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Home My WebLink AboutFood Establishment Inspection ReportsTOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name CD U� % 76USe _Z11 Date �yLlResidential � / Type of Operation(s) Type of Inspection -Id" Food Service ❑ Retail Kitchen ❑ Mobile ❑ Temporary Ll Caterer ❑ Bed & Breakfast Permit No. Routine U Re -inspection Previous Inspection Date: C3 Pre-operation U Suspect Illness U General Complaint U HACCP ❑ Other Address '� 7 G__ &Pv Telephone OwnerHACCPY/N ❑ 20. Time as a Public Health Control Person in Charge (PIC) Time In: Out: Inspector /`/�� wc) 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 Cl 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)(590003) ?4. 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 DESCRIPTION OF VIOLATION / PLAN OF CORRECTION PLEASE PRINT CLEARLY ❑ 17. Reheating ❑ 18. Cooling PIC' stgAatur ❑ 19. Hot and Cold Holding of Pages ❑ 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: Inspe o Si t re / Print DESCRIPTION OF VIOLATION / PLAN OF CORRECTION PLEASE PRINT CLEARLY Date Verified PIC' stgAatur Print/Page of Pages Item Code No. Reference C - Critical Item R - Red Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION PLEASE PRINT CLEARLY Date Verified Disposal ❑ Other P,- 5 A-�k L` -QHS fi i7 /'7' Ci S r-- i��i- � -�t> OC-- .95 a \^� d Dis ' arge: � Correction Action Required: ❑ No ❑Yes { � Gin\� ❑ Voluntary Compliance Cl Employee Restriction/ Exclusion Cl Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 NameDate Print _ �• Type of Operation(s) Type of Inspection U Food Service U Routine Address a 6 j. %! U Retail J Residential Kitchen U Re -inspection Previous Inspection lr0QKS PG=s Telephone ? U Mobile U Temporary Date: U Pre-operation OwnerHACCP Y/N U Caterer U Bed & Breakfast U Suspect Illness 4 General Complaint U HACCP Person in Charge (PIC) Time In: Inspector 1� Out: Permit No. U Other_ Each violation checked requires an explanation on the narrative page(s) and a citation of specltic provision(s) viomieia. 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) 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 ❑ 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION ❑ 8. Separation/Segregation/Protection ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ❑ 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 ❑ 10. Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11. Good Hygienic Practices ❑ 22. Posting of Consumer Advisories 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 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'" lure Print _ �• C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date R - Red Item PLEASE PRINT CLEARLY Verified PIC's Signa Print /go ey r Cid }ftLi;d Page ?_ of Pages Item No. Code Reference C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date R - Red Item PLEASE PRINT CLEARLY Verified lr0QKS PG=s to --- S L-4-4�^ vzp ac -1Z --mss ri L1_ n M -2 L- LL IU D I, .C> Correction Action Required: ❑ No ❑ Yes Discussion with Person in Charge: ❑ Voluntary Compliance ❑ Employee Restriction / rY P Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other - n 5