HomeMy WebLinkAboutFood Establishment Inspection ReportsTOWN OF YARMOUTH BOARD OF HEALTH
1146 ROUTE 28
I`nnn FgTnRI ISHMFNT INSPECTION REPORT SOUTH YARMOUTH, MA 02664
NameDate
�
P
�iz G X `CC"
-7,1",
/
Type of Operation(s)
Type of Inspection
'yiJ. Food Service
U Retail
U Residential Kitchen
1,4�Routine
U Re -inspection
Previous Inspection
Address
Telephone
"7
U _ 7-2,
U Mobile
U Temporary
Date:
U Pre-operation
HACCP Y/N
Owner
U Caterer
U Bed &Breakfast
Permit No34C9
U Suspect Illness
U General Complaint
U HACCP
U Other_
Person in Charge (PIC) c 110009
Time
In:
Out:
Inspector Z"
Each violation checked requires an explanation on the narrative page(s) ana a citation or specITlc provlslonts/ vluraicu.
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 ❑ 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
U 8. Separation/Segregation/Protection
❑ 9. Food Contact Surfaces Cleaning and Sanitizing
❑ 10. Proper Adequate Handwashing
U 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
❑ 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:
Ins for Signat re Print
s t Page_ of ? Pages
Q's Signat
PI ' O a (�
Item
No.
Code
Reference
C - Critical Item
R - Red Item
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION Date
PLEASE PRINT CLEARLY verified
Disposal
❑ Other
GT 1
1
Vim.\I +`i
h�
pG ffl
Re _ ! c
{ s� u CIE` C24,
�4 v tit �f/'c, n
?i C \{'��.... GU
Discussion with Person in Charge:
Correction Action Required:
❑ No
❑Yes
:3 Voluntary Compliance ❑ Employee Restriction /
Exclusion
❑ Re -inspection Scheduled U 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
Name
Date
Type of Operation(s)
Type of Inspection
J-FoodService
U Retail
U Residential Kitchen
U_Routme
U Re -inspection
Previous Inspection
FOOD PROTECTION MANAGEMENT
' s,'`rf
!
Address ;) ��� 4i p "1
❑ 13. Handwash Facilities
Telephone
PROTECTION FROM CHEMICALS
U Mobile
U Temporary
U Caterer
U Bed & Breakfast
Date:
U Pre-operation
U Suspect Illness
U General Complaint
U HACCP
Owner
HACCP Y/N
Person in Charge (PIC)
Time
In: € Is
❑ 4. Food and Water from Approved Source
Inspector " ",-�
Out
Permit No.
U Other_____
Each violation checked requires�an explanation on the narrative page(s) and a citation of specific provision(s) violated.
Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Non-compliance with:
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.
Page _ of _Pages
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
# CG
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 Order for Correction: Based on an inspection today,
C N
r
the items checked indicate violations of 105 CMR 590.000/
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)
DATE OF RE -INSPECTION:
30. Other
Inspector's Signature
Print/ '
DESCRIPTION OF VIOLATION / PLAN OF CORRECTION
PLEASE PRINT CLEARLY
PIC's Signature
r
Print i
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
Gi L v
14
J
# CG
r
1•
Discussion with Person in Charge:
Correction Action Required:
No ❑Yes
Ll Voluntary Compliance ❑ Employee Restriction /
Exclusion
❑ Re -inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary
Disposal
❑ Other
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