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Home My WebLink AboutMiscellaneous - 1820 TURNPIKE STREET 4/30/2018 (4)10ralo N (p O 'nrC� v Z > n :2C CD A aye ; d C') mM d o� r DelleChiaie, Pamela From: Sawyer, Susan Sent: Friday, March 18, 20119:58 AM To: 'Darcey Adams' Cc: Grant, Michele; 'Edward Holden'; DelleChiaie, Pamela Subject: FW: Spectrum NA Attachments: Spectrum Day Care plan approval 12.21.10.doc Hello Darcey, I wanted to recap discussions that took place yesterday and add some comments and reminders. - The building card has been signed off by our department and the issuance of the CO is in the Building Department's hands. Once the kitchen is cleaned and all contractor work is complete, food may be brought in as needed. The final inspection should be requested at minimum 48 hours before you need to permit to be active. It can be anytime before if you are ready, there is no need to wait until the 48 hours. If all is in place the permit will be issued. If not, we will return as soon as we are notified of any corrections made. I attached the letter again for reference. The approval letter provides a framework of things that will be looked for at the final inspection. The premise is that the kitchen should be ready to open. Please note that all refrigeration equipment must be at proper temperatures, w/ thermometers, and the dish machine should be ready for use. Sanitizer must be made. Sponges and steel wool are not allowed for use on food contact surfaces, therefore we recommend green scrubbing pads or something comparable of your choosing. Mops must be able to be hung to dry and I don't recall if that was in place during the last inspection. Lastly, the dumpster. You application notes a dumpster on a cement pad. This must be an enclosed area. Note that in the approval letter is the link for permitting if this is Spectrum's dumpster. If it is the complex's dumpster, please let us know so we may permit the proper applicant. Thank you Susan From: Sawyer, Susan Sent: Wednesday, March 16, 20113:06 PM To: Darcey Adams Cc: DelleChiaie, Pamela; Grant, Michele Subject: Spectrum NA Hi Darcey, As we move forward, I just wanted to remind you that your permit application was submitted back in the fall, but we will need $110 prior to scheduling the final inspection, payable to the "town of North Andover". Please speak with Pam if you have any questions about the annual permit. It will be good through December 31, 2011. Thank you Susan Stoan SawyAn Yub& ReaftA Diwzt" 1600 V igood Stud gtdg 211, unit 2-36 A PRINTED BY: Pamela DelleChiaie - PLEASE LEAVE IN PRINT-OUT TRAY....... THANK YOU. DelleChiaie, Pamela From: Sawyer, Susan Sent: Tuesday, January 25, 20113:31 PM To: DelleChiaie, Pamela Cc: Grant, Michele Subject: FW: Spectrum North Andover Attachments: SKA.08 Kitchen Interior Elevations REVISED_1.PDF; SKA.09 Plan Revisions_1.PDF Please print these out and place in the spectrum file. This is just a minor change that I approved verbally that had to be shown on a plan. Thx From: Sherrill O'Gorman Lmailto:SOGORMAN@nhs-healthlink. org] Sent: Thursday, January 20, 20112:32 PM To: Sawyer, Susan Cc: Darcey Adams Subject: Spectrum North Andover Good Afternoon Susan, On behalf of Darcey Adams and the Spectrum North Andover team, I have been asked to forward the revised specifications for the sinks. Please advise if further information is requested. Regards, Sherrill O'Gorman SPimW U' 'gowtan Administrative Assistant for Community Programs Northeast Senior Health 600 Cummings Center Suite 275 Z Beverly MA 01915 978-921-1697 ext. 213 978-921-1624 fax sogorman@nhs-healthlink.org This message and its contents are confidential and are intended for the use of the addressee only, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the intended recipient, this serves as notice that any unauthorized distribution, duplication, printing, or any other use is strictly prohibited. If you feel you have received this email in error, please delete the message and notify the sender so that we may prevent future occurrences. I OF 2 DelleChiaie, Pamela A Lcc Di = L C O O. N� y cu U j O C 3 -O 0) L m C O 0.0 + � UCL O C (LPE6-O.n C O� °>� P C.O. O N CL " om 00 U.0 Q 3: O L N 02 fQ C O cE07C+L• O -CNc N O a L O O +_' O O cC CL U 0.o y U 3 U CO LO 0 U) !p L p C = L C O O. N� y O O O U) N m C O 0.0 + C UCL O C (LPE6-O.n 0O O� °>� �O 00MCm U- U m O U O Q m CC 0) N .0 A -Z •L � .9 1, L1 1 .o -,c U O o N no jZ Ch / O M N � M r U N U 7 � � C IE li O N dWV1S 3SN3011 O N N !n m e o o o 5m�C0 = m a� S RR 0 d N c to a LL a0 Qi d Z L E O x j u6ise0ueW0 anpepyyVedaMuel 01s 0mp%ul enlogp4 N \ �t �w'' L w v42:�° EaG V r Y f 6 SNI S31VIDOSSV NDIS30 o o N NN IR G m Od N �a�In mo$ NOM In�� ;� to Z 2 q>tn Ci iL -zo � 1 �9y7 Of HORT1J O - 9 Town of North Andover s`'• �' HEALTH DEPARTMENT ,SSACMUSt CHECK #: c�%- T LOCATION: /4 U H/O NAME: CONTRACTOR NAME:_ y- Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ DD pster $ E7/Food Service - Type: d'�'� �'l�f'v�$--/� 1511 ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems ❑ Septic - Soil Testing $ ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other: (Indicate) $ ealth Agent Initials White - Applicant Yellow - Health Pink - Treasurer Food Establishment 16 `'''. ' ,Plan Review Guide FOOD ESTABLISHMENT PLAN REVIEW APPLICATION IS TO BE COMPLETED BY THE OPERATOR AND SUBMITTED TO THE REGULATORY AUTHORITY — at least 60 days in advance before commencement of any food establishment planned openings. TOWN OF NORTH ANDOVER, MA Regulatory Authority 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 Date: Nov I D. o I o NEW - New construction, not yet built REMODEL - partial or major renovation of existing establishment CONVERSION — existing establishment that you are purchasing Name of Establishment:v.�� AP.� RL,-, dJ 11 7)X4 NeAI`\ Corporate Name: JVva4eas� N:—)p � Category: Restaurant , Institution , Daycare , Retail Market , Otheri f 'p jA�,4 1 44\ Establishment Address: ':2D —1-1, a „, p. 'I�. % A N d 1cP 4 Phone: (at location if available) A E-mail Contacts: 71, 1� n (A v%% S r W 14 S - 14 e,a 1+4, 1,N I , Ce c, Name of Owner: I V U R4 to 5 + � . rU i'o 2 H 2A 14A, Mailing Address: (Sol) 12 975Z a-veqly, MA Telephone: q IS - I � qrt Xaa (o U Applicant's Name (if different than owner): `� Aa c_ e ay, w+5 . !�, C , S: Title (owner, manager, architect, etc.).71 ,,geC,� 0 r bw Cp h,rr` v,v I �, �R�r2 AV^S Mailing Address: �UU Lm mirvc S OAl2 .),k, ZP52 0011'5 Telephone: - q a 1- uD Q q Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 1 of 20 Date Received: BOH office use only Date Review completed: BOH office use only: Approved / Denied Date Revised application Received: BOH office use only Date Review completed: BOH office use only: Approved / Denied I Technical Assistance with the Permitting Process The Town Planning Department offers the option of attending a Technical Review Committee (TRC) meeting to all applicants. As the applicant, I acknowledge that I have received an explanation and understand that the purpose of the TRC meeting is it to assist me in the various town processes needed to open my establishment. j If declined I understand that I have forfeited this opportunity to learn more about the North Andover permitting j process. I wish to attend or ecline (circle one) participation in the TRC process. Date of TRC (BOH only) General Information Hours of Operation: Sun L105-4 Thurs� Mon �� - 5� Fri Ba -5 Tues Q� - �P Sat 0-1 ub.A Wed � ➢ Number of Seats for customers: GD ➢ Number