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Home My WebLink AboutSam's Mobil Mart - Routine - Food Est - Inspection - 12 MASSACHUSETTS AVENUE 8/11/2021 R-10 &orthAmlowr II`althDept.120%4iti S,ct FOOD ESTABLISHMENT INSPECTION REPORT \ono Andokcr,k1A 0 18 15 Inspection Number Date Time In/Out Inspection Type Client Type Inspector Sam's Mobil Mart 1374135 8/11/21 1:32 PM Routine Retail M.Baldwin 12 Massachusetts Avenue 1:47 PM North Andover, MA 01845 Permit Number Risk Variance Rating Score Priority Pf Core Repeat 0 0 2 ... ! 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 CO: 1.PIC present,demonstrates knowledge,and performs duties ,/ 15.Food separated and protected V 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 V 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 V 6.Proper eating,tasting,drinking,or tobacco use V21.Proper hot holding temperatures 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 24.Time as a Public Health Control;procedures&records � 9. No bare hand contact with RTE food or a pre-approved ,� Consumer Advisory IN OUT NA NO COE 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 V26.Pasteurized foods used;prohibited foods not offered 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 V28.Toxic substances properly identified,stored&used Conformance with Approved Procedures IN OUT NA NO CO: 29.Com liance with variance/s variance/specialized rocess/HACCP In Yellow p p p ......................Repeat..V.�.�.�.ati.�.n.S...H...g.h.�...g.htea................................... .............................. .. ... 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 ,t 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 2 V1 41.Wiping cloths;properly used&stored 56.Adequate ventilation&lighting;designated areas use 42.Washing fruits&vegetables J ZLFollow Up Required: Y Follow Up Date: M.Baldwin Ian-Expires Certificate#: R-10 Page Numbe FOOD SAFETY INSPECTION REPORT 2 Sam's Mobil Mart Inspection Number Date Time I n/Out Inspector 12 Massachusetts Avenue - North Andover, MA 01845 1374135 8/11/21 1:32 PM M.Baldwin 1:47 PM I'M IN IN i Repeat Violations Highlighted in NEW., 98 All products have labels- Physical Facilities Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT P�9eNumber 3 Sams Mobil Mart Inspection Number Date Time In/Out Inspector 12 Massachusetts Avenue B74B5 8/11/21 1:32 PM M.Baldwin North Andover, MA 01845 1:47 PM • ' • • • • ' • Repeat Violations Highlighted in Yellow Physical Facilities installed, maintained & cleaned 55 6-501.12 Cleaning. Frequency/Restrictions - Establishment - C Dust under packaged food display. Code: The physical facilities shall be cleaned as often as necessary to keep them clean. Except for cleaning that is necessary due to a spill or other accident, cleaning shall be done during periods when the least amount of food is exposed such as after closing. u p J JJ, i�i/J/ ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................. 55 6-501.12 Cleaning. Frequency/Restrictions - Establishment - C Clutter on d board. Clean three bay drying Y sink area. g Code: The physical facilities shall be cleaned as often as necessary to keep them clean. Except for cleaning that is necessary due to a spill or other accident, cleaning shall be done during periods when the least amount of food is �Jr✓, �m exposed such as after closing. , r 1, ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................. Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT P�9eNumber 4 Sams Mobil Mart Inspection Number Date Time In/Out Inspector 12 Massachusetts Avenue B74B5 8/11/21 1:32 PM M.Baldwin North Andover, MA 01845 1:47 PM • ' • • • • ' • Repeat Violations Highlighted in Yellow • Area Equipment Product Notes Temps Establishment Walk in Refrigerator Dunkin 41 °F ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Establishment Rockstar Ambient 40°F ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Establishment Walk in Refrigerator Ambient 36°F ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Temperatures in RED identify items in the temperature danger zone. See the report notes for specific details. Coffee service and prep packaged foods. Town of North Andover- Health Department