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HomeMy WebLinkAboutFood Est - Sam's - Routine - Inspection - 12 MASSACHUSETTS AVENUE 3/25/2021 R-10 FOOD ESTABLISHMENT INSPECTION REPORT North NIA 0 1 tt Inspection Number Date Time In/Out Inspection Type Client Type Inspector Sam's Mobil Mart 16FB2 3/25/21 9:26 PM Routine Retail M.Baldwin 12 Massachusetts Avenue 9:31 PM North Andover, MA 01845 Permit Number Risk Variance Priority Pf Core Repeat Violation Summary: 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 Protection from Contamination(Cont'd) IN OUT NA NO COE 1.PIC present,demonstrates knowledge,and performs duties 15.Food separated and protected 2. Certified Food Protection Manager 16.Food-contact surfaces;cleaned&sanitized Employee Health IN OUT NA NO COS 17.Proper disposition of returned,previously served, J 3. Management,food employee and conditional employee knowledge,responsibilities and reporting Time/Temperature Control for Safety IN OUT NA NO CO� 4. Proper use of restriction and exclusion 18.Proper cooking time&temperatures 5. Procedures for responding to vomiting and diarrheal events 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 �/ 21.Proper hot holding temperatures 7. No discharge from eyes,nose,and mouth 22.Proper cold holding temperatures Preventing Contamination by Hands IN OUT NA NO COS 23.Proper date marking and disposition 8. Hands clean&properly washed 24.Time as a Public Health Control;procedures&records � 9. No bare hand contact with RTE food or apre-approved Consumer Advisory IN OUT NA NO COS 10.Adequate handwashing sinks supplied and accessible 25.Consumer advisory provided for raw/undercooked food Approved Source IN OUT NA NO COS Highly Susceptible Populations IN OUT NA NO CO� 11.Food obtained from approved source 26.Pasteurized foods used;prohibited foods not offered 12.Food received at proper temperature Food/Color Additives and Toxic Substances IN OUT NA NO COS 13.Food in good condition,safe&unadulterated 27.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 COE Repeat Violations Highlighted in Yellow 29.Compliance with variance/specialized process/HACCP Safe Food and Water IN OUT NA NO COS Proper Use of Utensils IN OUT NA NO COE- 30.Pasteurized eggs used where required 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 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. Utensils, 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 Follow Up Required: Y Follow Up Date: M.Baldwin Ian-Expires Certificate#: R-10 Page Number FOOD SAFETY INSPECTION REPORT 2 Sam's Mobil Mart Inspection Number Date Time In/Out Inspector 12 Massachusetts Avenue 16FB2 3/25/21 9:26 PM M.Baldwin North Andover, MA 01845 9:31 PM ` Repeat Violations Highlighted in Yellow 98 - - Mask and social distancing signage is posted. j 1 I1III `0 1 i /„SIY i4DYnirtwA;�lu� I II uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu Town of North Andover- Health Department R-10 Page Number FOOD SAFETY INSPECTION REPORT 3 Sam's Mobil Mart Inspection Number Date Time In/Out Inspector 12 Massachusetts Avenue 16FB2 3/25/21 9:26 PM M.Baldwin North Andover, MA 01845 9:31 PM ` Repeat Violations Highlighted in Yellow 98 - - fw"(D f w� u o e w �J i v MII 1 r f r lJ ymJ y a rr y,w oX y y td�r"u4 Products observed to be within their sell b date y �YIrll ,, �; l y - ill/ ' a �r i / Olrr�i{ll/ yl¢ ,n a ��r « r,(� w r l � ne OD f,.� I»�l�fvr Q i"r'l�j�Y lu� o�wx�„rJ I�rrj�IU�x�r1 WN ivrrtr�il1f *I'x i%ir w'Wmf rlr 'uJw rll Y�I r �I OX1 Lp r 0 nN=l r`Ic'r r gir'%Illp�rr r/�v11U rf"r7 vl d I IM'� f✓/Pf?�rl I rrh6 W�, �!I J�v �f� 'r'�„ �1 it r NI� °IJ% a�lfl (U' ul�1 61, ;� ���J��r✓ I i ii�Iw�rr my���'"' /� f x kfii v'iwRl6r lui'au v�Pia,,/^� , o xuVl r r wolfilVro, bd n 111� M ,IN- h �V'ti I �V 1�V�rV�Q n Well Ynh,�rrlo�r1Wr�JIIVI'��A pl��/rl���w sran� ��� VC�I�itiIM-Id°� % Y drM�kNNNI N Nf 41yN � ur�ir lop rwrws' 4 n �mwrvNf o ri A /!/ffu �IrJ1 ',r �/r/r� if f r�1 r�r toFT 1W)M OWN r �r I '�1� ioi III Ix, 0 I 1 98 - - Chips appear wholesome and within their sell by date. - / � 1, H;�/ qrx IIIIIII I U rni rr r r � 1 IJI/ j" II 11 -C All A I n _ A 1 4- A A I r1_ A I—-& n L....� ,....J Town of North Andover- Health Department R-10 Page Number FOOD SAFETY INSPECTION REPORT 4 Sam's Mobil Mart Inspection Number Date Time In/Out Inspector 12 Massachusetts Avenue 16FB2 3/25/21 9:26 PM M.Baldwin North Andover, MA 01845 9:31 PM ` Repeat Violations Highlighted in Yellow IN= In Compliance ou1,,,,,,, = Out of Compliance NA= Not Applicable NO= Not Observed Permit up to date and posted? IN Staff wearing face coverings? IN Employees covid screened on each shift? IN Frequently touched surfaces regularly disinfected? IN Social distancing measures in place throughout establishment? IN Area Equipment Product Notes Temps Establishment Walk in Refrigerator Ambient 41 OF Establishment Freezer Ambient -2°F Temperatures in RED identify items in the temperature danger zone. See the report notes for specific details. lilli'l MEN 11 IN, Routine on site inspection reveals- Still no prepared coffee or foods being sold. Only prepackaged items sold at this time. Plexiglass up at counter `own of North Andover- Health Department