HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF YARMOUTH BOARD OF HEALTH
1146 ROUTE 28
FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
Name
❑ 16. Cooking Temperatures
t��y,
Daje
Type of Operation(s)
Type of Inspection
XFood Service
U Retail
U Residential Kitchen
'Im"Houtine
U Re -inspection
Previous Inspection
C,2G '' �1 1
(
III /�14
`,9
Address _3 1 iO`
REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS
Telephone
P
iR
u ^�
3� I - / a 00
CONSUMER ADVISORY
U Mobile
U Temporary
Date:
U Pre-operation
Owner
HACCPY/N
Foodborne Illnesses Interventions and Risk
T�0 t 'n 1 ^94
Factors (Red Items 1-22):
LJ Caterer
LI Bed &Breakfast
Permit No.
U Suspect Illness
U General Complaint
U HACCP
U Other
Person in Charge (PIC)
Time
In.
Out:
Inspector �f�)� T�
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) ❑ 590.009 (F) ❑
corrective action as determined by the Board of Health.
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
❑ 4. Food and Water from Approved Source
❑ 5. Receiving/Condition
❑ 6. Tags/Records/Accuracy of Ingredient Statements
❑ 7. Conformance with Approved Procedures/HACCP Plans
PROTECTION FROM CONTAMINATION
❑ 8. Separation/Segregation/Protection
❑ 9. Food Contact Surfaces Cleaning and Sanitizing
❑ 10. Proper Adequate Handwashing
❑ 11. Good Hygienic Practices
Violations Related to Good Retail Practices (Blue Items)
Critical (C) violations marked must be corrected immediately
or within 10 days as determined by the Board of Health.
Non-critical (N) violations must be corrected immediately
or within 90 days as determined by the Board of Health.
C N
23. Management and Personnel (FC -2)(590.003)
24. Food and Food Protection (FC -3)(590.004)
25. Equipment and Utensils (FC -4)(590.005)
26. Water, Plumbing and Waste (FC -5)(590.006)
27. Physical Facility (FC -6)(590.007)
28. Poisonous or Toxic Materials (FC -7)(590.008)
29. Special Requirements (590.009)
30. Other
TIME/TEMPERATURE CONTROLS (Potentially Hazardous Foods)
❑ 16. Cooking Temperatures
C - Critical Item
R - Red Item
❑ 17. Reheating
PIC' Sign r l -
❑ 18. Cooling
Page' of t Pages
❑ 19. Hot and Cold Holding
C,2G '' �1 1
❑ 20. Time as a Public Health Control
REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS
(HSP)
❑ 21. Food and Food Preparation for HSP
CONSUMER ADVISORY
❑ 22. Posting of Consumer Advisories
Number of Violated Provisions Related to
Foodborne Illnesses Interventions and Risk
Factors (Red Items 1-22):
Official Orderfor Correction: Based on an inspection today,
the items checked indicate violations of 105 CMR 590.000/
federal Food Code. This report, when signed below by a
Board of Health member or its agent constitutes an order of
the Board of Health. Violations not corrected are subject to
fines per Yarmouth Board of Health. If aggrieved by this
order, you have a right to a hearing. Your request must be
in writing and submitted to the Board of Health at the above
address within 10 days of receipt of this order.
DATE OF RE -INSPECTION:
Inspectr i ture
Print
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION
PLEASE PRINT CLEARLY
PIC' Sign r l -
Priri ! f
Page' of t Pages
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION
PLEASE PRINT CLEARLY
Date
Verified
Disposal
❑ Other
C,2G '' �1 1
P f} i
p IF
1
c3 �-
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
Li Employee Restriction /
LI Voluntary Compliance Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
Disposal
❑ Other
TOWN OF YARMOUTH BOARD OF HEALTH
1146 ROUTE 28
1:0n l FSTORI ISHMFNT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
Name �i
Date
Type of Operation(s)
Type of Inspection
U• Food Service
J .Routine
t
r'f
FOOD PROTECTION MANAGEMENT
Address "�
` ;
U Retail
U Residential Kitchen
U Re -inspection
Previous Inspection
PROTECTION FROM CHEMICALS
Telephone
❑ 14. Approved Food or Color Additives
U Mobile
U Temporary
Date:
U Pre-operation
FOOD FROM APPROVED SOURCE
HACCP Y/N
Owner
❑ 16. Cooking Temperatures
U Caterer
❑ Bed & Breakfast
U Suspect Illness
J General Complaint
Person in Charge (PIC)
Timej
❑ 7. Conformance with Approved Procedures/HACCP Plans
In: I :?�� '
Out:
I Permit No.
U HACCP
U Other
Inspector o
Each violation checked requires an explaAtion on the narrative page(s) and a citation of specific provision(s) violatea.
Code
Reference
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) U 590.009 (F) ❑
corrective action as determined by the Board of Health.