of Staff: lJ� (Maximum per shift) ➢ Total Square Feet of Facility: ➢ Number of Floors on which operations are conducted l 5 4F Icon ➢ Maximum Daily Meals to be Served: (approximate number) Type of Service: (check all that apply) ➢ Breakfast LPD ➢ Lunch LOD ➢ Dinner ty l o Sit Down Meals_ Take Out Caterer Mobile Vendor Other Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 2 of 20 Please enclose the following documents: Proposed Menu (including seasonal, off-site and banquet menus) __I_ Manufacturer Specification sheets for each piece of equipment shown on the plan __)L_ Site plan showing location of business in building; location of building on site including alleys, streets; and location of any outside equipment (dumpsters, well, septic system - if applicable) '� Plan drawn to scale of food establishment showing location of equipment, plumbing, electrical services and mechanical ventilation Equipment schedule CONTENTS AND FORMAT OF PLANS AND SPECIFICATIONS 1. Provide plans that are a minimum of 11 x 14 inches in size including the layout of the floor plan accurately drawn to a minimum scale of 1/4 inch = l foot. This is to allow for ease in reading plans. 2. Include: proposed menu, seating capacity, and projected daily meal volume for food service operations. 3. Show the location of each piece of equipment. Each must be clearly labeled on the plan with its common name. Each unit must be sequentially numbered and the numbers must correspond to the equipment specification sheets and an equipment schedule. All self-service hot and cold holding units must have sneeze guards. 5. Label and locate separate food preparation sinks when the menu dictates to preclude contamination and j cross -contamination of raw and ready -to -eat foods. 6. Clearly designate adequate hand washing lavatories for each toilet fixture and in the immediate area of food preparation, cooking and ware washing. (a hand sink should be located within 10 feet of each area for easy access for all food handlers) 7. Provide the room size, aisle space, space between and behind equipment and the placement of the equipment on the floor plan. 8. On the plan, represent auxiliary areas such as storage rooms, garbage rooms, toilets, basements and/or cellars used for storage or food preparation. Show all features of these rooms. 9. Include and provide specifications for: a. Entrances, exits, loading/unloading areas and docks; b. Complete finish schedules for each room including floors, walls, ceilings and coved juncture bases; c. Plumbing schedule including location of floor drains, floor sinks, water supply lines, overhead waste -water lines, hot water generating equipment with capacity and recovery rate, backflow prevention, and wastewater line connections; Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 3 of 20 d. Lighting schedule with protectors; (1) At least 110 lux (10 foot candles) at a distance of 75 cm (30 inches) above the floor, in walk-in refrigeration units and dry food storage areas and in other areas and rooms during periods of cleaning; (2) At least 220 lux (20 foot candles): (a) At a surface where food is provided for consumer self-service such as buffets and salad bars or where fresh produce or packaged foods are sold or offered for consumption; (b) Inside equipment such as reach -in and under -counter refrigerators; (c) At a distance of 75 cm (30 inches) above the floor in areas used for handwashing, warewashing, and equipment and utensil storage, and in toilet rooms; and (3) At least 540 lux (50 foot candles) at a surface where a food employee is working with food or working with utensils or equipment such as knives, slicers, grinders, or saws where employee safety is a factor. e. Food Equipment schedule to include make and model numbers and listing of equipment that is certified or classified for sanitation by an ANSI accredited certification program (when applicable). f. Source of water supply and method of sewage disposal. Provide the location of these facilities and submit evidence that state and local regulations are complied with; g. A mop sink or curbed cleaning facility with facilities for hanging wet mops; h. Garbage can washing area/facility; i. Cabinets for storing toxic chemicals; j. Dressing rooms, locker areas, employee rest areas, and/or coat rack as required; k. Site plan (plot plan for new construction) PLEASE CIRCLE/ANSWER THE FOLLOWING QUESTIONS FOOD PREPARATION REVIEW Check categories of Potentially Hazardous Foods (PHF's) to b qeopwpam -and erved. CATEGORY* (YES) (LO) 1. Thin meats, poultry, fish, eggs (hamburger; sliced meats; fillets) (x) ( ) 2. Thick meats, whole poultry (roast beef; whole turkey, chickens, hams) (X) ( ) 3. Cold processed foods (salads, sandwiches, vegetables) (X) ( ) 4. Hot processed foods (soups, stews, rice/noodles, gravy, chowders, casseroles) ( Y) ( ) Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 4 of 20 5. Bakery goods (pies, custards, cream fillings & toppings) 6. Other FOOD SUPPLIES: 1. Are all food supplies from inspected and approved sources? YE / NO 2. What are the projected frequencies (daily, weekly, etc) of deliveries for Frozen foods Refrigerated foods QJ 0&e K , and Dry goods o2x W eels 3. Provide information on the amount of space (in cubic feet) allocated for: Dry storage 1 3�2 , j Cu . CF- , Refrigerated Storage of of . $ Cu, F �. , and Frozen storage I S, q e.. � �. 4. How will dry goods be stored off the floor? L _� a e A 45�\Q,Iy es COLD STORAGE: 1. Is adequate and approved freezer a refrigeration available to store frozen foods frozen, and refrigerated foods at 41 T (5°C) and below?ES /NO 2. Will raw meats, poultry and seafood be stored in the same refrigerators and freezers with cooked/ready-to- eat foods? YE NO If yes, how will cross -contamination be prevented? 3. Does each refrigerator/freezer have a thermomete . YES NO i Number of refrigeration units: I Number of freezer units: _j_ 4. Is there a bulk ice machine available? YES NO Is ice packaged and sold for retail? YE Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 5 of 20 I THAWING FROZEN POTENTIALLY HAZARDOUS FOOD: Please indicate by checking the appropriate boxes how frozen potentially hazardous foods (PHF's) in each category will be thawed. More than one method may apply. Also, indicate where thawing will take place. Food Thawing Method *Thick or Bulk Frozen *Thin/Portioned Frozen i Refrigeration Running Water Less than i 70'F(21 -C) Microwave (as part of cooking process) Cooked from Frozen state � T - -- --T Other (describe) *Frozen foods: approximately one inch or less = thin, and more than an inch = thick. PREPARATION: 1. Please list categories of foods prepared more than 12 hours in advance of service. 2. Will food employees be trained in good food sanitation practices? ES NO Method of training: Number(s) of employees: Dates of completion: Slq/ U (o 0 3. Will d' osable gloves and/or utensils and/or food grade paper be used to prevent handling of ready -to -eat foods? YLS NO 4. Is there a written policy to exclude or restrict food workers who are sick or have infected cuts and lesions? 0/ NO Please describe briefly: 11�- PR A00we6- 40 �2� c�o3vyhe-U 26 . 5R A - Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 6 of 20 1 Will employees have paid sick leave? ES NO 5. How will cooking equipment, cutting boards, counter tops and other food contact surfaces which cannot be submerged in sinks or put through a dishwasher be sanitized? �l Chemical Type: iMu I }; - tvLoCa(-2 5q„„ t�z.evL Concentration: I D 0 % Test Kit: YES /0 6. Will ingredients for cold ready -to -eat foods such as tuna, mayonnaise and eggs for salads and sandwiches be pre -chilled before being mixed and/or assembled?