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HomeMy WebLinkAboutb.good - 07.15.2015 thru 11.09.2021 - Inspection - 99 TURNPIKE STREET 11/30/2021 II Q1[.I l Establishment Name: 3. Date: r 1/ l I Page: of Item Code C—Critical item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item PLEASE PRINT CLEARLY Verified e A. Ciao,i C b P� n C-,(-(,A kc' G� CtC /�hGeX /"r-6t' Iti G�O.ev+t ��1 QUA tE4 6^ cam► -��..oc L u U ech,j sl+ll c.+�rv.-r r� drere.] �-.a. .1rw c CaS++�c�1.� c.+�C.►Qe�C 3�v Yr«�, „ ���C,(,P,o�f ; 1 /. Lr QAAL �Q&1kCQk Discussion With Person in Charge .may I I/- n n d` Corr dive Action Required: ❑ No i Yes it Voluntary Compliance ❑ Employee Restriction I Exclusion ff ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure 13 Voluntary Disposal ❑ Other. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items 1-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIOtNS 11SP PROTECTION FRO,II CHEMICALS 121 3-801.1 I(A) Unpasteurized Pre-packaged Juices and 14 Food or Color Additives Beverages with Warning Labels* 3-202.12 Additives* 3.801.1 I Use of Pasteurized Eggs* 3-302.14 Protection from Unapproved Additives* 3-801.11(D) Raw or Partially Cooked Animal Food and 15 Poisonous or Toxic Substances Raw Seed Sprouts Not Served.* 7-101.11 Identi ,ing Information-Original Containers* 3-801.1 I C Unopened Food Package Not Re-served. 7-102.11 Common Name-Working Containers* 7-201,11 -Separation-Storage* CONSUMER ADVISORY 7-202.11 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 7-202.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203.11 Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.1 I Sanitizers,Criteria-Chemicals* Pathogens.* 0"nr u►" 7-204.12 Chemicals for Washing Produce Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Sliell Eggs* 7-204.14 -Drying Agents Criteria* 7-205.11 incidental Food Contact,lubricants* SPECIAL RE UIREAIENTS 7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590,009(A)-(D)in 7-206.12 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.13 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. TI\1EfrEMPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under#29-Special 3-401.11A 1 2)O Eggs- 155°F [5 Sec. Requirements. ( E s-Imtnediate Service 145°F15seck 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.1 l(B)(1)(2) Pork and Beef Roast- 130°F 121 min* (Blue Items 23-30) 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec.* Critical and non-critical violations,ivhich do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, illness interventions and riskfactors listed above,can be found in the Stuffing Containing Fish,Meat,Poultry or following sections of the Food Code and 105 011?590.000. Ratites-165°F 15 sec.* 3-401.1 I(C)(3) Whole-muscle,Intact Beef Steaks 145°F* Irene Good Retail Practices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23. Mana enientand Personnel FC-2 .003 Microwave 165°F* 24. Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 25. Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding 26. Water Plumbing and Waste FC-5 .006 27. Physical Facilit FC-6 .007 3 403.11(A)&(D) PHFs [65°F 15 sec.* 28. Poisonous or Toxic Materials FC-7 .008 3-403.11(B) Microwave- 165°F 2 Minute Standing 29. S cial Requirements .009 Time* 30. Other 3-403.11(C) Commercially Processed RTE Food- 140°F* 3-403.11(E) Remaining Unsliced Portions of Beef 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590,000, Roasts* 18 Proper Cooling of P11Fs 3-501.14(A) Cooling Cooked PIIFs from 140°F to 70°F Within 2 Hours and From 70°F to 41°F/45°F Within 4 Hours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/451F Within 4 Hours* 3-501.14(C) PIIFs Received at Temperatures According to Law Cooled to 41°F/45°F Within 4 Hours.* 3-501.15 Cooling Methods for PHFs 19 PHF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590,004(F) 410/450 F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. a27 Time as a Public Health Control 3-501.19 Time as a Public Health Control* 590.004 11 Variance Requirement Q b L Establishment Name: I Date: if `( Page: / of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item PLEASE PRINT CLEARLY Verified rmo ,T -1 64ka3 dirt f c�. ✓LZa r 5 f { C-Car r to Discussion With Person in Charge: " 22 Corrective Action Required: Cl No Yes Voluntary Compliance ❑ Employee Restriction! Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items 1-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IISP PROTECTION FROM CHEIMICALS 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 14 Food or Color Additives Beverages with Warning Labels* 3-202.12 Additives* 3-801.11 Use of Pasteurized Eggs* 3-302.14 Protection front Unapproved Additives* 3-801.11(D) Raw or Partially Cooked Animal Food and 15 Poisonous or Toxic Substances Raw Seed Sprouts Not Served.* 7-I01.11 Identilying Information-Original Containers* 3 801.1 I C Unopened Food Package Not Re-served. 7-102.11 Common Name-Working Containers* 7-201.11 Separation-Storage* CONSUMER ADVISORY 7-202.11 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 7-202.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203.1 I Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.11 Sanitizers,Criteria--Chemicals* Pathogens.*'ff""r" 7-204.12 Chemicals for Washing Produce Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 7-204.14 Drying Agents,Criteria* 7-205.11 incidental Food Contact,Lubricants* SPECIAL REQUIRENIENTS 7-206,11 Restricted Use Pesticides Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 1 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.13 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. TINIE/TEMPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under 429--Special 3-401.I1A(1)(2) Eggs- 155°F 15 Sec. Requirements. Eggs-Immediate Service 145°FI5sec* 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 see.* VIOLATIONS RL•LATED TO GOOD RETAIL PRACTICES 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* (Blue Items 23-30) 3-401.1 l(A)(2) Ratites,Injected Meats-155°F 15 sec.* Critical and non-critical violations,ivhich do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, illness interventions and riskfactors listed above,can be found in the Stuffing Containing Fish,Meat,Poultry or following sections of the Food Code and 105 CXIR 590.000. Ratites-f 65°F 15 sec.* 3-40I.I t(C)(3) Whole-muscle,intact Beef Steaks 145°F* E29.:j Good Retail Practices FC 590.000 3-401.12 Raw Animal Foods Cooked in a Management and Personnel FC-2 .003 Microwave 165°F* Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding Water,Plumbingand Waste FC-5 .006 Physical Focilit FC-6 .007 3-403.11(A)&(D) PHFs l65°F 15 see.* Poisonous or'roxic Materials FC-7 .008 3-403.11(B) Microwave- 165°F 2 Minute Standing 5 cial Re uirements .009Time* Other 3-403.11(C) Commercially Processed RTE Food- 140°F* 3-403.l 1(E) Remaining Unsliced Portions of Beef •Denotes critical item in the federal 1999 Food Code or 105 CMR 590,000. Roasts* l8 Proper Cooling of PilFs 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Within 2 Hours and From 70°F to 41°F/45°F Within 41lours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/45°F Within 4 Hours* 3-501.14(C) PI lFs Received at Temperatures According to Law Cooled to 411F/45°F Within 4 Hours.* E193-501.15 Cooling Methods for PHFs PHF Hof and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590,004(F) 410/450 F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. 20 1 Time as a Public Health Control 3-501.19 Time as a Public Health Control* 590.004(l1) Variance Requirement ` RN o \r rtlt And�rccr Ncvith lkla. tznal�;.�r�r FOOD ESTABLISHMENT INSPECTION REPORT \unh:\nrb�cr,AtA01 f4t" ��/ Inspection Number Date Time In/Out Inspection Type Client Type Inspector b.good {`� OC330 8/21/20 3:35 PM Routine Retail M.Baldwin 99 Turnpike Street 3:54 PM North Andover, MA 01845 Permit Number Person In Charge Variance Priority Priority f Core Marcelo- 0 0 1 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 Protection from Co tamination Contr IN OUT NA NOC 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 ❑ Employee Health 17.Proper disposition of returned,previously served, n 3. Management,food employee and conditional employee V V `^-• knowledge,responsibilities and reporting & TifneTremperature Control for Safety IN OUT NA NO COI 4. Proper use of restriction and exclusion 18.Proper cooking time&temperatures V t_1L 5. Procedures for responding to vomiting and diarrheal events V19.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 V 22.Proper cold holding temperatures �/ ❑® __ - -- Preventing Contamination by Hands IN OUT NA NO COS 23.Proper date marking and disposition E 8. Hands clean&properly washed V �� 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 pprOVeu, OUICe " tN OUT NA NO COS Highly SUSCeptlble 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 1V Food/Color Additives and Toxic Substances IN OUT NA NO COS 13.Food in good condition,safe&unadulterated 1 L] 27.Food additives:approved&properly used IU U I Li 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 ... Retail Practices Safe Food and Water IN OUT NA NO cos Proper Use Of Utensil IN OUT NA NO CO: 30.Pasteurized eggs used where required V 43.In-use utensils:properly stored L� 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. UtC'nSIIS,Equipment d Vendin IN OUT NA NO COS 47.All contact surfaces cleanable,properly designed, 34.Plant food properly cooked for hot holding ❑EID r-sr�-- 48. Warewashinq facilities:installed,maintained&used;test 35. Approved thawing methods used 49. Non-food contact surfaces clean 36. Thermometers provided&accurate Physical Facilities-' I J `NA NO Food Id ;;- -.,IN OUT NA NO COS 50.Hot&cold water available;adequate pressure 37.Food properly labeled;original container 51.Plumbing installed;proper backflow devices eventiOR Of Food Conta OUT NANO COS 52.Sewage&waste water properly disposed ❑ El38.Insects,rodents&animals not present ❑ I 53.Toilet facilities:properly constructed,supplied,&cleaned ❑ ❑ 39.Contamination prevented in prep,storage&display ® 54.Garbage&refuse properly disposed;facilities maintained El41.Wiping cloths;properly used&stored 4 .Personal cleanliness ❑ 55.Physical facilities installed,maintained&clean 1 El❑ !I ❑® 42.Washing fruits&vegetables 56.Adequate ventilation&lighting;designated areas use ❑j 60.105 CMR 590 violations/local regulations 210111711 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 cessation of food establishment operations.If you are subject to a notice of suspension,revocation,or non-renewal �In - - Follow Up Required: Y Follow Up Date: Inspector PIC ^�nn^n� D Town of North Andover- Health Department 9 1(V" IU,`VIIU•`VI R.10 FOOD SAFETY INSPECTION REPORT Page Number 2 b.good Inspection Number Date Time In/Out Inspector 99 Turnpike Street OC330 8/21/20 3:35 PM M.Baldwin North Andover, MA 01845 3:54 PM Inspection - • •rt (Continued) Repeat Violations Highlighted in Yellow 88 - - Mask Signage at entrance - TO; Face masks are � I IL 88 - - Stickers showing social distancing guidance on the floor near the register. - Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT Page Number 3 b.good Inspection Number Date Time In/Out Inspector 99 Turnpike Street OC330 8/21/20 3:35 PM M.Baldwin North Andover, MA 01845 3:54 PM Inspection - • •rt (Continued) Repeat Violations Highlighted in Yellow 88 - - Every other table closed to ensure social distancing of 6 -; feet. - , . 98 - - Hand sink is properly set up. - 1 "x Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT >�g N imb r 4 b.good Inspection Number Date Time In/Out Inspector 99 Turnpike Street OC330 8/21/20 3:35 PM M.Baldwin North Andover, MA 01845 3:54 PM Inspecti on - • •rt (Continued) Repeat Violations Highlighted in Yellow 98 - - Serve safe posted. - WrvSrafe' IFICATION 98 - - Restrooms appear clean. - Physical Facilities Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT Rage Number 5 b.good 99 Turnpike Street Inspection Number Date Time In/Out Inspector North Andover, MA 01845 OC330 8/21/20 3:35 PM M.Baldwin 3:54 PM Inspection • •rt (Continued) Repeat Violations Highlighted in Yellow Physical Facilities installed, maintained & cleaned 55 6-501.12 Cleaning. Frequency/Restrictions - Back dry storage room - C Strawberry debris on floor near refrigerator. Clean floor. ~ 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. Check List IN= In Compliance OUT = Out of Compliance NA= Not Applicable NO= Not Observed Certified Food Protection Managers Certificate posted? IN Ventilation hood inspection sticker up to date? IN Food Employee Reporting Agreement in place? IN Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT PageNg 6 b.good Inspection Number Date Time In/Out Inspector 99 Turnpike Street OC330 8/21/20 3:35 PM M.Baldwin North Andover, MA 01845 3:54 PM Inspection • •rt (Continued) Highlighted in Yellow • Area Equipment Product Notes Temps Sweet potato 40°F Potato fries 38 OF Turbo air Ambient 31 OF Raw chicken 41 OF Fridge drawer Eggs 34 OF Back freezer Ambient -2 OF Temperatures in RED identify items in the temperature danger zone. See the report notes for specific details. Inspection conducted per covid guidelines including pre-inspection phone interview on 8/17/20, followed by site inspection on 8/21/20 at 10 AM. Pre-inspection interview with Marcelo revealed- B Good is open for indoor and outdoor dining, as well as take out and delivery. No recent menu changes. All staff and drivers wear masks. Take out is conducted using racks at the front of the establishment. Staff temp is taken daily and staff are asked the series of screening questions. They use a Perexidite disinfectant. Front glass, tables, chairs, doorknobs are cleaned between customers or every 15-20 min. Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT Page Number 7 b.good Inspection Number Date Time In/Out Inspector 99 Turnpike Street North Andover, MA 01845 OC330 8/21/20 3:35 PM M.Baldwin 3:54 PM Inspection • • • • Repeat Violations Highlighted in Yellow Town of North Andover- Health Department R-10 nhAtxkwcrHivld,IklK. FOOD ESTABLISHMENT INSPECTION REPORT v 120\lain Stnrt \..nh.\niHncr.MAOIt4i5 Inspection Num6tD Time ction e Client Type Inspector b.good 5AAD411:11 AM Routin Retail M.Baldwin 99 Turnpike Street Permit Number Person In Charge Variance Priority Priority f Core North Andover, MA 01845 Marcelo 0 0 1 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 GO,' 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 Employee Health IN OUT NA No Go 17.Proper disposition of returned,previously served, 3. Management,food employee and conditional employee knowledge,responsibilities and reporting Timelrem erature Control for Safety IN OUT NA NO CO: 4. Proper use of restriction and exclusion V 18.Proper cooking time&temperatures 5. Procedures for responding to vomiting and diarrheal events V 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 V 21.Proper hot holding temperatures 7. No discharge from eyes,nose,and mouth V 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 a pre-approved I/ Consumer Advisory IN OUT NA NO COE 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 V 26.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 27.Food additives:approved&properly used V 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 .•• Retail Practices Safe Food and Water IN OUT NA NO COS Proper Use of Utensils IN OUT NA NO COE 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. V 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 1 V 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 cessation of food establishment operations.If you are subject to a notice of suspension,revocation,or non-renewal pursuant to 105 CMR 590.000 you may request a hearing before the board of health in accordance with 105 CMR 590.015(B). 9. !� Follow Up Required: Y Follow Up Date: Inspector PIC Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT Page Number 2 b.good 99 Turnpike Street Inspection Number Date Time Inspector North Andover, MA 01845 5AAD4 7/23/19 11:11 AM M.Baldwin Inspection • •rt (Continued) Repeat Violations Highlighted in Yellow Physical Facilities Plumbing installed; proper backflow devices 51 5-203.13 Service Sink- - COS C Drain plugged. Corrected on site. Code:At least 1 service sink or 1 curbed cleaning facility equipped with a floor drain shall be provided and conveniently located for the cleaning of mops or similar wet floor cleaning tools and for the disposal of mop water and similar liquid waste. Toilets and urinals may not be used as a service sink for the disposal of mop water and similar liquid waste. Positive Notes Proper Food Safety Practices 98 98 Proper Food Safety Practices - - N Hood appears clean-good. - Excellent. Town of North Andover- Health Department R-10 Page Number FOOD SAFETY INSPECTION REPORT 3 b.good 99 Turnpike Street Inspection Number Date Time Inspector North Andover, MA 01845 5AAD4 7/23/19 11:11 AM M.Baldwin Inspection • •rt (Continued) Repeat Violations Highlighted in Yellow 98 98 Proper Food Safety Practices - - N Person in Charge able to explain cold holding temps. - Excellent. .1 t a I F 2 p + { f; tll �''a1 Temperatures Area Equipment Product Temps lQuinoi ( 155 Right low refrigerator I Bean salad 138 Left low refrigerator I ( Bean salad 141 Raw chicken 138 Temperatures in RED identify items in the temperature danger zone. See the report notes for specific details. Bodily fluid clean up kit available and PIC able to explain procedures. Town of North Andover- Health Department R-10 FOOD SAFETY INSPECTION REPORT Page Number 4 b.good 99 Turnpike Street Inspection Number Date Time Inspector North Andover, MA 01845 5AAD4 7/23/19 11:11 AM M.Baldwin Inspection • •rt (Continued) IIIIIIIIIIIRepeat Violations Highlighted in Yellow PICable to explain cooking temps - chicken cooked to 165. Dish rinse 200. Post Serve Safe once you receive it. Town of North Andover- Health Department THE COMMONWEALTH OF ACHUSETTS •a"`� TOWN OF NORTH ANDOVER 120 Main Street MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover,Massachusetts 01845 Division of Food and Drugs 4 Phone-978.688.9540 FOOD ESTABLISHMENT INSPECTION R 1P Fax- 978.688.9542 e-mail: healthdeptC�northandoverma.gov Name of Establishment Dptexpe of O Aerations Type of Inspection U o o 1 j k Food Service N Routine Address C1 C' - ; Risk Level ❑ Retail ❑Re-inspection Telephone ❑ Residential Kitchen De Previous Inspection ❑ Mobile Owner HACCP: ❑ Temporary ❑Pre-operation Y / N ❑ Caterer ❑ Suspect Illness Person-in-Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint 0�1'�l f✓ r i I In: } 6 ❑ HACCP Inspector ,�� I ❑ Other Mt 5 - cx ��vv ✓� Out: \�u� Year: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 (G)❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwashing 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 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8.Separation/Segregation/Protection ❑ 20.Time as a Public Health Control 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 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 Official Order for Correction:Based on an inspection today,the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code.This C N 23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order,you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29. Special Requirements (590.009) DATE OF RE-INSPECTION: 30. Other Inspector's Signatur Print: NIP Q�✓t, 1��� f / PICs Signature: r Print: Page of_ ages Dow It Gt1her`sh , Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) FOOD PRO.1'ECI'ION MANAGEMENT 1 590.003(A) Assi nment of Responsibility* PROTECTION FROM CONTAMINATION 590.003(B) Demonstration of Knowled e* 18 Cross-contamination 2-103.11 Person in charge-duties 3-302.11(A)([) Raw Animal Foods Separated from Cooked and RTE Foods* EMPLOYEE HEALTH Contamination from Raw In redients 2 590.003(C) Responsibility of the person in charge to 3-302.11(A)(2) Raw Animal Foods Separated from Each require reporting by food employees and Other* applicants* Contamination from the Environment 590.003(F) Responsibility Of A Food Employee Or An 3-302.1 I A Food Protection* Applicant To Report To The Person In 3-302.15 Washing Fruits and Vegetables Charge* 3-304.11 Food Contact with Equipment and 590.003(G) Reporting by Person in Charge* Utensils* 3 590.003 Exclusions and Restrictions* Contamination from the Consumer 590.003(F.) Removal of Exclusions and Restrictions 3-306.14 A B Returned Food and Reservice of Food* Disposition ofAdulterated or FOOD FROM APPROVED SOURCE Contaminated Food 4 Food and Water From Regulated Sources 3-701.11 Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201.12 Food in a Hermetically Sealed Container* 9 Food Contact Surfaces 3-201.13 Fluid Milk and Milk Products* 4-501,111 Manual Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.112 Mechanical Warewashing-Hot Water 3-202.16 1 ice Made From Potable Drinking Water* Sanitization Temperatures* 5-101.11 Drinking Water from an Approved System* 4-501.114 Chemical Sanitization-temp.,pH, 590.006(A) Bottled Drinking Water* concentration and hardness. 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Utensils Clean* Source Shellfish and Fish From an Approved 4-602.11 Cleaning Frequency of Equipment Food- Contact Surfaces and Utensils* 3-201,14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency of Sanitization of Utensils and Shellfish* Food Contact Surfaces of Equipment* 3-201.15 Molluscan Shellfish from NSSP Listed 4-703.11 Methods of Sanitization-Hot Water and Sources* Game and Wild Mirshroonrs Approved by Chemical* Re ulator Awho•il) 10 Proper,Adequate Handwashin 3-202.18 Shellstock Identification Present* 2-301.11 Clean Condition-Hands and Arms* 590.004(C) Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Game Animals* 2-301.14 When to Wash* 5 Receiving/Condition 11 Good Hygienic Practices 3-202.11 PHFs Received at Proper Temperatures* 2-401.11 Eating,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401.12 Discharges From the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* 6 Tags/Records:Shellstock 3-301.12 Preventing Contamination when Tasting* 3-202.18 Shellstock Identification* 12 Prevention of Contamination from 3-203.12 Shellstock Identification Maintained* Hands Tags/Records:Fish Products590.004(E) Preventing Contamination from Employees* 3-402.11 Parasite Destruction* 13 I ash Facilities 3-402,l2 Records,Creation and Retention* Convenient( Located and Accessible 590.004{J) 5-203.11 Numbers and Capacities* Labeling of ingredients* 5-204.11 Location and Placement* 7 Conformance with Approved 5-205.11 Accessibility,Operation and Maintenance Procedures/HACCP Plans Supplied with Soap and Hand Drying 3-502.l 1 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance nvith Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Establishment Name: , (�O"A Date: �a_ 1 l`) Page: a of a Item Code C—Critical item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item PLEASE PRINT CLEARLY Verified to Q4 1 �V C. l E_�: z-v. Q0 I tit a ss L- CJ�u e c� C. —{ c'^ram} Fe, o c-4 ems+ 1, -t- c, ,,- i ct J 77 Cilpcle- G t a C CI C' ti9 Discussion With Person in Charge: Corrective Action Required: ❑ No Yes ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal 0 Other. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items 1-22) (Cont,) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IISP PROTECTION FROM CHEJHCALS 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 14 Food or Color Additives Beverages with Warning Labels* 3-202.12 Additives* 3-801.11(B) Use of Pasteurized Eggs* 3-302.14 Protection from Unapproved Additives* 3-801.11(D) Raw or Partially Cooked Animal Food and iS Poisonous or Toxic Substances Raw Seed Sprouts Not Served.* 7-101.11 ldcjiti6,ing Information-Original Containers* 3-801.11 C Unopened Food Package Not Re-served. 7-102.1 I Common Name-Working Containers* 7-201.11 -Separation-Storage* CONSUMER ADVISORY 7-202.l 1 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 7.202.12 Conditions of Use* Aninnal Foods That are Raw,Undercooked or 7.203.11 Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.1 l Sanitizers,Criteria-Chemicals* Patho ens.*r0"'" 7-204.l2 Chemicals for Washing Produce,Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell E s* 7-204.14 -Drying Agents,Criteria* 7-205.11 incidental Food Contact,Lubricants* SPECIAL REQUIREMENTS 7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.l2 1 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.l3 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions arid risk factors. TIMEITEMPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Ternperatores for PHFs practices should be debited under#29--Special 3-401.11A 1 Requirements. ( )(2> Eggs- I55°F ES Sec. Eggs-Immediate Service 145°F15sec* 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals-155°F 15 sec.* VIOLA TIONS RELA TED TO GOOD RETAIL PRACTICES 3-401.1 l(B)(I)(2) Pork and Beef Roast-130°F 121 min* (Blue Items 23-30) 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec.* Critical and non-critical violations,which do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, illness interventions and risk factors listed above,can be found in the Stuffing Containing Fish,Meat,Poultry or follotuing sections of the Food Code and 105 CAIR 590,000. Ratites-165°F 15 sec.* 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* Item I Good Retail Practices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23. Mana ement and Personnel FC-2 .003 Microwave 165°F* 24. Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 25. Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding 26. Water Plumbin and Waste FC-5 .006 27. Physical Facilit FC-6 .007 3 403.11(A)&(D) PHFs 165°F 15 sec.* 28. Poisonous or'foxic Materials FC-7 1 .008 3-403.11(B) Microwave-165°F 2 Minute Standing 1 29. 1 Special Requirements .009 Time* 30. 1 Other 3-403.11(C) Commercially Processed RTE Food- 140°F* 3-403.11(E) Remaining Unsliced Portions of Beef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Roasts* 18 Proper Cooling of PilFs 3-501.14(A) Cooling Cooked PIIFs from 140°F to 70°F Within 2 Hours and From 70°F to 41°F/45°F Within 4 Hours.* 3-501.14(B) Cooling PHPs Made From Ambient 7 Temperature Ingredients to 4 VF/45°F Within 4 Hours* 3-501.14(C) P111's Received at Temperatures According to Law Cooled to 41°F/45°F Within 4 Hours.* 3-501.15 Cooling Methods for PHFs =/ I9 PHF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 41°/450 F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. 