Item I Location Temp(°F) Item I 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 /lict. / Td-i ..A''e cry-, It -- i_ .1cV5� ' ( ccP' Yam,'--t- (.-072 i=42.- .,o7 timt::' '`.. -e Mc,CL i't c 't— ch csu- ef' a i C3c•-• 3C F. - C 1 .7 D r5 WC 22 & eLGZ-v t= -4 -- -) - -. _ /.zc7—`' 7 � 7 ,S z-e 1 1� _... .5 ( f � rr-n k_- if (sz rz. tri. , b c5 . '' Gv. e••k'. Z, �6,2..-ezricr-e- Tom- 3 - p c-f c, ,S x Z _ �- -_._ - .3�- =; ���.� �- , / 7--7/i / 5 -1- '`'i , s / e,c, -// 5 e.,-/,/ -x Ae - C4 Gc-, te-y xc S 4 " ©-F Gect .) .›�- '= `7 er")-+ -- - Ica' CO-iG--,c->e -cJ 'fir' : •�S- `_ S rJ �`.� � :�. _-, r-/" P - p S- / -k_2S4 '...,_/ I- . yt/se ► r'!-Fr—., farrx- (_-;-- , --' '3 1-1 -, Oc"J Signature of Person-in-Charge: Date: Signature of Inspector: - ,�.. Date: " /0.-:-.5 MDPH report form—10/5/18 version r