(ONO If not, how will ready -to -eat foods be cooled to 41'F? 7. Will all produce be washed on-site prior to use? YESNO Is there a planned location used for washing produce? YES / Describe (a la na ds !4 -Rim O ng -5 i h-, 1►v -Raad,4 - In - eo t �0 RW. A wd f) R e �R IA k1 P0►Z IM e,M bi rz S i ri OURt )�4a" If not, describe the procedure for cleaning and sanitizing multiple use sinks between uses, c� i 8. Describe the procedure used for minimizing the length of time PHF's will be kept in the temperature danger zone (41'F - 140°F) during preparation. )y /a G Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 7 of 20 9. Where raw meats, poultry and seafood are prepared in the same work area or using the same equipment as cooled/ready to eat foods, how will cross contamination be prevented? N to 10. Please list all PHF's you plan to serve which will/may not be cooked to the previously listed minimum temperatures. A proper "consumer advisory" warning notation must be printed on menu or menu boards. 11. Provide a HACCP plan for specialized processing methods such as vacuum packaged food items prepared on-site or otherwise required by the regulatory authority. N 12. Will the facility be serving food to a highly susceptible population?�/ NO If yes, List measures taken to comply with code requirements. e,d. COOKING: 1. Will food product thermometers be used to measure final cooking/reheating temperatures of PHF's? ES NO What type of temperature measuring device: APV kh.0 mP-; eP 9 01 Minimum cooking time and temperatures o0roduct utilizing convection and conduction heating equipment: ➢ beef roasts ➢ 130-F(121 min) ➢ solid seafood pieces ➢ 145°F (15 sec) ➢ other PHF's ➢ 145°F (15 sec) ➢ eggs: ■ Immediate service 145°F (15 sec) pooled* 155°F (15 sec) (*pasteurized eggs must be served to a highly susceptible population) ➢ pork ➢ 145°F (15 sec) ➢ comminuted meats/fish ➢ 155°F (15 sec) ➢ poultry ➢ 165°F (15 sec) ➢ reheated PHF's ➢ 165°F (15 sec) 2. List types of cooking equipment. 5to-t- 4-0p 0VemJ Y�►GRo r,JAve— Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 8 of 20 HOT/COLD HOLDING: 1. How will hot PHF's be maintained at 140°F (60°C) or above during holding for service? Indicate type and number of hot holding units. I 1 r1 Wi A ► h) S �� I a �C�1_ 0—aa-i-, \44- 2. 44 2. How will cold PHF's be maintained at 41'F (5°C) or below during holding for service? Indicate type and number of cold holding units. �RAWSpoP,kcl_ ViA i N5uliCai?�5 2vV —1dAsI-e4'ui R Iry Please indicate by checking the appropriate boxes how PHF's will be cooled to 41'F (5°C) within 6 hours (140°F to 70°F in 2 hours and 70°F to 417 in 4 hours). Also, indicate where the cooling will take place. COO] MET] Shallc Ice B Redu Volun Rapic Other SING THICK THIN MEATS THIN SOUPS/ THICK IOD MEATS GRAVY SOUPS/ GRAVY w Pans iths ie or Size Chill (describe) l RICE/ NOODLES REHEATING: 1. How will PHF's that are cooked, cooled, and reheated for hot holding be reheated so that all parts of the food reach a temperature of at least 165°F for 15 seconds. Indicate type and number of units used for reheating foods. Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 9 of 20 tV % A O U �o�, 6 � l5 po1F3e, d. A t�" 6 ed4 k s 2. How will reheating food to 1657 for hot holding be done rapidly and within 2 hours? A. FINISH SCHEDULE Materials selected must be durable and appropriate to the area and its intended use. High moisture and food splash areas must be non-absorbent, smooth and easily cleanable. All openings must be tight fitting, properly sealed and without voids. Applicant must indicate which materials (ie. quarry tile, stainless steel, 4" plastic coved molding, etc.) will be used in the following areas. (be specific) f Kit r- Bai Fo( t Otl i Toi Dri Kit i Ga Rei chen FLOOR COVING WALLS I id Storage --� ter Storage I let Rooms ►I� P�A6+,G :ssing Rooms �_Ar.twA-- A5i i'c- DIP, yW4-11 chen LA -- ----- 11 j WA l� III rbage & use Storage�� CEILING — ` I�. kop —DQ of i ROP Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 10 of 20 Mop Basil War Area Wall Refr Free B. INSECT & RODENT CONTROL APPLICANT. PLEASE CHECK APPROPRIA TE BOXES YES NO N/A 1. Will all outside doors be self-closing and rodent proof? Service i Area ,A vh VN') 0,t4, A-5 l'C, R W A � 1 �R o �! washing 2. Are screen doors provided on all entrances left open to the outside? X 3. Do all openable windows have a minimum #16 mesh screening? Y An igerators and MA I :ers exhaust and intakes protected? B. INSECT & RODENT CONTROL APPLICANT. PLEASE CHECK APPROPRIA TE BOXES Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 11 of 20 YES NO N/A 1. Will all outside doors be self-closing and rodent proof? X 2. Are screen doors provided on all entrances left open to the outside? X 3. Do all openable windows have a minimum #16 mesh screening? Y 4. Is the placement of electrocution devices identitied on the plan? x 5. Will all pipes & electrical conduit chases be sealed; ventilation systems exhaust and intakes protected? 6. Is area around building clear of unnecessary brush, litter, boxes and other harborage? X 7. Will air curtains be used? If yes, where? X 8. Do you have a plan to have a contract pest control company? If yes, list company name, describe frequency of inspection and type of service. �( Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 11 of 20 ---------------- - -- C. GARBAGE AND REFUSE INSIDE YES NO N/A 9. Do all containers have lids? X 10. Will refuse be stored inside? If so, where? 11. Is there an area designated for a garbage can or floor mat cleaning? OUTSIDE 12. Will a dumpster be used? Number: Size of: a. Number: J //�� &1d w VWVVeyZ 40 30 b. Size of: c. Frequency of Pick -Up? Indicate days and how often 13. Will a compactor be used? X Number: Size: Frequency of Pick -Up 14. Will garbage cans be stored outside? 15. Describe surface and location where dumpster/compactor/garbage cans are to be stored. GAebwj, V-Aws I'w pC,tcAew ARt^ 17u,�,, e s k.,z b U11 s der i w R �4 � o �' 60 ►d., w S 0 ru t' (A -t P a Yep SD 1 Q A G.t 16. Describe location of grease storage receptacle v h 17. Is there an area to store recycled containers? 18. Is there any area to store returnable, damaged goods? X Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 12 of 20 D. PLUMBING CONNECTIONS The FDA Food code and plumbing requirements do not replace or supersede the MA State Plumbing Code, which also must be fully met; instead, it highlights potential hazardous circumstances and particular types of equipment common to food service operations that, if through improper design or installation, could result in contamination of food or water supply. Please indicate proposed properly installed equipment. Equipment Code Confirmed Describe/ Comments Requirements by Operator please initial Dish Machine Backflow prevention device I! I Indirect Waste Steam Jacketed Backflow prevention Kettle device I, wlr� Indirect Waste Steamer Backflow prevention device - - -- NIA I Indirect Waste Garbage Disposals Backflow prevention or dish table device troughs; Submerged inlets At all hose Backflow prevention connections device Garbage can Backflow prevention washer device YO Carbonated Carbonated Backflow beverage prevention device t f' a dispenser Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 13 of 20 I- -- Refrigerator Indirect Waste condensate/ drain lines !i Ice storage bins Indirect Waste nks - -- - AirGap- ----- - --- i I Cream dipper Air Gap r Townof North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- All si -- Ice wells Othe 19. Are floor drains provided & easily cleanable, if so, indicate location: AL,-apcC" E. WATER SUPPLY 20. Is water supply public ()0 or private ( ) ? 