20 Time as a Public Health Control 3-501.19 Time as a Public Health Control* 590.004(11) Variance Requirement THE COMMONWEALTOOFACHUSETTS ""'� TOWN OF NORTH ANDOVER120 Main Street AtASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover,Massachusetts 01845 qWDivision of Food and Drugs Phone-978.688.9540 FOOD ESTABLISHMENT INSPECTION Fax- 978.688.9542 e-mail: healthdept@northandoverma.gov Name of Establishment Dat Type of Operation(s) Type of Inspection 6, �rdC�r.4 �i / ® Food Service ZRoutine Address Risk Level ❑ Retail ❑ Re-inspection l.,.r Telephone ❑ Residential Kitchen Previous Inspection ❑ Mobile Date' Owner HACCP: ❑ Temporary ❑ Pre-operation Y / N ❑ Caterer ❑ Suspect Illness Person-in-Charge(PIC) Time El Bed&Breakfast ❑ General Complaint In: �2 0 ❑ HACCP Inspector n Out: ( i Year: ❑ Other Each violation chec ed requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 (G)❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwashing 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 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8.Separation/Segregation/Protection ❑ 20.Time as a Public Health Control 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 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 Official Order for Correction:Based on an inspection today,the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code.This C N 23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health.Failure to correct violations 25. Equipment and Utensils (FC 4)(590.005) cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order,you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29. Special Requirements (590.009) DATE OF RE-INSPECTION: 30. Other Inspector's Signatur Print: PICs Signature: Print: L Page)ones Violations Related to Foodborne Ilbtess Interventions and Risk Factors (Red Items 1-22) FOOD PROTLCI'ION DIANAGENIENT 1 590.003(A) Assignment of Responsibility* PROTECTION FROM CONTAMINATION 590.003(B) Demonstration of Knowledge* 8 Cross-contamination 2-103.11 Person in charge-duties 3-302.1 t(A)(t) Raw Animal Foods Separated from Cooked and RTE Foods* EMPLOYEE HEALTH Contamination from Raw In redients 2 590.003(C) Responsibility of the person in charge to 3-302.11(A)(2) Raw Animal Foods Separated from Each require reporting by food employees and Other* applicants* Contamination from the Environment 590.003(F) Responsibility Of A Food Employee Or An 3-302.11 A Food Protection* Applicant To Report To The Person in 3-302.15 Washing Fruits and Vegetables Charge* 1 3-304.11 Food Contact with Equipment and 590.003(G) Reporting by Person in Charge* Utensils* 3 590.003(D) Exclusions and Restrictions* Contamination fr•on the Consumer 590.003(E) Removal of Exclusions and Restrictions 3-306.14 A B Returned Food and Reservice of Food* Disposition oJAdu/terated or FOOD FRO,INI APPROVED SOURCE Contaminated Food 4 Food and Water From Regulated Sources 3-701.1 I Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201.12 Food in a Hermetically Sealed Container* 9 Food Contact Surfaces 3-201.l3 Fluid Milk and Milk Products* 4-501.111 Manual Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization'Penn eratures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.112 Mechanical Wnrewashing-Hot Water 3-202.16 1 ice Made From Potable Drinking Water* Sanitization'1'em eratures* 5-101.11 Drinking Water from an Approved System* 4-501.114 Chemical Sanitization-temp.,pIl, 590.006(A) Bottled Drinking Water* concentration and hardness.* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Shellfish and Fish From an Approved Utensils Clean* Source 4-602.I 1 Cleaning Frequency of Equipment Food- 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces and Utensils* Shellfish* 4-702.11 Frequency of Sanitization of Utensils and 3-201.15 Molluscan Shellfish from NSSP Listed Food Contact Surfaces of Equipment* Sources* 4-703.11 Methods of Sanitization-Hot Water and Game and II'ild Muslu•oorns Approved by Chemical* Regulatory Autlrorit 10 Proper-,Adequate Handwashin 3-202.18 Shellstock Identification Present* 2-301.11 Clean Condition-Hands and Arms* 590.004(C) Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Game Animals* 2-301.14 When to Wash* S Receiving/Condition 11 Good Hygienic Practices 3-202.11 PHFs Received at Proper Temperatures* 2-401.11 Eatin ,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401.12 Discharges From the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* 6 Ta s/Rcco•ds-Shellstock 3-301.12 Preventing Contamination When Tasting* 3-202.18 Shellstock Identification* 12 Prevention of Contamination from 3-203.12 Shellstock Identification Maintained* Hands Tags/Records:Fish Products 590.004(E) Preventing Contamination from Employees* 3-402.1 I Parasite Destruction* 13 Ilandwash Facilities 3-402.12 Records,Creation and Retention* ConvenientlyLocated and Accessible 590.004(J) 5-203.11 Numbers and Ca pacifies* Labeling of ingredients* 5-204.1 l Location and Placement* 7 Conformance with Approved 5-205.1 l Accessibility,Operation and Maintenance Procedures/HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availabili 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Establishment Name: 6• Date: [ 1 Page: of —~ Item Code C—Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red I m PLEASE PRINT CLEARLY Verified le 3 C ' l 1�0 ai ctm� .�_ 0 Discussion With Person in Charge: �J Corrective Action Required: ❑ No Yes '--Voluntary Compliance ❑ Employee Restriction/ ` Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal 0 Other. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items 1-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IISP PROTECTION FROM CH-EiMICALS 21 3-801.L1(A) Unpasteurised Pre-packaged Juices and 14 Food or Color Additives Beverages with Warning Labels* 3-202.12 Additives* 3-801.11(B) Use of Pasteurized Eggs* 3-302.14 Protection from Unapproved Additives* 3-801.11(D) Raw or Partially Cooked Animal Food and 15 Poisonous or Toxic Substances Raw Seed Sprouts Not Served.* 7-101.11 Identi6,ing Information-Original Containers* 3-801.1 I C Unopened Food Package Not Re-served, 7-102.11 Common Name-Working Containers* 7-201.11 -Separation-Storage* CONSUMER ADVISORY 7-202.11 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 7-202.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203.11 Toxic Containers--Prohibitions* Not Otherwise Processed to Eliminate 7-204.11 Sanitizers,Criteria--Chemicals* Patho ens.*t$""moor 7-204.12 Chemicals for Washing Produce,Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 7-204.14 Drying Agents,Criteria* 7-205.1 I incidental Food Contact,Lubricants* SPECIAL RE UIRENIEIVTS 7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.I3 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. TINIE/TENIPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under#29-Special 3-401.11A(I)(2) Eggs- 155°F 15 Sec. Requirements. Inunediate Service 145°F15sec* 3-401.1 I(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 sec.* 1110LATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* (Blue Items 23-30) 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 see,* Critical and non-critical violations,which do not relate to file foodborne 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, illness interventions and riskfactors listed above,can be found in the Stu fling Containing Fish,Meat,Poultry or following sections of the Food Code and 105 ChIR 590.000, Ratites-165°F 15 see.* 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* Item Good Retail Practices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23, Management and Personnel FC-2 .003 Microwave 165°F* 24. Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 25. Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding 26. Water,Plumbing and Waste FC-5 .006 27. Physical Facilit FC-6 .007 3 403.11(A)&(D) PHFs I65°F 15 sec.* 28. Poisonous or Toxic Materials FC-7 .008 3-403.11(B) Microwave-165°F 2 Minute Standing 29. S cial Requirements .009 Time* 30. Other 3-403.11(C) Commercially Processed RTE Food- l40°F* 3-403.11(E) Remaining Unsliced Portions of Beef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Roasts* 18 Proper Cooling of PIIFs 3-501.14(A) Cooling Cooked PIIFs from 140°F to 70°F Within 2 Hours and From 70°F to 41°F/45°F Within 4 Hours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/45017 Within 41iours* 3-501.14(C) Pl IFs Received at Temperatures According to Law Cooled to 41°F/45017 Within 4 Hours.* 3-501.15 Cooling Methods for PHFs 19 PHF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 410/45'F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. 20 Time as a Public Health Control 3-501,19 Time as a Public Health Control* 590.004(11) Variance Requirement THE COMMONWEALTH OF MASSACHUSETTS ""'w . TOWN OF NORTH ANDOVER 120 Main Street MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover,Massachusetts 01845 Division of Food and Drugs Phone-978.688.9540 FOOD ESTABLISHMENT INSPECTION REPOR__( Fax - 978.688.9542 e-mail: healthdept@northandoverma.gov Name of Establishment "Da T o 0 eration s Ttge of Inspection O C7 r� W Food Service Routine Address Il t Risk Level U Retail ❑ Re-inspection Telephone El Residential Kitchen Previous Inspection ❑ Mobile Date: Owner HACCP: ❑ Temporary ❑Pre-operation Y / N ❑ Caterer ❑ Suspect Illness Person-in-Charge(PIC) ��,t ad ����]'lSOn Time �} ❑ Bed&Breakfast General El HACCP Complaint In- 12 Inspector �A. r. lkycOut: I P Year: ❑ Other Each violation checked equires an explanation on the narrative page(s)and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 (G)❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties 13. Handwashing 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 TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION NQ19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑ 20. Time as a Public Health Control 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 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 Official Order for Correction:Based on an inspection today,the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code.This C N 23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health.Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order,you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29. Special Requirements (590.009) DATE OFRE-INSPECTION: 30. Other Inspector's Signature: , �, Print: �,�� i� -E r � / PICs Signature: Print: C Page C of 6�ges Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) FOOD PROTEC-I'ION 181ANAGEi\IENT 1 590.003(A) Assignment of Responsibility* PROTECTION FROM CONTAMINATION 590.003(B) Demonstration ofKnowledge* 8 Crass-Contamination 2-103.11 Person in charge-duties 3-302.11(A)(1) Raw Animal Foods Separated from Cooked and RTE Foods* EMPLOYEE HEALTH Contamination from RaNy Ingredients 2 590.003(C) Responsibility of the person in charge to 3-302.1 l(A)(2) Raw Animal Foods Separated from Each require reporting by food employees and Other* applicants* Contamination from the Environment 590.003(F) Responsibility Of A Food Employee Or An 3-302.1 I A Food Protection* Applicant To Report To The Person in 3-302.15 Washing Fruits and Vegetables Charge* 3-304.11 Food Contact with Equipment and 590.003(0) Reporting by Person in Charge* Utensils* 3 590.003(D) Exclusions and Restrictions* Contamination from the Consumer 590.003 T:) Removal of Exclusions and Restrictions 3-306.14 A B Returned Food and Reservice of Food* Disposition ofAdulterated or FOOD FROM APPROVED SOURCE Contaminated Food 4 Food and Water From Regulated Sources 3-70t.I I Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201.l2 Food in a I lerncticall y Scaled Container* 9 Food Contact Surfaces 3-201.13 Fluid Milk and Milk Products* 4-501.111 Manual Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization'fcnu eratures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.112 Mechanical Wnrewashing-Hot Water 3-202.16 1 ice Made From Potable Drinking Water* Sanitization Tem eratures* 5-101.11 Drinking Water from an Approved System* 4-501.114 Chemical Sanitization-temp.,phl, 590.006(A) Bottled Drinking Water* concentration and hardness.* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Utensils Clean* Shellfish and Fish From an Approved Source 4-602.1 I Cleaning Frequency of Equipment Food- Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan Shellfish 4-702.11 Frequency of Sanitization of Utensils and 3-201.15 Molluscan Shellfish from NSSP Listed Food Contact Surfaces of Equipment* 4-703.11 Methods of Sanitization-Hot Water and Sources* Game and Wild Mushrooms Approved by Chemical* Re ulator Autlrorit 10 Proper,Adequate Handwashin 3-202.18 Shellstock Identification Present* 2-301.11 Clean Condition-Hands and Arms* 590.004(C) Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Game Animals* 2-301.14 When to Wash* 5 Receiving/Condition 11 Good Hygienic Practices 3-202.11 PHFs Received at Proper Temperatures* 2-401.11 Eating,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401.12 Discharges From the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* G Tags/Records:Shellstock 3-301.12 Preventing Contamination When Tasting* 3-202,18 Shellstock Identification* 12 Prevention of Contamination from 3-203.12 Shellstock Identification Maintained* Hands Ta sMecar•ds:Fish Products 590.004(E) Preventing Contamination from Em to ces* 3-402.11 Parasite Destruction* 13 Ilandwash Facilities 3-402.12 Records,Creation and Retention* Convenient) Located and Accessible 590.004(J) 5-203.11 Numbers and Capacities* Labeling of Ingredients* 5-204.11 Location and Placement* 7 Conformance with Approved 5-205.11 Accessibility,Operation and Maintenance Procedures/HACCP Plaits Supplied with Soap and Hand Drying 3-502.1 1 Specialized processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handmishing Cleanser,Availabili 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Establishment Name: - i6voc& Date: �a Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item PLEASE PRINT CLEARLY Verified not j2 �- 1 "M e' f1 C�.rk l )� • ,0 ho 7 30 iew&l J n lno b, f - l G' - e&=� - :9z 5 13-- -r ex,Vr ` ( — -- - e)cw• Uc. A Discussion With Person in Charge: Corrective Action Required: ❑ No Yes El S° Voluntary Compliance 13 Employee Restriction/ Exclusion 1 „� ❑ Re-inspection Scheduled ❑ Emergency Suspension ' l/�l ��Q/y\ 7 y ❑ Embargo ❑ Emergency Closure o9 0 ❑ Voluntary Disposal ❑ Other. fJ L4 a 4:�,;1,6: C\1,, ::1 1 Violations Related to Foodbor ne Illness Interventions and Risk Factors(Red Items 1-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IISP PROTECTION FROM CHEMICALS 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 14 Food or Color Additives Beverages with Warning Labels* 3-202.12 Additives* 3-801.11 Use of Pasteurized Eggs* 3-302.14 Protection from Unapproved Additives* 3-801.11(D) Raw or Partially Cooked Animal Food and 15 Poisonous or Tonic Substances Raw Seed Sprouts Not Served.