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HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF YARMOUTH FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 1146 ROUTE 28 SOUTH YARMOUTH, MA 02664 Name Print Q ` Date Type of Operation(s) Type of Inspection A Food Service , Routine , n S I/A Address E6-,-7- /2% 3U 14 U Retail U Residential Kitchen U Re -inspection Previous Inspection Telephone l �U�i v a_ 01 a q r U Mobile U Temporary Date: U Pre-operation Owner HACCP Y/N U Caterer U Bed & Breakfast Permit No.14 _ ( ) U Suspect Illness U General Complaint U HACCP U Other__ Person in Charge (PIC) G fi y Time In: Out: Inspector I �^ ! -T. Each violation checked Irequires 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) 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 Ll 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 U 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 (590o09; 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) CI 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 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: InspectI Si nature Print Q ` PIC's Signature Print Page _\_ of __ Pages Item Code C - Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date No. Reference R - Red Item PLEASE PRINT CLEARLY `` Verified \ L - n f�cV n`✓� C, A •; `i F- - - c K So C Qk!A c 1 , 1,1Z4 SL4- 1 C M(IC 11 Ai' Q F'Gn G vIse- Lo Discussion with Person in Charge: Correction Action Required: ❑ No ❑Yes L) Voluntary Compliance ❑ Employee Restriction/ Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary r Disposal ❑ Other r TOWN OF YARMOUTH BOARD OF HEALTH 1146 ROUTE 28 FOOD ESTABLISHMENT INSPECTION REPORT SOUTH YARMOUTH, MA 02664 Name { t. Date Tvoe of Operation(s) Type of Inspection Lil-Food Service U Routine corrective action as determined by the Board of Health. ❑ Other " Address r_t 9- (� a', d f 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: ❑ Pre-operation Owner HACCP Y/N ❑ 4. Food and Water from Approved Source ❑ 16. Cooking Temperatures U Caterer U Bed & Breakfast Permit No. U Suspect Illness U General Complaint U HACCP ❑ Other___ Person in Charge (PIC) Time In: Out: (� Inspector t\ t �, j Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Print i 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. ❑ 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 Orderfor Correction: Based on an inspection today, C N the items checked indicate violations of 105 CMR 590.000/ 23. Management and Personnel (FC -2)(590.003) federal Food Code. This report, when signed below by a i l3 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) DATE OF RE -INSPECTION: 30. Other Inspector's Signature_ , Print i DESCRIPTION OF VIOLATION / PLAN OF CORRECTION PLEASE PRINT CLEARLY PIC's Signature Y s 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 ( r ..i l i l3 Discussion with Person in Charge: Correction Action Required: ❑ No ❑Yes ❑ Voluntary Compliance ❑ Employee Restriction / P Exclusion ❑ Re -inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other