21. If private, has source been approved? YES () NO ( ) PENDING ( ) Please attach copy of written approval and/or permit. i 22. Is ice made on premises ( ) or purchased commercially ( )? A If made on premise, are specifications for the ice machine provided? YES () NO ( ) i Describe provision for ice scoop storage: Provide location of ice maker or bagging operation 23. What is the capacity of the hot water generator? 12-9— Fax: 978.688.8476 Page 14 of 20 24. Is the hot water generator sufficient for the needs of the establishment? Provide calculations for necessary hot water I25 25. Is there a water treatment device? YES ( ) NO (� If yes, how will the device be inspected & serviced? 26. How are backflow prevention devices inspected & serviced? ft F. SEWAGE DISPOSAL 27. Is building connected to a municipal sewer? 28. If no, is private disposal system approved? Please attach copy of written approval and/or permit. 29. Are grease traps provided? If so - where? YES ()4 NO( ) YES ( ) NO ( ) PENDING ( ) YES( ) NO (V Note: Grease Traps must have the following sign. The language in bold is specific; please do not change it in any way. If you have one or more interior grease traps please note the plumbing code 248 CMR 10.09 (m): 1. A laminated sign shall be stenciled on or in the immediate area of the grease trap or interceptor in letters one -inch high. The sign shall state the following in exact language: IMPORTANT This grease trap/interceptor shall be inspected and thoroughly cleaned on a regular and frequent basis. Failure to do so could result in damage to the piping system, and the municipal or private drainage system(s). G. DRESSING ROOMS 30. Are dressing rooms provided? �'5�A�F C h,l �" BPAp Cr_ YES (X) NO ( ) 31. Describe storage facilities for employees' personal belongings (i.e., purse, coats, boots, umbrellas,etc.) Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 15 of 20 H.GENERAL 32. Are insecticides/rodenticides stored separately from cleaning & sanitizing agents? YES ( ) NO (N4 Indicate location: (yo t rv5ec'b c,� e3 o 22. he e,ot i N 4-L P2 A��^^ 33. Are all toxics for use on the premise or for retail sale (this includes personal medications), stored away from food preparation and storage areas? YES (�() NO( ) 34. Are all containers of toxics including sanitizing spray bottles clearly labeled? YES() NO ( ) Note: Material Safety Data Sheets (MSDS) are required to be kept for all chemicals on the premises. Where will the MSDS information be kept on display for easy access in an emergency? 35. Will linens be laundered on site? If yes, what will be laundered and where? If no, how will linens be cleaned? QUJ si &- Vew&og 36. Is a laundry dryer available? 37. Location of clean linen storage: ALP, YES( ) NO (\4 YES( ) NO (-� 38. Location of dirty linen storage: 39. Are containers constructed of safe materials to store bulk food products? YES () NO () rU I A Indicate type: 40. Indicate all areas where exhaust hoods are installed: r LOCATION y + FILTERS WOR SQUARE FEET FIRE AIR CAPACITY EXTRACTION PROTECTION CFM DEVICES r Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 16 of 20 AIR MAKEUP CFM 41. How is each listed ventilation hood system cleaned? I. SINKS 42. Is a mop sink present? YES ()ONO ( ) If no, please describe facility for cleaning of mops and other equipment: 43. If the menu dictates, is a food preparation sink present? YES ( ) NO ( ) detail answer R11 G,,A,gdrn ,41s nov,nA.2-e o do k ' R.0 pn yo S2 ,ve., J. DISHWASHING FACILITIES 44. Will sinks or a dishwasher be used for warewashing? Dishwasher N Two compartment sink( ) Three compartment sink ( ) 45. Dishwasher j Type of sanitization used: Hot water (temp. provided) Booster heater Chemical type All Is ventilation provided? YES O NO (Xjl 46. Do all dish machines have templates with operating instructions? YES ()ONO ( ) 46. Do dish machines have temperature/pressure gauges as required that are accurate? YES (Y.) NO ( ) 48. Does the largest pot and pan fit into each compartment of the pot sink? YES ('14 NO ( ) If no, what is the procedure for manual cleaning and sanitizing? Poi 5 usaA a 1160V5e161A- SI2� Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, j North Andover, MA 0184S --Phone: 978.688.9S40-- Fax: 978.688.8476 Page 17 of 20 49. Are there drain boards on both ends of the pot sink? YES( )NO( ) 50. What type of sanitizer is used? d(Chlorine ❑Iodine ❑Quaternary ammonium at -lot Water ❑Other 0I�r 51. Are test papers and/or kits available for checking sanitizer concentration? YES ( ) NO (� K. HANDWASHING/TOILET FACILITIES 52. Is there a handwashing sink in each food preparation, cooking and warewashing area? YES M NO ( ) 53. Do all handwashing sinks, including those in the restrooms, have a mixing valve or combination faucet? YES ()� NO( ) 54. Do self-closing metering faucets provide a flow of water for at least 15 seconds without the need to reactivate the faucet? YES ( ) NO 55. Is hand cleanser available at all handwashing sinks? YES (�) NO ( ) 56. Are hand drying facilities (paper towels, air blowers, etc.) at all handwashing sinks? YES (,g NO ( ) 57. Are covered waste receptacles available in each restroom? YES (y) NO ( ) 58. Is hot and cold running water under pressure available at each handwashing sink? YES ()o NO ( ) 59. Are all toilet room doors self-closing? YES ( ) NO (y) 60. Are all toilet rooms equipped with adequate ventilation? YES (V) NO ( ) 61. Are handwashing signs and instructions posted in each employee restroom? YES ()6 NO ( ) Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 18 of 20 L. SMALL EQUIPMENT REQUIREMENTS 62. Please specify the number, location, and types of each of the following proposed for on site use: Slicers /1/ I a Cutting boards ok Can openers _ Mixers Floor mats Other STATEMENT: I hereby certify that the above information is correct, and I fully understand that any deviation from the above without prior permission from this Health Regulatory Office may nullify final approval. ,�-� 1 Signatirre(s) Print: owner(s) or responsible representative(s) Date: 1k 0 Approval of these plans and specifications by this Regulatory Authority does not indicate compliance with any other code, law or regulation that may be required --federal, state, or local. It further does not constitute endorsement or acceptance of the completed establishment (structure or equipment). A preconstruction inspection with equipment in place and a preopening inspection of the establishment will be necessary to determine if it complies with the local and state laws governing food service establishments. Page Last Updated: 10/27/2009 Town of North Andover, Health Department, 1600 Osgood Street, Building 20; Suite 2-36, North Andover, MA 01845 --Phone: 978.688.9540-- Fax: 978.688.8476 Page 19 of 20 OW, - --4-i Grant, Michele From: Sawyer, Susan Sent: Friday, March 18, 20119:58 AM To: 'Darcey Adams' Cc: Grant, Michele; 'Edward Holden'; DelleChiaie, Pamela Subject: FW: Spectrum NA Attachments: Spectrum Day Care plan approval 12.21.10.doc Hello Darcey, I wanted to recap discussions that took place yesterday and add some comments and reminders. - The