* 7-101.11 ldenti ,ing Information-Original Containers* 3-801.1 I C Unopened Food Package Not Re-served. 7-102.11 Common Name-Working Containers* 7-201.11 Separation-Storage* CONSUMER ADVISORY 7-202.11 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 7-202.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203.11 Toxic Containers--Prohibitions* Not Otherwise Processed to Eliminate 7-204.11 Sanitizers,Criteria-Chemicals* Pathogens.*£,gone racoon 7-204.12 Chemicals for Washing Produce,Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell E s* 7-204.14 Drying Agents,Criteria* 7-205.11 incidental Food Contact,Lubricants* SPECIAL RE UIREMENTS 7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.13 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. TIMEfrENIPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under#29-Special 3-401.11A(1)(2) Eggs- I55°F 15 Sec. Requirements. E s-Immediate Service 145°F15sec* 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.1 I(B)(1)(2) Pork and Beef Roast- 130°F 121 min* (Blue Items 23-30) 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec.* Critical and non-critical violations,which do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, Illness interventions and risk factors listed above,can be found in the Stuffing Containing Fish,Meat,Poultry or follosving sections of Cite Food Code and 105 CGb1R 590,000. Ratites-165°F 15 see.* 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* Rent Good Retail Practices FC S90.000 3-401.12 Raw Anintn]Foods Cooked in a 23. Management and Personnel FC-2 .003 Microwave 165°F* 24. Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F15 sec.* 25. Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding 26. water,Plunibing and Waste FC-5 .006 27. Physical Facilit FC-6 .007 3 403.l l(A)&(D) PHFs 165°F 15 sec.* 28. Poisonous or'foxic Materials I FC-7 1 .008 3-403.11(B) Microwave- 165°F 2 Minute Standing 29. Spec iat Requirements .009 Time* 30. Other 3-403.11(C) Commercially Processed RTE Food- 140°F* 3-403.11(E) Remaining Unsliced Portions of Beef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590,000. Roasts* 18 Proper Cooling of PilFs 3-501.14(A) Cooling Cooked PIIFs from 140°F to 70OF Within 2 Hours and From 70°F to 41°F/45°F Within 4 hours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41117/45117 Within 4 Hours* 3-501.14(C) PIlFs Received at Temperatures According to Law Cooled to 41°F/45°F Within 4 Hours.* 3-501.15 Cooling Methods for PHFs 19 PHF Hot and Cold Holding 3-501,16(B) Cold PHFs Maintained at or below 590.004(F) 410/450 F* 3-501.16(A) Hot PHFs Maintained at or above 140*F. 3-501.16(A) I Roasts Held at or above 130°F. 20 Time as a Publie Health Control 3-501.19 Time as a Public Health Control* 590.004Ii Variance Requirement OWN THE COMMONWEALTH OF MASSACHUSETTS J 1600 Osgood Street, Building 20; Suite 2-36 * TOWN OF NORTH ANDOVER g g North Andover, Massachusetts 01845 *'•.=- * Phone-978.688.9540 Fax-978.688.8476 y�sseexasE��S FOOD ESTABLISHMENT INSPECTION e-mail: healthdeptna townofnorthandover.com Name of Establishment Date T e o .c O eration Tt'ne of Inspection b, 7-%/-/.?- X Food Service X Routine Address Risk Level ❑ Retail ❑ Re-inspection r r ❑ Previous Inspection Residential Kitchen P Telephone ❑ Mobile Date: Owner HACCP: ❑ Temporary ❑ Pre-operation Y / N ❑ Caterer ❑ Suspect Illness Bed& Breakfast ❑ C, CCIeneralComplaint Person-in-Charge(PIC) Time El ❑ H ACCP tJ ;l,yr�C,. ��Q t�� �� Inspector �t����, �y�i In:Out: j I)�IS Year: ❑ Other Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate Tobacco 590.009(F) ❑ corrective action as determined by the Board of Health. Allergen Awareness 590.009 (G)6<. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwashing 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 TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8.Separation/Segregation/Protection ❑20.Time as a Public Health Control 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 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 Official Order for Correction:Based on an inspection today,the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code.This C N 23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent 24. Food and Food Protection constitutes an order of the Board of Health. Failure to correct violations (FC 3)(590.004) cited in this report may result in suspension or revocation of the food 2 Equipment and Utensils (FC-4)(590.005) establishmentgermit and cessation of food establishment operations. If 26.. Water, Plumbing and Waste (FC 5)(590.006) aggrieved by this order,you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days-of receipt of this order. 29. Special Requirements (590.009) DATEOFRE-INSPECT/ON: 30. Other Inspector's Signature: Print: AA A PICs Signature: I LL Print: Page of;9 Pages 3-501.14(C) PHFs Received at Temperatures Violation Related to Foodborne Illness Interventions and Risk According to Law Cooled to Factors(Red Items 1-22) (Cont.) 41°F/45°F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below 3-302.14 Protection from Unapproved Additives* 590.004(F) 41°/45°F* 15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 140°F.* Containers* 3-501.16(A) Roasts Held at or above 130°F. 7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control 7-201.11 Separation-Storage* 1 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use* 7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP) 7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.14 Drying Agents,Criteria* Beverages with Warning Labels* 7-205.11 Incidental Food Contact,Lubricants* 3-801.1 l(B) Use of Pasteurized Eggs* 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served. * 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) I Unopened Food Package Not Re-served, 71 Monitoring* CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 16 Proper Cooking Temperatures for PHFs *ens����� Not Otherwise Processed to Eliminate 3-401.11A(1)(2) Eggs- 155°F 15 Sec. Pathogens. Eggs-Immediate Service 1450F15sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 sec.* SPECIAL REQUIREMENTS 3-401.11(B)(1)(2) Pork and Beef Roast- 130 F 121 min* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. catering,mobile food,temporary and * residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites-165°F 15 sec.* interventions and risk factors. Other 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 17 Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFs 165°F 15 sec.* Critical and non-critical violations, which do not relate to the foodborne illness interventions and risk factors listed above, can be 3-403.1 l(B) Microwave- 165°F 2 Minute Standing found in the following sections of the Food Code and 105 CMR Time* 590.000. 3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000 140°F* 23. Management and Personnel FC-2 .003 3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .604 Roasts* 25. Equipment and Utensils FC-4 .605 18 Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .606 3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 70°F Within 2 Hours and From 70°F Y9. Special Requirements .009 to 41017/450F Within 4 Hours.* 30. 1 Other 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/45°F Within 4 Hours* •Denotes critical item in the federal. 1999 Food Code or 105 CMR 590.000. I 1 � Establishment Name: l7. O0�`0 Date: /1 Page: of Item Code C-Critical item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Z erence R-Red l em PLEASE PRINT CLEARLY Verified U 09 o ' rd Py G Lc w r � 1 Discussion With Person in Charge Co rective Action Required: ❑ No Yes j �I� ,- ❑ Voluntary Compliance ❑ Employee Restriction/ fOril L OF / / r f EXCIUSIOn aG r ❑ Re-inspection Scheduled ❑ Emergency Suspension t� f e 11 Embargo 0 Emergency Closure El Voluntary Disposal Other. .r' •� s'"-�GL►�Y� �\Q el ( ` r\� C Y� LT �t �'✓(I` ��',+' . ( y `�"� i►'\ Yt�Ce C d o�C9--� 0--,n� -�u 1C •�.1 `Z h r� -� ✓ear r�Qn M ka Q4- 1 k, rnAl � - r Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items 1-22) (Cont) REQUIREDIENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IISP or Color Additives PROTECTION F CHEMICALS 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 14 Food Bevera es with Warning Labels* 3-202.12 Additives* Coves* 3-801.11 Use of Pasteurized Eggs* 3-302.14 Protection from Unapproved Additives* 3-801.11(D) Raw or Partially Cooked Animal Food and [5 Poisonous or Toxic Substances Raw Seed Sprouts Not Served.* 7-101.11 Identi6,ing information-Original Containers* 3-801.1 I C Unopened Food Package Not Re-served. 7-102.11 Common Name-Working Containers* 7-201.11 Separation-Storage* CONSUMER ADVISORY 7-202.11 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 7.202.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7.203.11 Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.11 Sanitizers,Criteria-Chemicals* Pathogens.*rff«mr""201 7-204.12 Chemicals for Washing Produce Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell E s* 7-204.14 Drying Agents,Criteria* 7-205.11 Incidental Food Contact,Lubricants* SPECIAL RE UIREMENTS 7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.13 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. TENIE/TENIPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under#29--Special 3-401.11A(t)(2) Eggs- 155°F 15 Sec. Requirements. E s-hunted ate Service 145*Fl5sec* 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals-155°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.1 l(B)(1)(2) Pork and Beef Roast- 130*F 121 min* (Blue Items 23-30) 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec.* Critical and non-critical violations,which do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stuiied PHFs, illness interventions and riskfactors listed above, can be found in the Stuffing Containing Fish,Meat,Poultry or following sections of the Food Code and 105 Ch1R 590,000. Ratites-165°F 15 sec.* 3-401.11(C)(3) Whole-muscle,intact Beef Steaks 145OF* Itent Good Retail Practices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23. Management and Personnel FC-2 .003 Microwave 165*F* 24. Food and Food Protection FC--3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 25. Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding 26. water,Plumbing and Waste FC-5 .006 27. Physical Facility FC-6 .007 3-403.11(A)&(D) PHFs 165OF 15 sec. 1 28. 1 Poisonous or'foxic Materials FC-7 .008 3-403.11(B) Microwave-165*F 2 Minute Standing 29, Special Requirements 1 .009 Time* 30. Other 3-403.11(C) Commercially Processed RTE Food- 140*F* 3-403.11(E) Remaining Unsliced Portions of Beef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Roasts* 18 Proper Cooling of P1117s 3-501.14(A) Cooling Cooked PIIFs from 140*F to 70°F Within 2 Hours and From 70*F to 41113/451F Within 4 Hours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/45*F Within 4 Hours* 3-501.14(C) PI IFs Received at Temperatures According to Law Cooled to 41°F/45*F Within 4 Hours.* 3-501.15 Cooling Methods for PHFs 19 PHF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 410/450 F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. 20 Time as a Public Health Control 3-501.19 Time as a Public Health Control* 590,004(1I) Variance Requirement THE COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER 1600 Osgood street suite 2035 MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover,Massachusetts 01845 Division of Food and Drugs Phone-978.688.9544) FOOD ESTABLISHMENT INSPECTION REPOR Fax-978.688.8476 e-mail: hcalthde tCatov<,nofnorthandover.com Name of Establishment Date Type of Operation(s) T e of Inspection ' Food Service Routine Address 0r✓r^n Risk Level ❑ Retail ❑ Re-inspection ❑ Residential Kitchen Previous Inspection Telephone ❑ Mobile Date: O,ner HACCP: ❑ Temporary ❑ Pre-operation Y / N ❑ Caterer ❑ Suspect Illness ❑ Bed&Breakfast ❑ General Complaint Person-in-Charge(PIC) Q �n Cim� s,. HACCP In. ( � El Other Inspector �; &� Out: ) Year: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 (G)❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands j_j 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwashing 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 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION K 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑ 20.Time as a Public Health Control 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 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 Official Order for Correction:Based on an inspection today, the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code. This C N 23. Management and Personnel (FC-2)(590.003) report, when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.0051 cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing.Your request must 27. Physical Facility (FC 6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29. Special Requirements (590.009) DATE OF RE-INSPECTION: 30. Other Inspector's Signature: Print: A ti w PICs Signature: Print: Page)of 2-Pages Violations Related to Foodborue 111ness Interventions and Risk Factors (Red Items 1-22) FOOD PROTECTION MANAGi NTENT 1 590.003(A) Assi nment of Res onsibilit * PROTECTION FROM CONTAMINATION 590.003(B) Demonstration ofKnowled e* 18 Cross-contamination 2-103.11 Person in charge-duties 3-302.11(A)(1) Raw Animal Foods Separated from Cooked and RTE Foods* EMPLOYEE HEALTH Contamination from Raw Ingredients r590.003(C) Responsibility of the person in charge to 3-302.11(A)(2) Raw Animal Foods Separated from Each require reporting by food employees and Other* a licRnts* Contamination front the Environment 590.003(F) Responsibility Of A Food Employee Or An 3-302.11 A Food Protection* Applicant To Report To The Person In 3-302.15 Washing Fruits and Vegetables Charge* 3-304.11 Food Contact with Equipment and 590.003(G) Reporting by Person in Charge* Utensils* 3 590.003 Exclusions and Restrictions* Contamination from the Consumer 590.003 f: Removal of Exclusions and Restrictions 3-306.14 A B Returned Food and Reservice of Food* Disposition ojAdulterated or FOOD FROM APPROVED SOURCE Confaminated Food 4 Food and Water From Regulated Sources 3-701.11 Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201.12 Food in a I lermeticall y Scaled Container* 9 Food Contact Surfaces 3-201.13 Fluid Milk and Milk Products* 4-501.111 Manual Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitizatiol'l'ent eratures* 3-202.14 EgRs and Milk Products Pasteurized* 4-501.112 Mechanical Wnrewashing-Hot eater 3-202.16 Ice Made From Potable Drinking Water* Sanitization Tenn eratures* 5-101.11 Drinking Water from an Approved System* 4-501.114 Chemical Sanitization-temp.,p1l, 590.006(A) Bottled Drinking Water* concentration and hardness.* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Shellfish and Fish From an Approved Utensils Clean* Source 4-602.11 Cleaning Frequency of Equipment Food- 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces and Utensils* Shellfish* 4-702.11 Frequency of Sanitization of Utensils and 3-201.15 Molluscan Shellfish from NSSP Listed Food Contact Surfaces of Equipment* Sources* 4-703.11 Methods of Sanitization-Hot Water and Game and THU Mushrooms Approved by Chemical* Regulatory Autirat•it i 10 Proper,Ade uate Handwashin 3-202.18 Shellstock Identification Present* 2-301.11 Clean Condition-Hands and Arms* 590.004(C) Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Game Animals* 2-301.14 When to Wash* 5 Receiving/Condition 11 Good Hygienic Practices 3-202.11 PHFs Received at Proper Temperatures* 2-401.11 Eating,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401.12 Discharges Front the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* 6 Tags/Records:Shellstocki 3-301.12 Preventing Contamination When Tasting* 3-202.18 Shellstock Identification* 12 Prevention of Contamination front 3-203.12 Shellstock Identification Maintained* Hands 590.004(E) Preventing Contntnination front Ta s/Records:Fish Products Em to ees* 3-402.11 Parasite Destruction* 13 Ilandwash Facilities 3-402.l2 Records,Creation and Retention* Conveniently Located and Accessible 590.004(J) 5-203.11 Numbers and Capacities* Labeling of Ingredients* 5-204.11 Location and Placement* 7 Cott forma nce with Approved 5-205.11 Accessibility,Operation and Maintenance Procedures/HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availabili 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Establishment Name: ©� Date: 3 1 Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item PLEASE PRINT CLEARLY Verified Frct C+ n 2vezm 1ant\�c- 4cam, : e v i o ae- r-_, 11) ,r4a J1 a zI d j r U l i'rl C p_ f` C �SCv d9 t 0 2 PIK, Discussion With Person in Charge: Corrective Action Required: Cl No Yes Voluntary Compliance ❑ Employee Restriction/ Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension o Embargo ❑ Emergency Closure ❑ Voluntary Disposal 13 Other. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items 1-22) (Cont,) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PROTECTION FROM CHEMICALS POPULATIONS 1ISP 14 food or Color Additives 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 3-202.12 Additives* Beverages with Warning Labels; 3-302.14 Protection from Unapproved Additives* 3-801.I 1 Use of Pasteurized Eggs* IS Poisonous or Toxic Substances 3-801.11(D) Raw or Partially Cooked Animal Food and Raw Seed Sprouts Not Served. 7-101.1 I Identi ,ing Information-Original Containers* 3-801.11 C Ra ned Food isNotPackage Not Re-served. 7-102.11 Common Name-WorkingContainers* 7-201.11 Separation-Storage* CONSUMER ADVISORY 7-202,11 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 77202.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203.11 Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.1 I Sanitizers,Criteria-Chemicals* Pathogens.*'W'1111 11112001 7-204.12 Chemicals for Washing Produce,Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 7-204.14 Drying Agents,Criteria* 7-205.11 incidental rood Contact,Lubricants* SPECIAL RL UIREMENTS 7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.13 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. TLNIE/TEMPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under 429-Special 3-401.11A(1)(2) Eggs- 155°F I5 Sec. Requirements. Eggs-hnmediate Service 145°F15sec* 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 see.* 3-401.1 t(B)(1)(2) Pork and Beef Roast- 130°P 121 min* 111OLATIONSRL•LATED TO GOOD RETAIL PRACTICE'S 3-401.11(A)(2) Ratites,In'ccted Meats-l55°F IS sec.* (Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stu(led PHFs, illness interventions and riskfacto s listed above, can be found in the Stuffing Containing Fish,Meat,Poultry or following sections of the Food Code and/05 CAM 590.000. Ratites-165°F 15 sec.* 3-401.1 I(C)(3) Whole-muscle,Intact Beef Steaks 145°F* Item Good Retail Practices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23, Management and Personnel FC-2 .003 Microwave 165°F* 24. Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 25. Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding 26• water,Plumbing and Waste FC-5 .006 3-403.11(A)&(D) PHFs 165°F 15 see.* 27. Physical Facility FC-6 .007 28. Poisonous or'foxic Materials FC-7 .008 3-403.11(B) Microwave- 165°F 2 Minute Standing 29. Special Requirements 009 Time* 30. Other 3-403.1 I(C) Commercially Processed RTE Food- 140°F* 3-403.11(E) Remaining Unsliced Portions of Beef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Roasts* 18 Proper Cooling of PIiFs 3-501.14(A) Cooling Cooked PIIFs from 140°F to 70°F Within 2 Hours and From 70°17 to 41°F/45°F Within 41lours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/450F Within 4 Hours* 3-501.14(C) PI IFs Received at Temperatures According to Law Cooled to 41 117/45017 Within 4 Hours.* P3-501.15 Cooling Methods for PHFs 19 PIIF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 410/450 F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. 20 Time as a Public Health Control 3-501.19 Time as a Public Health Control* 590.004(H) Variance Requirement THE COMMONWEALTH CF MASSACHUSETTS TOWN OR CITY OF /lf^C��-�1-► C -� Establishment Name: Date: i Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified PLEASE PRINT CLEARLY Date: ___ ime:__ ea Time:..PM Removable Mgr: pis r,� , _ ^ > F `'vt w at k_ — @.(` ii C� 1 _�i a s ^IA �'l Q ✓ 'e -C a Discussion With Person in Charge: Corrective Action Required: El No ❑ Yes t �G�.SCt-� C�ve ❑ Voluntary Compliance ❑ Employee Restriction/ J G- !�-��(� Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension 4 � /� ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: Form 734 B A.M_Si lkin Cn Rostnn MA 3-501.14(C) PHFs Received at Temperatures Vlo/ations Related to Foodborne Illness Interventions and Risk According to Law Cooled to Factors(Red kerns 1-22) (Cont.) 41°F/45°F Within 4 Hours. • PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 1�19 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below 3-302.14 Protection from Unapproved Additives* 590.004(F) 41°/45°F* 15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 140°F. * Containers* 3-501.16(A) Roasts Held at or above 130°F. ' 7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control 7-201.11 Separation-Storage* 3-501.19 Time as a Public Health Control* 7-202.11 Restriction-Presence and Use' 590.004(H) Variance Requirement 7-202.12 Conditions of Use* 7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers,Criteria-Chemicals* POPULATIONS(HSP) 7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.14 Drying Agents,Criteria* Beverages with Warning Labels* 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(B) Use of Pasteurized Eggs* 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served. * 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-served. Monitoring* CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 16 Proper Cooking Temperatures for PHFs Not Otherwise Processed to Eliminate 3-401.11A(1)(2) Eggs- 155°F 15 Sec. Pathogens.* Effective'"a001 Eggs-Immediate Service 145°Fl5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 3401.11(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 sec. ' SPECIAL REQUIREMENTS 3-401.11 B 1)( ) Pork and Beef Roast- 130°F 121 min*2 590.009(A)-(D) Violations of Section 590.009(A)-(D)in ( )( 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec. catering,mobile food,temporary and residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodbome illness Poultry or Ratites-165°F 15 sec. interventions and risk factors. Other 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F+ 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.' VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 17 Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFs 165°F 15 sec. * Critical and non-critical violations, which do not relate to the foodborne illness interventions and risk factors listed above,can be 3-403.11(B) Microwave- 165°F 2 Minute Standing found in the following sections of the Food Code and 105 CUR Time* 590.000. 3-403.11(C) Commercially Processed RTE Food- Item Good Retail Practices FC 590.000 140°F* 23. Management and Personnel FC-2 .003 3-403.11(E) Remaining Unsliced Portions of Beef 24. Food and Food Protection FC-3 .004 Roasts' 25. Equipment and Utensils FC-4 .005 18 Proper Cooling of PHFs 26. Water,Plumbing and Waste FC-5 .006 3-501.14(A) Cooling Cooked PHFs from 140°F to 27• Physical Facility FC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 70OF Within 2 Hours and From 70°F 29. Special Requirements .009 to 41°F/45°F Within 4 Hours.* 30. Other 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41017/450F Within 4 Hours* •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 3/8/2017 Town of North Andover Mail-North Andover Bgood Action Plan NORTH ANDOVER Massachusetts Michele Grant<mgrant@northandoverma.gov> North Andover Bgood Action Plan 1 message Chad Robinson <chad@bgood.com> Wed, Mar 8, 2017 at 11:47 AM To: "m grant @northandoverma.gov" <mgrant@northandoverma.gov> Cc: Jason MacLeod <jmacleod@bgood.com> Good Morning Michele, Thank you for taking the time yesterday to walk through and show me the opportunities my store has, and the actions that need to happen. I take food safety very seriously and will be working with both my team and District Manager Jason MacLeod to get the store where it needs to be. I have attached my action plan for the store and will be implementing the systems right away and will be reviewing with my team daily. I will implementing the cleaning system you suggested with a checklist. My team and I will have the deep clean done no later than Sunday, March 19. If you would like to reach out to either myself or my District Manager both of our information is below. Chad Robinson chad@bgood.com 603-860-2102 Jason MacLeod jmacleod@bgood.com 978-697-4334 Thank you, Chad Robinson C Bgood North Andover Action Plan.docx 13K https://mail.google.com/mai I/ca/u/O/?ui=2&ik=d4458df3dg&view=pt&search=i nbox&th=15aaedl d87dcdf2a&si m 1=15aaedl d87dcdf2a 1/1 Bgood North Andover: Action Plan • Deep clean(pressure wash walls, grout, floors,underneath behind grill, grill hoods and above grill) • Wash all racks • Fix hot hold unit crack • Reseal walk in • Fix grease trap and have plumber fix pipes • Wash knife rack • Reorganize walk in to establish proper hierarchy eggs cannot be next to cured bacon • Replace gasket under grill unit • Organize grill unit for proper hierarchy(eggs next to tofu) • Find safe way to hold knives on line (take down magnet on salad unit) • Establish procedure for blender cleaning • No metal scoops resting in food • Establish cleaning schedule and hold all employees accountable • Review proper handwashing and sanitizer procedures. THF CORINIONW ALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER 1600 Osgood Street Suite 2035 11%SS;�cllt'sb:l`I's i)i?PARTk�iF.'1'T OF PUBLIC HEAf.TII North Andover,Massachusetts 01845 t)i�ision of rood and Drugs Phone-978.688.9540 FOOD ESTABLISHMENT INSPECTION REPORT Fax-978.688.8476 e-mail: healthde tCaltownofnorthandmer-cram Name of Establishment Date Tyne of Operation(s) Tv)e o Ins ection &0C)c-k : --3 ' 1] Food Service Routine address C. 7"uY fJi J�c� _ c:? -' Risk Level ❑ Retail ❑Re-inspection Telephone ❑ Residential Kitchen Date: Inspection ❑ Mobile ❑pte-operation --- Owner HACCP: ❑ Temporary ❑ Suspect Illness / N ❑ Caterer ❑General Complaint Person-in-Charge(PIC) �Cl KL�U Q�,� Tim Olt ❑ Bed& Breakfast ❑ ItACCP In: Other Inspector {?C tL v1 ({w Out: 12 �2 Year: ❑ Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Nan-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red ftems) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 A❑ FOOD PROTECTION MANAGEMENT ❑12.Prevention of Contamination from Hands ❑ 1. PIC Assigned Knowledgeable/Duties ❑13.Handwashing Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS Cj 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 TIMErrEMPERATUREOONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑17.Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑18.Cooling K]19. Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time as a Public Health Control ❑ a.Separation/Segregation,/Protection REQUIREMENTS FOR HIGH LY•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 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 Official Order for Correction:Based on an inspection today,the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code.This v report,when signed below by a Board of Health member or its agent 23. Management and Personnel tFC-P)(590.0 4) constitutes an order of the Board of Health.Failure to correct violations 2 Food and Food Protection (Fc 3}(590 cited in this report may result in suspension or revocation of the food 25.. Equipment and Utensils (FC-4)(590.005005) establishment permit and cessation of food establishment operations. If 26. Water, Plumbing and Waste {FC 5)(590.006) aggrieved by this order,you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28, Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29, Special Requirements (590.009) DATE OF RE-INSPECT10,v:_.____�. 30. Other _ Inspector's Signature: r Print: PiCs tilgnuture: Print: Page)of 2+ages 3/7/2017 Town of North Andover Mail-B Good update rotation etc. NORTH AN DOVER MassachusettsMichele Grant<mgrant@northandoverma.gov> B Good update rotation etc. 1 message Megan Baldwin <megan@sweetsafellc.com> Sat, Mar 4, 2017 at 10:39 AM To: Michele Grant <mgrant@northandoverma.gov> Cc: Brian LaGrasse <blagrasse@northandoverma.gov>, Bridget Sweet <bridget@sweetsafellc.com>, Kevin Sweet <kevin@sweetsafellc.com> Hi Michele, You recently asked me to inspect B Good with a focus on food rotation. Please see attached inspection report for details. On rotation: The PIC advised they follow a FIFO procedure, and use "Use First" and Day/item/use by stickers to track items in the walk in. Several boxes of Kale were dated best by 2/25 on day of inspection which was 3/3 so the PIC removed the items. Boxes of chicken appeared to be stored in a FIFO fashion, 3/10 date above 3/12 to be used first. Two working containers of food products had the day stickers on them but were not filled out with date, time, use by information. The PIC stated he would re-train staff that day on proper rotation procedures. The regular manager was not there, and the PIC I spoke to was there just for the day, so he didn't have extensive knowledge of that particular location. Other: Also of note they had cooked Quinoa holding at 70 deg F in a small slow cooker. They stated it had been put in to re-heat an hour earlier from holding over night in walk in. I asked they re-heat to 165. The holding temp at the end of my inspection, apparently after re-heating, was still under 140 so they discarded it and used freshly cooked quinoa that I tempted at 200 deg F in another large rice cooker. They were advised that Quinoa that was previously cooked (as well as their brown rice) MUST always be re-heated rapidly from cold to 165 and held at 140 deg F or above. The re-thermalizer they usually use to reheat is broken. The small slow cooker lid does not close tightly which probably contributed to the low holding temp on Quinoa. They need to utilize only operational equipment that can achieve proper reheat and holding temperatures. Since they achieved proper temps the by end of inspection I didn't schedule a re-inspection - but if you'd like I can follow up again to confirm they are maintaining proper rotation and reheating procedures. Let me know if you have any questions! The District manager was on site briefly, and I explained this to him. He was actually just coming back from renewing his permit at your office. Best, Megan Baldwin, MS, IRS Vice President Sweet Safe, LLC 279 East Central Street, Suite 252 Franklin, MA 02038 Tel/Fax (508)969-1314 www.sweetsafellc.com B good.pdf 5919K https://m ai i.googl e.com/m ai I/ca/u/0/?ui=2&i k=d4458df3d9&view=pt&search=inbox&th=15a99fa5b2c2af4e&si m l=15a99fa5b2c2af4e 1/2 THE COMMONWEALTH CF MASSACHUSETTS TOWN OR CITY OF— Establishment Name: � 4— . '�` �`'^�'�� Date: Page: � of item code C-Critical Item r DESCRIPTION OF VIOLATION t PLAN OF CORRECTION [)ate No. Reference R-Red Item Verified PLEASE PRINT CLEARLY THURSDAY di I ✓� Item: I V QAM ' Date: Time: ❑pM � Use nAµ i gy:_ Time: opµ Removal, Emp:_ Mgr. C _ el ( :r �r.. ,i- r C kols r i /1 1,14 v, -e -Ic 7 , Ace o-bo'--c zt l z xc�,r piscussionWith,Person Charge: 4 Corrective Action Required: ❑ No o Yes '- ❑ Voluntary Compliance ❑ Employee Restriction l Exclusion I ❑ Re-inspection Scheduled ❑ Emergency Suspension; � r���� � ��� ❑ Embargo ❑ Emergency Closure e�� J Voluntary Disposal 7 Other. p,..r„ Rnonn. MA _.... Establishment Name: 0 1 � v Date: � �") � � Page: of 1 l/ 03 2 Code C--Critical Item Reference R—Red Item PLEASE PR DESCRIPTION OF VIOLATION!PLAN OF CORRECTION t No- INT CLEARLY Yesrtted '�iQ�J I QJPla� lG�ht� C V f' o GLf ' d min i� -50) , .1 r, L t 1 ( r¢ e iS CA + 3 I ( t:5� .l ` . ` GvL 2-7 Discussion With Person in Charge: Corrective Action Required: o No Yes OZ,Voluntary Compliance ❑ Employee Restriction t Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure I 13 Voluntary Disposal ❑ Other. THE COMMONWEALTH OF MASSACHUSETTS • "°' TOWN OF NORTH ANDOVER 120 Main Street MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover,Massachusetts 01845 Division of Food and Drugs Phone-978.688.9540 FOOD ESTABLISHMENT INSPECTION REPORT Fax - 978.688.9542 e-mail: healthdept@northandoverma.gov Name of Establishment Date Type of Operation(s) T e of Inspection � eO oc� I I-6k° - 69 Food Service X Routine Address 7-t<r rl Risk Level �] Retail ❑ Re-inspection Telephone El Residential Kitchen PrevPrevious Inspection El Mobile Owner HACCP: El Temporary ❑Pre-operation y / N ❑ Caterer ❑ Suspect Illness Person-in-Charge PIC Time �� ❑ Bed &Breakfast General HACCP Complaint g ( ) ') � P0 i Ck N� Inspector ) q45 ❑ Other � Q.,l'� �C1 1iv°l�� Out: l� Year: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 (qQ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwashing 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 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑ 20.Time as a Public Health Control 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 �y Critical (C) violations marked must be corrected immediately Foodborne Illnesses Interventions and Risk C1 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 Official Order for Correction:Based on an inspection today,the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code.This C N 23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health.Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order,you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29. Special Requirements (590.009) DATE OF RE-INSPECTION: 30. Other Inspector's Signature: Y� ,,,� Print: _ PICs Signature: 11�_i Print Page / of ages Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items 1-22) FOOD PROTECTION MANAGEINIENT 1 590.003(A) Assi nment of Res onsibilit y* PROTECTION FROM CONTAMINATION 590.003(B) DemonstrationofKnowledge' 18 Cross-contamination 2-103.11 Person in charge-duties 3-302.11(A)(1) Raw Animal Foods Separated from Cooked and RUE Foods* EMPLOYEE HEALTH Contamination from Raw Ingredients 2 590.003(C) Responsibility of the person in charge to 3-302.11(A)(2) Raw Animal Foods Separated from Each require reporting by food employees and Other* applicants* Contamination from the Environment 590.003(F) Responsibility Of A Food Employee Or An 3-302.1 I A Food Protection* Applicant To Report To The Person in 3-302.15 Washing Fruits and Vegetables Charge* 3-304.11 Food Contact with Equipment and 590.003(G) Reporting by Person in Charge* Utensils* 3 590.003 ) Exclusions and Restrictions* Contamination from the Consumer 590.003(E) Removal of Exclusions and Restrictions 3-306.14 A f3 Returned Food and Reservice of Food* Disposition ofAdulterated or FOOD FROM APPROVED SOURCE Contaminated Food 4 Food and Water Front Regulated Sources 3-701.1 I Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201.12 Food in a Ilermcticall y Scaled Container* 9 Food Contact Surfaces 3-201.13 Fluid Milk and Milk Products* 4-501.111 Manual Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization'I'em eratures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.112 Mechanical Warewashing-Hot eater 3-202.16 Ice Made From Potable Drinking Water* Sanitization'l'em eratures* 5-101.11 Drinking Water from an Approved System* 4-501.114 Chemical Sanitization-temp.,pli, 590.006(A) Bottled Drinking Water* concentration and hardness.* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Utensils Clean* Shellfish and Fish From an Approved Source 4-602.11 Cleaning Frequency of Equipment Food- 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces and Utensils* Shellfish* 4-702.11 Frequency of Sanitization of Utensils and 3-201.15 Molluscan Shellfish from NSSP Listed Food Contact Surfaces of Equipment* Sources* 4-703.11 Methods of Sanitization-Hot Water and Game and Wild Mushrooms Approved by Chemical* Regulatory Regulalwy Awhorit y 10 Proper,Adequate Handrvashin 3-202.18 Shellstock Identification Present* 2-301.11 Clean Condition-Hands and Arms* 590.004(C) Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Game Animals* 2-301.14 When to Wash* 5 Receiving/Condition I1 Good Hygienic Practices 3-202.I 1 PHFs Received at Proper Temperatures* 2-401.11 Eating,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401.12 Discharges From the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* 6 Tags/Records:Shellstock 3-301.12 Preventing Contamination When Tasting* 3-202.18 Shellstock Identification* 12 Prevention of Contamination from 3-203.12 Shellstock Identification Maintained* Hands Ta s/Reca•ds:Fish Products 590.004(E) Preventing Contamination from Em to�ccs* 3-402.11 Parasite Destruction* 13 H ployees Facilities 3-402,l2 Records,Creation and Retention* Conveniently Located and Accessible 590.004(J) 5-203.11 Numbers and Capacities* Labeling of ingredients' 5-204.1 l Location and Placement* 7 Conformance with Approved 5-205.11 Accessibility,Operation and Maintenance Procedures/HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handa;tshin Cleanser,Availability 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Establishment Name: b, 60 0c9 Date: I(—L�)-'-16 Page:_of c>C Item Code c-critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item PLEASE PRINT CLEARLY Verified /� �9 �J �IQ{[1 u Pr� Cc t C r G t vti s+ O t/1 C, s ssa C L-aie TTS R t. co a yc,♦ C \4 F -CyY - Nk A LA) 171.1-1.11-je- — ✓ -04 t la 1 r� k e,,-SSo � a 6-00 CUe LL ,t Sf- r e~ e.re-t / et is _ P Discussion With Person in Charge: Corrective Action Required: ❑ No Yes ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure 0 Voluntary Disposal 0 Other. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Rents 1-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PROTECTION FROM CHEMICALS POPULATION'S IIISP 14 Food or Color Additives 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 3-202.12 Additives* Beverages with Warning Labels* 3-302.14 Protection from Unapproved Additives* 3-801.1 I Use of Pasteurized Eggs* IS 3-801.1 l(D) Raw or Partially Cooked Animal Food and Poisonous or Toxic Substances Raw Seed Sprouts Not Served.* 7-101.11 Identi6,ing Information-Original Containers* 3-801.11 C Unopened Food Package Not Re-served, 7-102.11 Common Name-Working Containers* 7-201.11 Separation-Storage* CONSUMER ADVISORY 7-20 7-20211 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203..1 I Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.t 1 Sanitizers,Criteria-Chemicals* Pathogens.*r1"'^"11 7-204.12 Chemicals for Washing Produce,Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 7-204.14 Drying Agents,Criteria* 7-205.1 I Incidental Food Contact,Lubricants* SPECIAL RE UIREMEN'TS 7-206. 1I Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.I3 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. T NIE/TEIIIPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PH Fs practices should be debited under 429-Special 3-401.11A(I)(2) Eggs- 155°F IS Sec. Requirements. Eggs-Immediate Service 145°F15sec* 3-401.11(A)(2) Conunimrted Fish,Meats&Game Animals- 155°F 15 sec.* 3-401.1 I(B)(I)(2) Pork and Beef Roast- 130°F 121 min* I"IOLATIONSRELATED TO GOOD RETAIL PRACTICES (Blue Items 23-30) 3-401.1 I(A)(2) Ratites,In'ccted Meats-155°P 15 sec.* Critical and non-critical violations,which do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, illness interventions and riskfactors listed above, can be found in the Stuffing Containing Fish,Meat,Poultry or following sections of fire Food Cade and 105 CAIR 590,000. Ratites-165°F 15 sec.* 3-401.1 I(C)(3) Whole-muscle,Intact Beef Steaks 145°F* Itenr Good Retail Practices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23. Man a ement and Personnel FC-2 .003 Microwave 165°F* 24. Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 25. Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding 26• Water Plumbing and Waste FC-5 .006 3-403.11(A)&(D) PHFs l65°F 15 sec.* 27• Physical Facilit FC-6 .007 28. Poisonous or Toxic Materials FC-7 .008 3-403.11(B) Microwave- 165°F 2 Minute Standing 29. SpeciiiRequirements 009 Time* 30. 1 Other 3-403.11(C) Commercially Processed RTE Food- 140°F* 3-403.11(E) Remaining Unsliced Portions of Beef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Roasts* 18 Proper Cooling of P1I17s 3-501.14(A) Cooling Cooked PIIFs from 140°F to 70°F Within 2 Hours and From 70°F to 41°F/45°F Within 4 Hours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/45°F Within 4 Hours* 3-501.14(C) P11Fs Received at Temperatures According to Law Cooled to 411F/45117 Within 4 Hours.* 193-501.15 CoolingMethods for PHFs PHF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 410/450 F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. 