HomeMy WebLinkAboutSam's Mobil Mart - Food Est Inspection Report - Inspection - 12 MASSACHUSETTS AVENUE 1/27/2020 3
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120MainSirmt FOOD ESTAB HMENT INSPECTION REPORT
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Inspection Number Date ITime In/Out Inspection Type Client Type Inspector
Sam's Mobil Mart 6224E 1/27/20 4 10:47 AM Routine Retail M.Baldwin
12 Massachusetts Avenue 10:59 AM
North Andover, MA 01845 Permit Number Person In Charge Variance Priority Priority f Core
Ian 1 1 0
Foodborne Illness Risk Factors and Public Health Interventions
IN=in compliance OUT=out of compliance N/O=not observed N/A=not applicable COS=corrected on-site during inspection Repeat Violations Highlited in Yellow
Supervision IN OUT NA NO COS I Protection from Contamination Cont'd IN OUT NA NO CO:
1.PIC present,demonstrates knowledge,and performs duties V 15.Food separated and protected V
2. Certified Food Protection Manager V 16.Food-contact surfaces;cleaned&sanitized 1
Employee Health IN OUT NA NO QQS 17.Proper disposition of returned,previously served, J
3. Management,food employee and conditional employee
knowledge,responsibilities and reporting V Time/Temperature Control for Safety IN OUT NA NO CO:
4. Proper use of restriction and exclusion V 18.Proper cooking time&temperatures V
5. Procedures for responding to vomiting and diarrhea[events V 19.Proper reheating procedures for hot holding
Good Hygienic Practices IN OUT NA NO COS 20.Proper cooling time and temperature
6.Proper eating,tasting,drinking,or tobacco use V 21.Proper hot holding temperatures V
7. No discharge from eyes,nose,and mouth
22.Proper cold holding temperatures V
Preventing Contamination by Hands IN OUT NA NO COS 23.Proper date marking and disposition
8. Hands clean&properly washed V
24.Time as a Public Health Control;procedures&records V
9. No bare hand contact with RTE food or a pre-approved V Consumer Advisory IN OUT NA NO CO:
10.Adequate handwashing sinks supplied and accessible V 25.Consumer advisory provided for raw/undercooked food V
Approved Source IN OUT NA NO COS Highly Susceptible Populations IN OUT NA NO CO;
11.Food obtained from approved source 1 26.Pasteurized foods used;prohibited foods not offered V
12.Food received at proper temperature V Food/Color Additives and Toxic Substances IN OUT NA NO Cos
13.Food in good condition,safe&unadulterated V27.Food additives:approved&properly used
14.Required records available:shellstock tags,parasite 28.Toxic substances properly identified,stored&used
Conformance with Approved Procedures IN OUT NA NO CO:
Repeat Violations Highlighted in Yellow 29.Compliance with variance/specialized process/HACCP V
... Retail Practices
Safe Food and Water IN OUT NA NO COS Proper Use of Utensils IN OUT NA NO CO:
30.Pasteurized eggs used where required V 43.In-use utensils:properly stored
31.Water&ice from approved source 44.Utensils,equip.&linens:property stored,dried&handled
32.Variance obtained for specialized processing methods V 45.Single-use/single-service articles:properly stored&used
Food Temperature Control IN OUT NA NO COS 46.Gloves used properly
33.Proper cooling methods used;adequate equip.for temp. VUtensils,Equipment and Vending IN OUT NA NO COS
47.All contact surfaces cleanable,properly designed,
34.Plant food properly cooked for hot holding
35. Approved thawing methods used 48. Warewashinq facilities:installed,maintained&used;test
49. Non-food contact surfaces clean
36. Thermometers provided&accurate
Physical Facilities IN OUT NA NO COS
Food Identification IN OUT NA NO COS 50.Hot&cold water available;adequate pressure
37.Food properly labeled;original container
51.Plumbing installed;proper backflow devices
Prevention of Food Contamination IN OUT NA NO COS 52.Sewage&waste water properly disposed
38.Insects,rodents&animals not present 53.Toilet facilities:properly constructed,supplied,&cleaned
39.Contamination prevented in prep,storage&display 54.Garbage&refuse properly disposed;facilities maintained
40.Personal cleanliness
55.Physical facilities installed,maintained&clean
41.Wiping cloths;properly used&stored
56.Adequate ventilation&lighting;designated areas use
42.Washing fruits&vegetables
60.105 CMR 590 violations/local regulations
Official Order for Correction:Based on an inspection today,the items marked"OUT"indicated violations of 105 CMR 590.000 and applicable sections of the 2013 FDA Food Code.
This report,when signed below by a Board of Health member or its agent constitutes an order of the Board of Health.Failure to correct violations cited in this report may result in
suspension or revocation of the food establishment permit and cessationf
o food establishment operations.If you are subject to a notice of suspension,revocation,or non-renewal
ZL _�' !wio Follow Up Required: Y Follow Up Date:
Inspector PIC
Town of North Andover- Health Department
R-10 FOOD SAFETY INSPECTION REPORT p�9eNumber
2
Sam's Mobil Mart Inspection Number Date Time In/Out Inspector
12 Massachusetts Avenue 6224E 1/27/20 10:47 AM M.Baldwin
North Andover, MA 01845 10:59 AM
Inspection • •rt (Continued) Repeat Violations Highlighted in Yellow
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Approved Source
Food obtained from approved source
11 3-201.11 (C) Compliance with Food Law- -
Pf Cake exp date 11/25. PIC removed. Code:Packaged food shall be labeled in accordance with applicable
law and as specified under FC 3-202.17 and FC 3-202.18.
Protection From Contamination
Town of North Andover- Health Department
R-10 FOOD SAFETY INSPECTION REPORT P�9eNumber
3
Sam's Mobil Mart Inspection Number Date Time In/Out Inspector
12 Massachusetts Avenue
North Andover, MA 01845 6224E 1/27/20 10:47 AM M.Baldwin
10:59 AM
Inspection - • •rt (Continued) Repeat Violations Highlighted in Yellow
Food-contact surfaces, cleaned & sanitized
16 4-501.114(A)-(E)Chem.San. Temp./pH/Concentr./Hard. - -
Pr Provide sanitizer test strips for sanitizer. Code:A chemical sanitizer used in a sanitizing solution shall be
used in accordance with the EPA-registered label use instructions. A chlorine solution shall have a
temperature of 55°F-120°F, depending on water hardness, and concentration range of 25ppm to 100ppm.
An iodine solution shall have a minimum temperature of 68°F with a concentration range of 12.5ppm to
25ppm. A quaternary ammonium compound solution shall have a minimum temperature of 75°F and be
used according to the manufacturer's use directions.
Check List
IN= In Compliance OUT = Out of Compliance NA= Not Applicable NO= Not Observed
Permit up to date and posted? IN
Town of North Andover- Health Department
Y
R-10 FOOD SAFETY INSPECTION REPORT P�9eNumber
4
Sam's Mobil Mart Inspection Number Date Time In/Out Inspector
12 Massachusetts Avenue 6224E 1/27/20 10:47 AM M.Baldwin
North Andover, MA 01845 10:59 AM
Inspection • •rt (Continued) Repeat Violations Highlighted in Yellow
Temperatures
Area Equipment Product Notes Temps
Temperatures in RED identify items in the temperature danger zone. See the report notes for specific details.
Coffee pots washed rinsed and sanitized daily.
Town of North Andover- Health Department