building card has been signed off by our department and the issuance of the CO is in the Building Department's hands. Once the kitchen is cleaned and all contractor work is complete, food may be brought in as needed. The final inspection should be requested at minimum 48 hours before you need to permit to be active. It can be anytime before if you are ready, there is no need to wait until the 48 hours. If all is in place the permit will be issued. If not, we will return as soon as we are notified of any corrections made. I attached the letter again for reference. The approval letter provides a framework of things that will be looked for at the final inspection. The premise is that the kitchen should be ready to open. Please note that all refrigeration equipment must be at proper temperatures, w/ thermometers, and the dish machine should be ready for use. Sanitizer must be made. Sponges and steel wool are not allowed for use on food contact surfaces, therefore we recommend green scrubbing pads or something comparable of your choosing. Mops must be able to be hung to dry and I don't recall if that was in place during the last inspection. Lastly, the dumpster. You application notes a dumpster on a cement pad. This must be an enclosed area. Note that in the approval letter is the link for permitting if this is Spectrum's dumpster. If it is the complex's dumpster, please let us know so we may permit the proper applicant. Thank you Susan From: Sawyer, Susan Sent: Wednesday, March 16, 20113:06 PM To: Darcey Adams Cc: DelleChiaie, Pamela; Grant, Michele Subject: Spectrum NA Hi Darcey, As we move forward, I just wanted to remind you that your permit application was submitted back in the fall, but we will need $110 prior to scheduling the final inspection, payable to the "town of North Andover". Please speak with Pam if you have any questions about the annual permit. It will be good through December 31, 2011. Thank you Susan Sumas SIZwyn `J'aBP.ic Jteaffi Y)Iw " 16CC 06g"d Shed JV4 2U, wilt 2.36 ✓V"d Qndom,Ata 01845 aftim 978688-9540 fax 978 6884476 All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the [ http://www.sec.state.ma.us/pre/preidx.htm ]Massachusetts Public Records Law. Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. PUBLIC HEALTH DEPARTMENT (ommunity Development Division December 21, 2010 Darcey Adams L.I.C.S.W. Northeast Senior Health 600 Cummings Ctr. Suite 2752 Beverly, MA 01915 Re: Plan Approval - Spectrum Adult Day Health, 1820 Turnpike St. Dear Ms. Adams, The Health Department has completed the plan review of the new food establishment noted above. With the submission of plan changes and responses, dated December 7th and December 9th, 2010, the application has met the minimum standards of the Federal guidelines and state food code. The plan has been approved by the Health Department with the understanding that there is no variance request and all code requirements are being met including the drop-in sink from Advance Tabco, item #DL -3-10. Please be sure your contractor has the final approved kitchen plan including the sink specification. Once basic construction is complete and the equipment is in place, please have the contractor contact the health office for a construction inspection to verify that they have built it to plan. At that time we will; either leave you with a punch list of items to finish or sign off the building permit. Please do not bring in food to the establishment until given approval to do so. Once that is done, the final health inspection should be requested approximately 24-48 hours prior to preparing food or opening the establishment. At the final inspection, it is expected that the premises will be ready for business. Also, please make sure that all Health permit fees are paid. You have submitted your application but your Page 1 of 5 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Spectrum Day Care Plan Review Dec. 20, 2010 annual fee for a food establishment is $110 should be made payable to the "Town of North Andover". This fee covers the cost of the annual inspections and administrative duties. If you have a dumpster that your company is responsible for the permit application at can be found at http://www.townoffiorthandover.com/Pages/index and submitted with the appropriate fee. Please note that a final food inspection, at which time your food permit will be issued, will not be scheduled until all fees are paid to the Health Department. Some items needed to receive the permit to operate are: 1) The establishment will be clean of all construction materials 2) The handsink and bathroom will be stocked with a wall mounted paper towel and soap dispensers 3) The ladies room will have a covered trash can for feminine item disposal 4) Bathroom must have "employee must wash hands before returning to work" signage 5) All sinks should be labeled properly, "hand wash only", "wash", "rinse", "sanitize" etc. 6) There must be test strips for the Quaternary Ammonia sanitizer on site 7) Directions on mixing the sanitizer should be available. 8) Gloves must be on site. Please note that the state does not recommend the use of latex gloves due to some person's sensitivity to latex that may cause them illness. 9) At minimum, employees should be trained on the sick policy and sanitation basics. 10) Label grease trap per plumbing code If you have one or more interior grease traps please note the plumbing code 248 CMR 10.09 (m): 1. A laminated sign shall be stenciled on or in the immediate area of the grease trap or interceptor in letters one -inch high. The sign shall state the following in exact language: IMPORTANT This grease trap/interceptor shall be inspected and thoroughly cleaned on a regular and frequent basis. Failure to do so could result in damage to the piping system, and the municipal or private drainage system(s). We look forward to working with you in the opening of this establishment and its successful operation in North Andover. Please contact the Health Department if you have any questions regarding this approval. Sincerely, Susan Sawyer, REHS/RS Public Health Director Cc: Mark Rees, Town Manager Curt Bellavance, Community Development Dir. Page 2 of 5 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Spectrum Day Care Plan Review Dec. 20, 2010 Gerald Brown, Inspector of Buildings Board of Health Chairman and Members Gerald Brown, Inspector of Buildings Edward Holden, System Facilities Director for Northeast Health System Items of Deficiency noted in plan review Code ref. Corrective Action Plan does not address the issue of the free flowing of 2-103.11(B) Please address Health clients into the kitchen area during food service. concerns regarding the There is also no description of how the food in the allowance of refrigerators and cabinets is protected from "unnecessary persons" in unauthorized persons in the "participatory" style the area during food kitchen. Code states Persons unnecessary to the food service. Also, please preparation, storage or warewashing areas address the allowance of establishment operation are not allowed in the food free access of clients to areas except for brief tours etc. all cabinets, utensils, refrigeration and cooking equipment etc. Policy put in place "staff members only allowed in kitchen area during food service" see letter from Spectrum. Page 6 #4 description does not fully follow state food 590.003 (D) The Highly susceptible code recommendations "Any staff member showing (3) (a) populations require signs of illness