20 Time as a Public Health Control 3-501.19 Time as a Public Health Control* 590.004(11) Variance Requirement THE COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER 1600 Osgood Street Suite 2035 MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover,Massachusetts 01845 Division of Food and Drugs Phone-978.6889540 FOOD ESTABLISHMENT INSPECTION REPORT Fax-978.688.8476 e-mail: healthde t@to wnofnorthandover.com Name of Establishment Date Type of Operation(s) Tvpe of Inspection Food Service Routine Address 'L' �C)1 Risk Level ❑ Retail El Re-inspection ❑ Residential Kitchen Previous Inspection Telephone 12) , � ❑ Mobile Date: Owner HACCP: ❑ Temporary ❑ Pre-operation Y / N ❑ Caterer ❑ Suspect Illness Person-in-Charge(PIC) t � Time U ❑ Bed&Breakfast ❑ General Complaint ❑ HACCP In- Inspector E�� � - )� � Out: �� Year: El Other � r Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 (G)❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwashing 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 7115.Toxic Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8.Separation/Segregation/Protection ❑ 20. Time as a Public Health Control 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 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 Official Order for Correction:Based on an inspection today, the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code. This C N 23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29. Special Requirements (590.009) DATE OF RE-INSPECTION: A 30. Other '�j�x �„ J&t Inspector's Signature: T� .\ i J Print: G�j ^� PICs Signature: �,� ��;jv Acl Print: l Page I of Pages r J Violations Related to Foodborne Illness bnterventions and Risk Factors (Red Items I-22) FOOD PROTECTION MANAGEMENT I 590.003(A) Assignment of Responsibility* PROTECTION FROM CONTAMINATION 590.003(B) DemonstrationofKnowled e* 18 Cross-contaurination 2-103.11 Person in charge-duties 3-302.11(A)(1) Raw Animal Foods Separated from Cooked and RTIi Foods* EMPLOYEE HEALTH Contamination from Raw Ingredients r590.003(C) Responsibility of the person in charge to 3-302.11(A)(2) Raw Animal Foods Separated from Each require reporting by food employees and Other* A licR11ts* Contamination from the Environment 590.003(F) Responsibility Of A Food Employee Or An 3-302.1( A Food Protection* Applicant To Report To The Person In 3-302.15 Washing Fruits and Vegetables Charge* 3-304.11 Food Contact with Equipment and 590.003(G) _Reportingby Person in Charge* Utensils* 3 590.003(D) Exclusions and Restrictions* Contamination from the Consumer 590.003 T: Removal of Exclusions and Restrictions 3-306.14 A B Returned Food and Reservice of Food* Disposition ojAdulterated or FOOD FROM APPROVED SOURCE Contcnninated Foocl 4 Food and Water From Regulated Sources 3-701.1 I Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201.12 Food in a Hermetically Sealed Container* 9 Food Contact Surfaces 3-201.l3 Fluid Milk and Milk Products* 4-501.111 Manual Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization'I'em eratures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.112 Mechanical Warewashing-Hot eater 3-202.16 ice Made From Potable Drinking Water* Sanitization'Ten1 eratures* 5-101.11 Drinking Water from an Approved Sy stem* 4-501.114 Chemical Sanitization-temp.,pll, 590.006(A) Bottled Drinking Water* concentration and hardness.* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Utensils Clean* Shellfish and Fish From an Approved Source 4-602.1 I Cleaning Frequency of Equipment Food- Contact Surfaces and Utensils* 3-201.14 Fish and Recreationally Caught Molluscan SlleIlfish 4-702.11 Frequency of Sanitization of Utensils and 3-20 t.15 Molluscan Shellfish from NSSP Listed Food Contact Surfaces of Equipment* Sources* 4-703.11 Methods of Sanitization-Hot Water and Game and lVild Mushrooms Approved by Chemical* Re ulatot• Authority 10 Pro er,Adequate Handwashin 3-202.I8 Shellstock Identification Present* 2-301.11 Clean Condition-Hands and Arms* 590.004(C) Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Game Animals* 2-301.14 When to Wasli* 5 Receiving/Condition II Good Hygienic Practices 3-202.11 PHFs Received at Pro er Temperatures* 2-401.11 Eating,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401.12 Discharges From the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* 6 Ta s/Rccords:Shellstock 3-301.12 Preventing Contamination When Tasting* 3-202.18 Shellstock Identification* 12 Prevention of Contamination from 3-203.12 Shellstock Identification Maintained* Hands 590.004(E) Preventing Contamination from Ta s/Records:Fish Products Employees* 3-402.11 Parasite Destruction* 13 Ilandlvash Facilities 3-402,l2 Records,Creation and Retention* Convenient) Located and Accessible 590.004{J) 5-203.11 Numbers and Capacities* Labeling of ingredients* 5-204.11 Location and Placement* 7 Conformance with Approved 5-205.11 Accessibility,Operation and Maintenance Procedures/HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced ox en packaging,criteria* 6-301.11 Handwishing Cleanser,Availabili 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Establishment Name: OC-9 Date: 4,_5 1 /(C Page: 2— of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION pate No. Reference R—Red Item PLEASE PRINT CLEARLY Verified Moan i 71q CAI_(*r ' ice` ��� I n ��; -, c �' t:-.--� � tYl .56•� � _.,' �/y f / C4 G.7 n S lc,,. Ai c-S c- -2 iY JL�C K 11 °t�t �� � •trC G��o t Discussion With Person in Charge: Corrective Action Required: ❑ No F Yes Voluntary Compliance ❑ Employee Restriction/ Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure 13 Voluntary Disposal ❑ Other. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Itenrs 1-22) (Cont.) REQUIRE,DIEN'TS FOR HIGHLY SUSCEPTIBLE PROTECTION FROM CHEMICALS POPULATIONS IISP 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 14 food Color AdditivesBeverages with WarningLabels* 3-202.12 Additives* 3-801.11(B) Use of Pasteurized Eggs* 3-302.14 Protection from Unapproved Additives* 3-801.11(D) Raw or Partially Cooked Animal Food and IS Poisonous or Toxic Substances Raw Seed Sprouts Not Served. 7-101.1 I ldenti ,ing Information-Original Containers* 3-801.11 C Unopened Food Package Not Re-served, 7-102.11 Common Name-Working Containers* 7-201.11 Separation-Storage* CONSUNIER ADVISORY 7-202.11 Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 7-202.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203.11 Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.11 Sanitizers,Criteria--Chemicals* Pathogens.*P`11 UJ 1 7-204.12 Chemicals for Washing Produce,Criteria* 3-302.I3 Pasteurized Eggs Substitute for Raw Shell Eggs* 7-204.14 Drying Agents,Criteria* 7-205.11 Incidental Food Contact,Lubricants* SPECIAL REQUIREMENTS 7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.13 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. TENIE/TE IPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under 429-Special 3-401.11A(1)(2) Eggs- 155°F 15 Sec. Requirements. Eggs-hnmediate Service 145°F15sec* 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 sec.* VIOLA TIONS RE,L11 YT D TO GOOD RETAIL PRACTICES 3-401.1 l(B)(1)(2) Pork and Beef Roast-130°F 121 min* (Blue Iteuns 23-30) 3-401.11(A)(2) Ratites,In'ected Meats--l55°F 15 see.* Critical and non-critical violations,which do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,StulTed PHFs, 111ness interventions and riskfuctors listed above, can be found in the Stuffing Containing Fish,Meat,Poultry or following sections of the Food Cade and 105 011?590.000, Ratites-165°F 15 sec.* 3-401.11(C)(3) Whole-nnuscle,Intact Beef Steaks 145°F* Item Good Retail Practices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23. 1 Management and Personnel FC-2 .003 Microwave 165°F* 24. 1 Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 25. Equipment an Utensils FC-4 .005 17 Reheating fw•Hot Holding 26. water,Plumbing and Waste FC-5 .006 3 403.11(A)&(D) PHFs I65°F 15 sec.* 27• Physical Facilit FC-6 .007 28. Poisonous or'foxic Materials FC-7 .008 3-403.11(B) Microwave- 165°F 2 Minute Standing 29, Special Re uirements .009 Time* 30. 1 Other 3-403.11(C) Commercially Processed RTE Food- 140°F* 3-403.11(E) Remaining Unsliced Portions of Beef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590,000. Roasts* 18 Proper Cooling of PHFs 3-501.14(A) Cooling Cooked Pl•1Fs from NOT to 70°F Within 2 Hours and From 70°F to 41*F/45°F Within 4 Hours.* 3-501.14(B) Cooling PHFs Made From Ambient "Temperature Ingredients to 4l°F/45°F Within 4 Hours* 3-501.14(C) PHFs Received at Temperatures According to Law Cooled to 411F/451F Within 4 Hours.* 3-501.15 Cooling Methods for PHFs 19 PHF Hot And Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 410/450 F* 3-501.16(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. 20 Time as a Public Health Control 3-501.19 Time as a Public Health Control* 590.004(1I) Variance Requirement THE COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER 1600 Osgood Street Suite 2035 MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover,Massachusetts 01845 Division of Food and Drugs Phone-978.688.9540 FOOD ESTABLISHMENT INSPECTION REPORT Fax-978.688.8476 e-mail: healthde t@to wnofnorthandover.com Name of Establishment (�� Date Type o Operation s Type o Ins ection 7/0-/�s Food Service Routine Address l Risk Level Retail Re-inspection �7-7 ' ❑ Residential Kitchen Previous Inspection Telephone ❑ Mobile Date: Owner HACCP: ❑ Temporary ❑ Pre-operation Y / N ❑ Caterer ❑ Suspect Illness Person-in-Charge(PIC) Time ❑ Bed &Breakfast ❑ General Complaint oi��� In: ocry ❑ HACCP Inspector Su El Other _ p ll� ,� � I I Out: Year: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 (G)❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties C613. Handwashing 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 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8.Separation/Segregation/Protection ❑ 20. Time as a Public Health Control 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 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 Official Order for Correction:Based on an inspection today,the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code.This C N 23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. /�f 29. Special Requirements (590.009) DATE OF RE-INSPECTION: 1 __ 30. Other Inspector's Signature: Print: iN4-e Ott ) c[LA/i PICs Signature: � „� Print: J& awW Page of 1ges Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items I-22) FOOD PROTECHON MANAGEN7ENT 1 590.003(A) Assignment ofRes onsibilit y* PROTECTION FROM CONTAMINATION 590.003(B) Demonstration of Knowledge* 8 Cross-contamination 2-10111 Person in charge-duties 3-302.11(A)(1) Raw Animal Foods Separated from Cooked and RTE.Foods* EMPLOYEE HEALTH Contamination from Raw Ingredients 2 590.003(C) Responsibility of tine person in charge to 3-302.11(A)(2) Raw Animal Foods Separated from Each require reporting by food employees and Other* applicants* Contamination from the Environment 590.003(F) Responsibility Of A Food Employee Or An 3-302.11 A Food Protection* Applicant To Report To The Person In 3-302.15 Washing Fruits and Vegetables Charge* 3-304.11 Food Contact with Equipment and 590.003(G) I Reporting 1)),Person in Charge* Utensils* 3 590.02IQ2)_j Exclusions and Restrictions* Contamination from the Consumer 590.003 E) Removal of Exclusions and Restrictions 3.306.14(A)(B) Returned Food and Reservice of Food* Disposition of Adulterated or FOOD FROM APPROVED SOURCE Contaminated Food 4 rood and lVater From Rc ufated Sources 3-701.11 Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201A2 Food in a I lermetically Scaled Container* 9 Food Contact Surfaces 3-201.13 Fluid Milk and Milk Products* 4-501.11 l Manual Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.112 Mechanical Wareivashing-Hot Water 3-202.16 Ice Made From Potable Drinking Water* Sanitization Tem eratures* 5-101.11 Drinking Water from an Approved System* 4-501.114 Chemical Sanitization-temp.,pll, 590.006(A) Bottled Drinking Water* concentration and hardness.* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Utensils Clean* Shellfish and Fish From an Approver)Source 4-6011 f Cleaning Frequency of Equipment Food- 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces and Utensils* Shellfish* 4-702.1 1 Frequency of Sanitization of Utensils and 3-201.15 Molluscan Shellfish from NSSP Listed Food Contact Surfaces of Equipment* Sources* 4-703.1 1 {`Methods of Sanitization-Hot Water and Gnome and Wild h•Iushrooms Approved by Chemical* Re ulatogAuthorit, 10 Proper,Adequate Handwashin 3-202.18 Shellstock Identification Present* 2-301.1 1 Clean Condition-Hands and Arms* 590.004(C) Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Game Animals* 2-301.14 When to Wash* 5 Receiving/condition I1 Good Hygienic Practices 3-202.f 1 PHFs Received at Proper Temperatures* 2-401.11 Eating,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401,12 Discharges From the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* 6 Ta s/Rccords:Shellstock 3-301.12 Preventing Contamination When`fasting* 3-202.18 Shellstock Identification* 12 Prevention of Contamination from 3-203.12 Shellstock Identification Maintained* Hands 590.004(E) Preventing Contamination from Ta s/Records:Fish Products Em to gees* 3-402.1 l Parasite Destruction* 13 Handwash Facilities 3-402.12 Rccords,Creation and Retention* Conveniently Located and Accessible 590.004(J) 5-203.11 Numbers and Capacities, Labeling of Ingredients* 5-204.1 1 Location and Placement* 7 Conformance with Approved 5-205.1 f Accessibility,Operation and Maintenance Procedures/HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashing Cleanser,Availabili 8-103.12 Conformance with Approved Procedures* 6-301.12 Band Drying Provision 'Denotes critical item in the federal 1999 Food Code or 105 CA4R 590.000. 