❑ Other
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
❑ 8. 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 OrderforCorrection: Based on an inspection today,
the items checked indicate violations of 105 CMR 590.000/
C N
federal Food Code. This report, when signed below by a
23. Management and Personnel (FC -2)(590.003)
Board of Health member or its agent constitutes an order of
24. Food and Food Protection (FC -3)(590.004)
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)
on n.h
DATE OF RE -INSPECTION:
nspector's Signature Print
DIC's Signature r ' _ PrintI �ti \ �t` ' �,? Page __ of Page. G •+ V'
` J
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION
PLEASE PRINT CLEARLY
Date
Verified
Disposal
❑ Other
I t_
r �; i •
F' z
Discussion with Person in Charge:
Correction Action Required:
❑ No
LJ Yes
❑ Voluntary Com Compliance ❑ Employee Restriction /
P Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
Disposal
❑ Other
TOWN OF YARMOUTH
FOOD ESTABLISHMENT INSPECTION REPORT
BOARD OF HEALTH
1146 ROUTE 28
SOUTH YARMOUTH, MA 02664
Name
Print
"'
PIC's SignaturO `
Date
1 -: ,1
.i e.).
Type of Operation(s)
Type of Inspection
Food Service
U Retail
U Residential Kitchen
U Mobile
U Temporary
U Caterer
U Bed &Breakfast
Permit No. ? .i I'_¢f
�Jr,Routine
U Re -inspection
PreviDuteous Inspection
U Pre-operation
U Suspect Illness
U General Complaint
U HACCP
U Other _
Address 5 >�
TelephoneI
-7 2? O O
Owner
HACCPY/N
Person in Charge PIC
9 (PIC) -
Time
In.
Out:
Inspector w -}
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) U 590.009 (F) U
corrective action as determined by the Board of Health.
FOOD PROTECTION MANAGEMENT
❑ 1. PIC Assigned / Knowledgeable / Duties
EMPLOYEE HEALTH
❑ 2. Reporting of Diseases by Food Employee and PIC
❑ 3. Personnel with Infections Restricted/Excluded
FOOD FROM APPROVED SOURCE
❑ 4. Food and Water from Approved Source
❑ 5. Receiving/Condition
❑ 6. Tags/Records/Accuracy of Ingredient Statements
CI 7. Conformance with Approved Procedures/HACCP Plans
PROTECTION FROM CONTAMINATION
❑ 8. Separation/Segregation/Protection
❑ 9. Food Contact Surfaces Cleaning and Sanitizing
❑ 10. Proper Adequate Handwashing
❑ 11. Good Hygienic Practices
Violations Related to Good Retail Practices (Blue Items)
Critical (C) violations marked must be corrected immediately
or within 10 days as determined by the Board of Health.
Non-critical (N) violations must be corrected immediately
or within 90 days as determined by the Board of Health.
C N
23. Management and Personnel (FC -2)(590.003;
24. Food and Food Protection (FC -3)(590.004;
25. Equipment and Utensils (FC -4)(590.005
26. Water, Plumbing and Waste (FC -5)(590.006.
27. Physical Facility (FC -6)(590.007
28. Poisonous or Toxic Materials (FC -7)(590.008
29. Special Requirements (590.009;
30. Other
❑ 12. Prevention of Contamination from Hands
❑ 13. Handwash Facilities
PROTECTION FROM CHEMICALS
❑ 14. Approved Food or Color Additives
❑ 15. Toxic Chemicals
TIME/TEMPERATURE CONTROLS (Potentially Hazardous Foods)
❑ 16. Cooking Temperatures
❑ 17. Reheating
❑ 18. Cooling
❑ 19. Hot and Cold Holding
❑ 20. Time as a Public Health Control
REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP)
❑ 21. Food and Food Preparation for HSP
CONSUMER ADVISORY
❑ 22. Posting of Consumer Advisories
Number of Violated Provisions Related to
Foodborne Illnesses Interventions and Risk
Factors (Red Items 1-22):
Official Order for Correction: Based on an inspection today,
the items checked indicate violations of 105 CMR 590.000/
federal Food Code. This report, when signed below by a
Board of Health member or its agent constitutes an order of
the Board of Health. Violations not corrected are subject to
fines per Yarmouth Board of Health. If aggrieved by this
order, you have a right to a hearing. Your request must be
in writing and submitted to the Board of Health at the above
address within 10 days of receipt of this order.
DATE OF RE -INSPECTION:
Inspector's Signature r
_
Print
C - Critical Item
R - Red Item
PIC's SignaturO `
Print JrPage,.-*
_ of / Pages
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY Verified
Other
Crz r a
-z_ I -k- rP
� C -- 1 � � r- C• -
L 1<
-. T7/A k
�r
�(s-Ci�.;
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
LJ Voluntary Compliance ❑ Employee Restriction /
Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary Disposal 0
Other