will not be allowed to serve food to exclusions in certain program members". Please review policy for sick cases. Please submit a workers. sick policy noting this. OK see letter Page 7 #5 a multi surface cleaner cannot be used on food FC4-501.114 Identify type of sanitizer contact surfaces. The food code allows for bleach, and change test strips to quaternary ammonia or iodine to be used. Also a test kit "yes" OK for the chosen sanitizer must be on site at all times. Page 7 description of cleaning and sanitizer is incomplete. Please elaborate on process "food -service grade sanitizer" This statement does not OK describe a procedure Page 7 #8 minimizing length of time PHF's are in the No action needed danger zone Answer should describe process ie. that hot foods will arrive and be tested. If temp is not above 140 either the food will be reheated to 165 degrees or served immediately. If cold foods arrive not less than 41 degrees, they will be served immediately or cooled immediately. Page 8 #12 measures taken listed do not indicate level of FC 3-801.11 The Highly susceptible Page 3 of 5 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 St)ectrum Day Care Plan Review Dec. 20, 2010 care for high risk populations. ie. no re -service of populations require unopened packages such as butter, ketchup, creamers etc. compliance with this section. Please review and revise answer OK Page 10 finish schedule not specific as requested on form. FC chapter Please direct questions with Ie. all splash zones are not washable durable surfaces. 6 Health Dept and revise as Ceilings over food service areas are not washable tiles. needed Coving not stated as curved base, usually vinyl. Please see attached "finish schedule" noting The ware washing area is the area around the 3 bay sink. It acceptable finishes per is not N/A FDA guidelines. Changes acceptable Page 13 requests the plumbing boxes be initialed. Often Please have plumber initial the plumber can complete this for the applicant if you are as requested to ensure not sure. This is a confirmation only. compliance to code Not received. Forth coming Page 15 #29 no grease trap. The plumbing code may or Plumbing Investigate and confirm that may not require one with the three -bay sink. Please code inspector does not require a confirm with plumbing inspector grease trap per plumbing insp. If required please submit spec sheet for rease tra MSDS sheets are not submitted with application. If all Please submit copies for our chemicals are not chosen to date, please submit when able files OK Page 18 — NO checked on test strips FC 4-302.14 Please change to yes OK Equipment No three bay sink. Only 2 -bay shown. We concur with 4-301.12 Please revise as a three -bay Sullivan Eng. That the MA Code allows for 2 bay if (D)(1) or submit a request in allowed. This allowance can be approved by variance by writing to address the BOH the Board of Health, if when presented, the Board deems it at a scheduled mtg. 3 -bay appropriate for this application. being installed. OK Dish machine spec sheet says either hot water with booster Please specify machine type or chemical. OK Location of handsink may not be accessible by all parties 5203.11 Provide safety and in the kitchen. Possible safety issue. Located very close to Please adequate hand wash stove. check with facility OK building dept Microwave installation instructions submitted. No unit Please submit spec sheets specifications found in packet. for NSF UL rated equipment OK. However be sure other depts. are ok with type of venting. If a vent is provided, no vent information Please Please inform Health check with with details OK building Page 4 of 5 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Spectrum Day Care Plan Review Dec. 20, 2010 Page 5 of 5 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 dept. No specification sheets for sinks. NA includes sinks in the category of equipment Please submit specification sheets Pending OK *** Page 5 of 5 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 DelleChiaie, Pamela From: Sawyer, Susan Sent: Wednesday, March 16, 20113:58 PM To: DelleChiaie, Pamela Subject: RE: Spectrum NA I beli I correct on that But be careful to put the name not as a day care. It is "Spectrum Adult Day Health" their permit must indicate this for grant funding purposes. I guess with Geo you may need a new category to do this. / thx From: DelleChiaie, Pamela Sent: Wednesday, March 16, 20113:39 PM To: Sawyer, Susan Cc: Grant, Michele Subject: RE: Spectrum NA The fee is for $195.00 for Healthcare over 50. Sea Rqai4, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 9 Office - 978-688-9540 0 Fax - 978-688-8476 Eil Email - udellechiaie(@townofnorthandover.com �b Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "--Anonymous From: Sawyer, Susan Sent: Wednesday, March 16, 20113:06 PM To: Darcey Adams Cc: DelleChiaie, Pamela; Grant, Michele Subject: Spectrum NA Hi Darcey, As we move forward, I just wanted to remind you that your permit application was submitted back in the fall, but we will need $110 prior to scheduling the final inspection, payable to the "town of North Andover". Please speak with Pam if you have any questions about the annual permit. It will be good through December 31, 2011. Thank you Susan Stmatz Sawyn Yub& 3fea tPe. 0kecton 16CC Uagoad Stud 2t4 2C, unit 2-36 .No4& Qndoueu, .Ma 01845 oglce 978 688-9540 DelleChiaie, Pamela Subject: spectrum final insp Start: Tue 3/29/2011 12:30 PM End: Tue 3/29/2011 1:30 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: Sawyer, Susan Required Attendees: Grant, Michele; DelleChiaie, Pamela Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 2 Office - 978-688-9540 Fax - 978-688-8476 Email - pdellechiaie(@townofnorthandover.com �JL Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "--Anonymous From: Sawyer, Susan Sent: Monday, March 28, 20119:23 AM To: Sawyer, Susan; 'Sherrill O'Gorman'; 'Cheryl Wall'; 'Darcey Adams'; 'Dianne Perry'; 'Edward Holden' Cc: DelleChiaie, Pamela; Grant, Michele Subject: permit info and Final BOH Inspection -Spectrum North Andover Pam, Please note for the Spectrum file that on Friday Sherril informed me that they are not having a dumpster of their own and that the building owner will be responsible. Hence you will be receiving a single check as the application is already in the file. Has the $110 come in for spectrum, so that we may confirm the tentative inspection for tomorrow? If not, please let me know when it does. I will find the building owner's contact information and provide him the information on the annual permit. Thank you, Susan From: Sawyer, Susan Sent: Thursday, March 24, 20113:46 PM To: 'Sherrill O'Gorman'; Cheryl Wall; Darcey Adams; Dianne Perry; Edward Holden Cc: DelleChiaie, Pamela; Grant, Michele Subject: RE: Final BOH Inspection -Spectrum North Andover Thank you Sherril, As I just mentioned on the phone, I did not realize that the permit fees have not been paid yet. This is required to be done prior to scheduling this appointment, however I will keep the date and time as a tentative appointment, and confirm when the fees are paid. If you are permitting a dumpster there is a $60 fee and the application is on our website, and the annual food establishment fee is $110. If applicable, two checks made out to the "town of north Andover" would be appreciated for our accounting procedure. Thank you, Susan Sawyer From: Sherrill O'Gorman [mailto:SOGORMAN@nhs-healthlink.org] Sent: Thursday, March 24, 20113:32 PM To: Cheryl Wall; Darcey Adams; Dianne Perry; Edward Holden; Sawyer, Susan Subject: Final BOH Inspection -Spectrum North Andover Importance: High Hello All, I have just confirmed the final Board of Health inspection with Susan Sawyer for Tuesday, 3/29/11 at 12:30. Please confirm, and advise if further information is needed prior. Regards, Sherrill O'Gorman �O Administrative Assistant for Community Programs Northeast Senior Health 600 Cummings Center Suite 275 Z Beverly MA 01915 978-921-1697 ext. 213 978-921-1624 fax sogorman@nhs-healthlink.org This message and its contents are confidential and are intended for the use of the addressee only, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the intended recipient, this serves as notice that any unauthorized distribution, duplication, printing, or any other use is strictly prohibited. If you feel you have received this email in error, please delete the message and notify the sender so that we may prevent future occurrences. Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. This message and its contents are confidential and are intended for the use of the addressee only, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the intended recipient, this serves as notice that any unauthorized distribution, duplication, printing, or PUBLIC HEALTH DEPARTMENT (ommunity Development Division November 23, 2010 Darcey Adams L.I.C.S.W. Northeast Senior Health 600 Cummings Ctr. Suite 2752 Beverly, MA 01915 Re: Plan Review - Spectrum Adult Day Care, 1820 Turnpike St. Dear Ms. Adams, The Health Department received your completed application submitted for the new food establishment to be known as "Spectrum Adult Day Care" on November 10, 2010. Acting under the authority of MGL Ch. 111, s. 127A, the office of the Board of Health reviewed these plans to determine whether or not the proposed remodeling complies with the 1999 FDA Food Code as revised by Chapter 10 of the State Sanitary Code, 105 CMR 590.000, Minimum Sanitation Standards for Food Establishments. This office is unable to grant its approval of these plans because the proposed construction does not comply with the above cited code. Please refer to the items listed below for those specific items which are not in compliance. The professional document submitted by R.W. Sullivan Engineering has been reviewed as well. We concur with the premise that a two - bay sink is allowed if approved, the need for a grease trap is determined by the Plumbing Inspector and the slop sink placement in the janitor closet is appropriate. Please review the items below and revise as needed and resubmit to the Health Department. Once received, a second review will be conducted and response will be sent to you in hopes to move forward as soon as possible. If the choice is to request a variance in any specific item please note that the next regularly scheduled meeting will be held on December 18, 2010. To be on the agenda, a request must be received at the Health Department by December Page 1 of 4 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Spectrum Day Care Plan Review Nov. 23, 2010 Stn The Board of Health will be provided copies of your submission and you may address the need for the variance. Please be aware that this until an approval letter is generated in this matter, the building permit application can not be signed by this office. Also note that once approval is received, the establishment will not be permitted to operate until it is in full compliance with 105 CMR 590.000. Under section 105 CMR 590.15(B) of the Food Code, you are entitled to a hearing in this matter. Written request for such a hearing must be received by this office within ten days of receipt of this letter. Thank you for your continued cooperation. We look forward to working with you on this project and in the future. 7Since , I- an Sawye , REHS/RS Public Health Director Cc: Curt Bellavance, Community Dev. Dir. Gerald Brown, Inspector of Buildings Dr Thomas Trowbridge, BOH Chairman Michael J. Moore, R.S., Rapid Response Team Project Coordinator MDPH/BEH Food Protection Program 305 South St., Jamaica Plain, MA 02130 phone: 617-983-6754 fax: 617-983-6770 Encl. 3- page Sample Finish Schedule- excerpt from FDA plan review guide Items of Deficiency noted in plan review Code ref. Corrective Action Plan does not address the issue of the free flowing of 2-103.11(B) Please address Health clients into the kitchen area during food service. concerns regarding the There is also no description of how the food in the allowance of refrigerators and cabinets is protected from "unnecessary persons" in unauthorized persons in the "participatory" style the area during food kitchen. Code states Persons unnecessary to the food service. Also, please preparation, storage or warewashing areas address the allowance of establishment operation are not allowed in the food free access of clients to areas except for brief tours etc. all cabinets, utensils, refrigeration and cooking equipment etc. Page 6 #4 description does not fully follow state food 590.003 (D) The Highly susceptible code recommendations "Any staff member showing (3) (a) populations require signs of illness will not be allowed to serve food to exclusions in certain program members". Please review policy for sick cases. Please submit a Page 2 of 4 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Spectrum Dav Care Plan Review Nov. 212010 workers. sick policy noting this. Page 7 #5 a multi surface cleaner cannot be used on food FC4-501.114 Identify type of sanitizer contact surfaces. The food code allows for bleach, and change test strips to quaternary ammonia or iodine to be used. Also a test kit "yes" for the chosen sanitizer must be on site at all times. Page 7 description of cleaning and sanitizer is incomplete. Please elaborate on process "food -service grade sanitizer" This statement does not describe a procedure Page 7 48 minimizing length of time PHF's are in the No action needed danger zone Answer should describe process ie. that hot foods will arrive and be tested. 1f -temp -is -not above --1-40 either the food will be reheated to 165 degrees or served immediately. If cold foods arrive not less than 41 degrees, they will be served immediately or cooled immediately. Page 8 #12 measures taken listed do not indicate level of FC 3-801.11 The Highly susceptible care for high risk populations. ie. no re -service of populations require unopened packages such as butter, ketchup, creamers etc. compliance with this section. Please review and revise answer Page 10 finish schedule not specific as requested on form. FC chapter Please direct questions with Ie. all splash zones are not washable durable surfaces. 