HomeMy WebLinkAboutInspection Report Food Establishment Report ec Ins tion - Town of Yarmouth Yarmouth Board of Health
p1146 Route.28,South Yarmouth,MA 02664
Establishment: Cc,, i C r.-1. . -3/2 �..
Date: sic.; 3 Page 1 of .
Address: /0-76, 48.E es� , cs `T Time in: Time out:
Telephone: 6'ermit 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: PiI 1 and Interventions(Items 1 through 29):
Type of Operation(s): Type of inspection: Other Information:
,./41 Food Service Establishment 0 Routine
O Retail Food Store 0 Re-inspection 1A
0 Residential:Cottage Foods I:J[Pre-operational ' ��i•�..
0 Residential;Bed& 0 Illness investigation "LS.G r
Breakfast 0 General complaint
O Mobile/Pushcart O HACCP P� -�
D Temporary Food Estab. 0 Other Gt } _
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 TOOT N/A IN/0 COS R Compliance Status I IN IOUTI N/A IN/OI COS R
Supervision Y Protection from Contamination tl////
1 Person-in-charge present, demonstrates / 15 Food separated and protected
knowledge, and performs duties 16 Food-contact surfaces; cleaned &
2 Certified Food Protection Manager sanitized
Employee Health Proper disposition of returned, /
Management,food employee and 17 previously served, reconditioned & I`/
3 conditional employee; knowledge, unsafe food
responsibilities and reporting 'f/ Time/Temperature Control for Safety
4 Proper use of restriction and exclusion Vi 18 Proper cooking time&temperatures L
5 Procedures for responding to vomiting % 19 Proper reheating procedures for hot
and diarrhea) events holding
Cri
Good Hygienic Practices / 20 Proper cooling time and temperature
Proper eating, tasting, drinking, or 21 Proper hot holding temperature
6 tobacco use 1 22 Proper cold holding temperature JJ/
7 No discharge from eyes, nose, and ,/ 23 Proper date marking and disposition ✓
mouth
Preventing Contamination by Hands/
24 Time as a Public Health Control
/ , L . Consumer Advisory
8 Hands clean & properly washed
No bare hand contact with ready-to-eat 25 Consumer advisory provided for raw/ v
ri II
9 food undercooked food
Highly Susceptible Populations
10 Adequate handwashingsinks properly Pasteurized foods used; prohibited foods
supplied andndaccessible
e 26
Approved Source not offered
11 Food obtained from approved source f Food/Color Additives and Toxic Substances
12 Food received at proper temperature VJ 27 Food additives: approved & properly
used ii't
Food received in good condition, safe, & Toxic substances properly identified,
13 unadulterated 28 stored & used
I'
14 Required records available: shellstock Conformance with Approved Procedures %
Rags, parasite destruction
29 Compliance with variance /specialized
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 I N/A I N/O I COS l R Compliance Status IN ouT NIA 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
50
32 Variance obtained for specialized I.' Hot& cold water available;
processing methods adequate pressure
Food Temperature Control 51 Plumbing installed; proper backflow x
Proper cooling methods used; devices
33 adequate equipment for V 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
36 Thermometers provided & accurate disposed; facilities maintained
Food identification 55 Physical facilities installed,
Food properly labeled; original
37 IImaintained, &clean
Adequate ventilation & lighting;
container 56
Prevention of Food Contamination designated areas used
Insects, rodents, & animals not Additional Requirements listed in 105 CMR 590.011
38 Anti-choking procedures in food /
present
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 f
41 Wiping cloths: properly used & M4 Mobile Food Operation
orary Food Establishment
stored M5 Temp
42 Washing fruits& vegetables I 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
46 Gloves used properly M10 Leased Commercial Kitchen
M11 Innovative Operation
i
Utensils,Equipment and Vending p
Food & non-food contact surfaces Local Requirements
47 cleanable, properly designed, L1 Local law or regulation
constructed & used L2 Other
Official Order for Correction: Based on an inspection today,the items marked"OUT"indicated violations of 105 CMR 590.000 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 Reinspeotlon: Di Ion with Person-in-Charge:
1
/,'7 / ��:
Signature of P*on-In-Char/.: Gi,'Zy- ,r._----, t,�Date:
Signature of In ps-1ry�/t-JC /'1 ,b.0 ���
MDPH report form- /5/18 version c /
Food Establishment Inspection Report - Town of Yarmouth
Establishment: CI i v,c c-T--e-) /,,,, v ifq24.0 of Date: 7/vim ' Page ,'=of --2
S r- / ✓
Temperature Observations
Item I Location Temp(°F) Item I 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
Item Section of Code Description of Violation Date to Correct By
Number
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Signature of Person-in-Charge: 1''' Date:
Signature of Inspector:)4,..)'~1 / /'��r -�, _ 5 _,,
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MDPH report form—10/5/18 version