6 Health Dept and revise as Ceilings over food service areas are not washable tiles. needed Coving not stated as curved base, usually vinyl. Please see attached "finish schedule" noting The ware washing area is the area around the 3 bay sink. It acceptable finishes per is not N/A FDA guidelines. Please revise Page 13 requests the plumbing boxes be initialed. Often Please have plumber initial the plumber can complete this for the applicant if you are as requested to ensure not sure. This is a confirmation only. compliance to code Page 15 #29 no grease trap. The plumbing code may or Plumbing Investigate and confirm that may not require one with the three -bay sink. Please code inspector does not require a confirm with plumbing inspector grease trap MSDS sheets are not submitted with application. If all Please submit copies for our chemicals are not chosen to date, please submit when able files Page 18 — NO checked on test strips FC 4-302.14 Please change to yes Equipment No three bay sink. Only 2 -bay shown. We concur with 4-301.12 Please revise as a three -bay Sullivan Eng. That the MA Code allows for 2 bay if (D)(1) or submit a request in allowed. This allowance can be approved by variance by writing to address the BOH the Board of Health, if when presented, the Board deems it at a scheduled mtg. appropriate for this application. Dish machinespec sheet says either hot water with booster Please specify machine type Page 3 of 4 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Spectrum Dav Care Plan Review Nov. 23 2010 or chemical. Location of handsink may not be accessible by all parties 5203.11 Provide safety and in the kitchen. Possible safety issue. Located very close to Please adequate hand wash stove. check with facility building dept Microwave installation instructions submitted. No unit Please submit spec sheets specifications found in packet. for NSF UL rated equipment If a vent is provided, no vent information Please Please inform Health check with with details ------------- ------ ----building — dept. No specification sheets for sinks. NA includes sinks in the category of equipment Please submit specification sheets Page 4 of 4 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 FM U.S. Food and Drug administration Home> Food> Food Safety> Retail Food Protection Food Food Establishment Plan Review Guide - Section III, Part 10 Food and Drug Administration and Conference for Food Protection —2n0Q—__--- — _—---- - — SECTION III FOOD ESTABLISHMENT GUIDE FOR DESIGN, INSTALLATION, AND CONSTRUCTION RECOMMENDATIONS PART 10 - FINISH SCHEDULE The following chart and footnotes provide acceptable finishes for floors, walls and ceilings, by area: FLOOR WALL CEILING KITCHEN Fiberglass Reinforced Polyester sheetrock COOKING Quarry tile, poured Stainless steel; aluminum; Ceramic Plastic coated or metal seamless, sealed concrete the clad fiberboard; Dry-wa epoxy, Glazed surface; OTHER STORAGE Same as above Plastic laminate FOOD PREP Same as above plus Same as above plus approved wall Same as above commercial grade vinyl panels (FRP) Fiberglass Reinforced Fiberglass Reinforced Polyester composition tile. Polyester Panel; epoxy painted Panel; epoxy painted drywall; filled with epoxy; glazed drywall; filled block with epoxy paint block with epoxy paint or glazed surface; plastic Iaminat( or glazed surface BAR Same as above Same as above for areas behind Meets building codes sinks FOOD STORAGE Same as above plus Approved wall panels (FRP) Acoustic tile; painted sealed concrete, Fiberglass Reinforced Polyester sheetrock commercial grade vinyl Panel; epoxy painted drywall; filled composition tile or sheets block with epoxy paint or glazed surface OTHER STORAGE Same as above Painted sheetrock Same as above TOILET ROOM Quarry tile; poured sealed Approved wall panels (FRP) Plastic coated or metal concrete; commercial Fiberglass Reinforced Polyester clad fiberboard; drywall grade vinyl composition Panel; epoxy painted drywall; filled with epoxy; glazed file or sheets block with epoxy paint or glazed surface; plastic Iaminat( surface DRESSING ROOMS Same as above Painted sheetrock GARBAGE & REFUSE Quarry tile; poured Approved wall panels (FRP) AREAS (Interiors seamless, sealed Fiberglass Reinforced Polyester concrete; commercial Panel; epoxy painted drywall; filled grade vinyl composition block with epoxy paint or glazed tile or sheets surface MOP SERVICE AREA Quarry tile; poured Same as above seamless sealed concrete Same as above plus painted sheetrock Plastic coated or metal clad fiberboard; drywall with epoxy; glazed surface; plastic laminat( Same as above http://www. fda.gov/Food/FoodSafety/RetailFoodProtectionIComplianceEnforcementluc... 11/22/2010 WAREWASHING Same as above plus Stainless steel; aluminum; approved Same as above AREA commercial grade vinyl wall panels (FRP) Fiberglass composition tile Reinforced Polyester Panel; epoxy painted drywall; filled block with epoxy paint or glazed surface WALK-IN Quarry tile; stainless Aluminum; stainless steel; enamel Aluminum; stainless REFRIGERATORS & steel; poured sealed coated steel (or other corrosion steel; enamel coated FREEZERS concrete; poured resistant material) steel (or other corrosion synthetic resistant material) Notes: FLOORS 1. All floor cc�verjrn_gs In food_pr_ep3ration,J_ood_stor_age,_utensil_washing-areas,--walk i-n-re-fxige-ration units—,----- dressing nits,------ dressing rooms, locker rooms, toilet rooms and vestibules must be smooth, non-absorbent, easily cleanable and durable. Anti -slip floor covering may be used in high traffic areas only. 2. Any alternate materials not listed in the above chart must be submitted for evaluation. 3. There must be coving at base junctures that is compatible to both wall and floor coverings; recommended to provide at least 1/4 inch radius and 4" in height. See figure #10-1. 4. Properly installed, trapped floor drains shall be provided in floors that are waterflushed for cleaning or that receive discharges of water or other fluid waste from equipment or in areas where pressure spray methods for cleaning equipment are used. Floors should be sloped to the drain at least 1/8" per foot. 5. Grouting should be non-absorbent and impregnated with epoxy, silicone or polyurethane. 6. All walk-in refrigeration units both with prefabricated floors and without, should be installed in accordance with the manufacturer's installation requirements. WALLS 1. The walls, including non -supporting partitions, wall coverings and ceilings of walk-in refrigerating units, food preparation areas, equipment washing and utensil washing areas, toilet rooms and vestibules shall be smooth, non-absorbent, and capable of withstanding repeated washing. Light colors are recommended for walls and ceilings. Studs, joists and rafters shall not be exposed in walk-in refrigeration units, food preparation areas, equipment washing and utensil washing areas, toilet rooms and vestibules. Where permitted to be exposed, studs, joists and rafters must be finished to provide an easily cleanable surface. 2. All alternate materials not listed in the above chart must be submitted for evaluation. 3. Glazed surfaces should be glazed block, or brick or ceramic tile. Grouting must be non-absorbent and impregnated with epoxy, silicone, polyurethane or an equivalent compound. Concrete block, if used, must be rendered non -porous and smooth by the application of an approved block filler followed by the application of an epoxy -type covering or equivalent. All mortar joints shall be only slightly tooled and suitably finished to render them easily cleanable. 4. Plastic laminated panels may find applications but are not recommended. Joint finishes should be compatible with the wall structure. Voids should be eliminated at joints. CEILINGS Finishes shall be light-colored, smooth, non-absorbent and easily cleanable. Acoustical material free of porous cloth or sponge may be used, provided ventilation is adequate to minimize soiling. http://www. fda.gov/Food/FoodSafety/RetailFoodProtectionIComplianceEnforcementluc... 11/22/2010 pull lit mile /IUIt71t"IItdtU#IISO I"Ut11Nei Ih7•UJiiMII t � • Gverharicg 9" - 4" 1 I Silicone : Coring At Base Junctures Figure #10-1 Links on this page: http://www.fda.gov/Food/FoodSafety/RetailFoodProtectionIComplianceEnforcementluc... 11/22/2010