1 Establishment Name: �' Q d Date: 1,;?, —I U —IS Page: C� of Item Code C—Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item PLEASE PRINT CLEARLY ified r- h , n),-- s Z U re 0 r ' r � b - 7, D U =xis LAOAS ` �j(,rPa� 4�O1+nl Discussion With Person in Charge: 0-1 Corrective Action Required: ❑ No d ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion Cl ❑ Re-inspection Scheduled ❑ Emergency Suspension , r -I li f QI ❑ Embargo ❑ Emergency Closure G e 1 ❑ Voluntary Disposal �OtherDo_�k� 3i� Violations Related to Foodborne Illness Interventions and Risk Factors(Red penis 1-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PROTECTION FROM CHENIICALS POPULATIONS LISP 14 EAdditives* Additives 21 3-80L11(A) Unpasteurized Pre-packaged Juices and E3-3O2.14 2 Beverages with WarningLabels* m Una roved Additives* 3-801.11 Use ofPasteurized E gs* 3-801.11(D) Raw or Partially Cooked Animal Food and 15 oxic Substances Raty Seed S routs Not Served. 1 formation-Original Containers* 3 801.1 l C Unopened Food Package Not Re-served, 7-102.11 Common Name-Workin Containers* 7-201.11 Separation-Storage* CONSUMER ADVISORY 7-202.1 I Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted for Consumption of 7-242.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203.11 Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.11 Sanitizers,Criteria-Chemicals* Pathogens.*4""'<11 7-204.12 Chemicals for Washing Produce,Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 7-204.I4 Drying Agents,Criteria* 7-205.1 I Incidental Food Contact,Lubricants* SPECIAL RE UIREMENTS 7-206.1 I Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 Rodent Bait Stations* catering,mobile food,temporary and residential 7-206.13 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitorin * appropriate sections above if related to foodborne illness interventions and risk factors. TL\IE/TEMPERATURE CONTROLS Other 590.009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under 429-Special 3-401.11A(1)(2) Eggs- 155°F 15 Sec. Requirements. Eggs-lmmediate Service 145°F15sec* 3-401.11(A)(2) Comminuted Fish,Meats&Game Animals- 155°F 15 sec.* 3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 min* i110LATIONS RELATED T O GOOD RETAIL PRACTICES 3-401.1 I A 2 °, * (Blue Items 23-30) ( )O Ratites,Iniected Meats-155 F 15 sec. ' Critical and non-crilical violations,which do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, illness interventions and riskfactors listed above, can be found in the Stuffing Containing Fish,Meat,Poultry or following sections oflite Food Code and 105 CAIR 590.000. Ratites-i65°F 15 sec.* 3-401.1 f(C)(3) Whole-muscle,Intact Becf Steaks 145°F* Iteal GaodRelaftPractices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23, Management and Personnel FC-2 .003 Microwave 165°F* 24. Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F15 sec.* 25, Equipment and Utensils FC-4 .005 17 Reheating for Hot Holding 26. Water Plumbing and Waste FC-5 .006 3-403.11(A)&(D) PHFs 165°F 15 sec.* 27. Physical Facility FC-6 .007 28. Poisonous or Toxic Materials ]!�EF 008 3-403.11(B) Microwave-165°F 2 Minute Standing 29. Special Requirements 009 Time* 30. Other 3-403.11(C) Commercially Processed RTG Food- I40°F* 3-403.11(E) Remaining Unsliced Portions of Beef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Roasts* 18 Proper Cooling of PIIFs 3-501.14(A) Cooling Cooked PI11s from 140°F to 70°F Within 2 Hours and From 70°F to 41°F/45°F Within 4 Hours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/45°F Within 4 Hours* 3-501.14(C) PIiFs Received at Temperatures According to Law Cooled to 41°F/45°F Within 4 Hours.* 3-501.15 Cooling Methods for PHFs 19 PHF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 410/450 F* 3-501.16(A) Hot PHFs Maintained at or above I40°F. 3-501.16(A) Roasts Held at or above 130°F. 20 Time as a Public Health Control 3-501.19 Time as a Public Health Control* 590.004(11) Variance Re uirement THE COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER 1600 Osgood Street Suite 2035 MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover,Massachusetts 01845 Division of Food and Drugs Phone-978.688.9540 FOOD ESTABLISHMENT INSPECTION REPORT Fax-978.688.8476 e-mail: healthde t@to wnofnorthandover.com Name of Establishment % Date Type of Operations) Type of Inspection b r2 ❑ Food Service ❑ Routine Address 2,-7�. �� s L vel ❑ Retail ❑ Re-inspection ❑ Residential Kitchen Previous Inspection Telephone �� Mobile Date: Owner HACCP: JgTernporary re-operation i �,7 4- Y / N aterer ki Suspect Illness Person-in-Charge(PIC) rn3 Time ❑ Bed&Breakfast ❑ General Complaint ❑ HACCP Inspector In: ❑ Other - Each Year: Each violation checked requires an explanation the narrative page(s)and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590,009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen Awareness 590.009 (G)❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties 13. Handwashing Facilities /Vt(5 'j O Z� EMPLOYEE HEALTH J 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 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time as a Public Health Control 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 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 Official Order for Correction:Based on an inspection today,the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code. This C N 23. Management and Personnel (FC-2)(590.003) report,when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing. Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29. Special Requiremen (590.009) DATE OF RE-INSPECTION: 30. Other Inspector's Signature: Print: O w r PICs Signature: Print: e u Page_of Pages z t � Violations Related to Foodborne Illness Interventions and Risk Factors (Red[terms 1-22) FOOD PROTECTION i1'IANAGEMENT 1 590.003(A) Assi nment of Res onsibilit * PROTECTION FROM CONTAMINATION 590.003(B) DemonstrationofKnowled e* 8 Cross-contamination 2-103.I1 Person in charge-duties 3-302.1 I(A)(1) Raw Animal Foods Separated front Cooked and RTE Foods* EMPLOYEE HEALTH Contamination from Raw Ingredients 2 590.003(C) Responsibility of the person in charge to 3-302.11(A)(2) Raw Animal Foods Separated froin Each require reporting by food employees and Other* applicants* Contamination from the Environment 590.003(F) Responsibility Of A Food Employee Or An 3-302.11 A Food Protection* Applicant To Report To The Person In 3-302.15 Washing Fruits and Vegetables Charge* 3-304.11 Food Contact with Equipment and 590.003(0) Reporting by Person in Charge* Utensils* 3 I 590.003(D) Exclusions and Restrictions* Contamination from the Consumer 590.003(E) Removal of Exclusions and Restrictions 3-306.14 A B Returned Food and Reservice of Food* Disposition ofAdulterated or FOOD FROM APPROVED SOURCE Contaminated Food 4 Food and Water From Regulated Sources 3-701.11 Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201.12 Food in a Hermetically Scaled Container* 9 Food Contact Surfaces 3-201.13 Fluid Milk and Milk Products* 4-501.111 Manual Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitizatioin'I'en» erahires* 3-202.14 Eggs and Milk Products Pasteurized* 4-501.112 Mechanical Warewashing-Hot Water 3-202.16 lee Made From Potable Drinking Water* Sanitization rem eratures* 5-101.11 Drinking Water from an Approved System* 4-501.I 14 Chemical Snnitization-temp.,p1l, 590.006(A) Bottled Drinking Water* concentration and hardness.* 590.006 B Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Shellfish and Fish From an Approved Utensils Clean* Source 4-602.11 Cleaning Frequency of Equipment Food- 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces and Utensils* Shellfish* 4-702.11 Frequency of Sanitization of Utensils and 3-201.15 Molluscan Shellfish from NSSP Listed Food Contact Surfaces of Equipment* Sources* 4-703.11 Methods of Sanitization-Hot Water and Canne and 131ild Mushrooms Approved by Chemical* Re ulatoi• Authorit, 10 Proper,Adequate Handwashin 3-202.18 Shellstock Identification Present* 2-301.11 Clean Condition-Hands and Arms* 590.004 C Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Game Animals* 2-30I.14 When to Wash* 5 Receiving/Condition 11 Good Hygienic Practices 3-202.11 PHFs Received at Proper Temperatures* 2-401A I Entin ,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401,12 Discharges From the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* 6 Ta s/Rcco•ds:Shellstock 3-301.12 Preventing Contamination When Tasting* 3-202.18 Shellstock Identification* 12 Prevention of Contamination from 3-203.12 Shellstock Identification Maintained* Hands 590.004(E) Preventing Contamination from Ta s/Records:Fish Products Employees* 3-402.11 Parasite Destruction* 13 llandwash Facilities 3-402.l2 Records,Creation and Retention* Conveniently Located and Accessible 590.004(J) 5-203.11 Numbers and Capacities* Labeling of ingredients* 5-204.1 l Location and Placement* 7 Conformance with Approved 5-205.1 l Accessibility,Operation and Maintenance ProcedureslHACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwishing Cleanser,Availabili 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision •Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Establishment Name: Z2 , r�?5,=:, Date: ` Page: Z7—of Item code C—Critical item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date R No. Reference R—Red Item PLEASE PRINT CLEARLY Verified - Grp 7 d ­ G7 rrC J " t!i C 1-� .. IT Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension ❑ Embargo ❑ Emergency Closure �// .-L ` �D ❑ Voluntary Disposal ❑ Other �3 'jh, G 9 G;L v! It K,, 1 GY Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items 1-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PROTECTION FROM CHTi4IICALS POPULATIONS IISP 14 Food or Color Additives 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 3-202.12 Additives* Beverages with Warning Labels* 3-302.t4 Protection from Una roved Additives* 3-801.11(B Use of Pasteurized E gs* 3-801.11(D) Raw or Partially Cooked Animal Food and 15 Poisonous or Toxic Substances Raw Seed Sprouts Not Served. 7-101.11 Identi6,ing Information-Original Containers* 3-801.11 C Unopened Food Package Not Re-served, 7-102.11 Common Name-Working Containers* 7-20L I 1 Separation-Storage* CONSUMER ADVISORY 7-202.I 1 Restriction-Presence and Use* 22 3-603.1 I Consumer Advisory Posted for Consumption of 7-202.12 Conditions of Use* Animal Foods That are Raw,Undercooked or 7-203.11 Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate 7-204.11 Sanitizers,Criteria-Chemicals* Pathogens.*41"'11 11 7-204.12 Chemicals for Washing Produce,Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Eggs* 7-204.14 Drying Agents,Criteria* 7-205.11 incidental Food Contact,Lubricants* SPECIAL REQUIREMENTS 7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 7-206.12 1 Rodent Bait Stations* entering,mobile food,temporary and residential 7-206.l3 Tracking Powders,Pest Control and kitchen operations should be debited under the Monitoring* appropriate sections above if related to foodborne illness interventions and risk factors. TL\IE/TEMPERATURE CONTROLS Other 590,009 violations relating to good retail 16 Proper Cooking Temperatures for PHFs practices should be debited under 429-Special 3-401.1IA(1)(2) Eggs- 155°F 15 Sec. Requirements. Eggs-Immediate Service 145°Fl5sec* 3-401.11(A)(2) Comminuted Fish,Meats&Ganie Animals- 155°F 15 see.* 3-401.1 I(B)(1)(2) Pork and Beef Roast- 130°F 121 mia* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-401.1 I A 2 (Blue Items 23-30) ( )O Ratites Iniected Meats-155°F I5 sec.* Critical and non-critical violations,which do not relate to the foodborne 3-401.11(A)(3) Poultry,Wild Game,Stufied PHFs, illness interventions and riskfactors listed above, can be found in tie Stuffing Containing Fish,Meat,Poultry or following sections of the Food Code and 105 CdIR 590.000. Ratites-165°F 15 see.* 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* Item GoodRetailPractices FC S90.000 3-401.12 Raw Animal Foods Cooked in a 23, Management and Personnel FC-2 .003 Microwave 165°F* 24. Food and Food Protection FC-3 .004 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec.* 25. Equipment and Utensils FC_-4 7005 17 Reheating for Hot Holding 26. Water,Plumbing and Waste FC-5 .006 3-403.11(A)&(D) PHFs 165°F 15 see.* 27• Physical Facility FC-6 .007 28. Poisonous or'foxic Materials FC-7 .008 3-403.11(B) Microwave- I65°F 2 Minute Standing 29. Special Requirements .009 Time* 30. Other 3-403.11(C) Commercially Processed RTE Food- 140°F* 3-403.11(E) Remaining Unsliced Portions of Reef *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Roasts* 18 Proper Cooling of PlIFs 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Within 2 Hours and From 70°F to 41°F/45°F Within 4 Hours.* 3-501.14(B) Cooling PHFs Made From Ambient Temperature Ingredients to 41°F/451F Within 4 Hours* 3-501.14(C) PIIFs Received at Temperatures According to Law Cooled to 41 0F/450F Within 4 Hours.* 3-501.15 Cooling Methods for PHFs 19 PHF Hot and Cold Holding 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 410/450 F* 3-501.I6(A) Hot PHFs Maintained at or above 140°F. 3-501.16(A) Roasts Held at or above 130°F. 20 �1) V1j'r1jta,'jse Public Health Control Public Health Control* Requirement THE COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER 1600 Osgood Street Suite 2035 MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH North Andover, '.Massachusetts 01845 Division of Food and Drugs Phone-978.688.9540 FOOD ESTABLISHMENT INSPECTION REPORT ` Fax-978.688.8476 e-mai : healthde t@townofnorthandover.com Name of Estab ' hment Date Type of Operation(s) Tvpe of Inspection j : ; CaEood Service ❑ ROLItine Address �, R sk Level Retail ❑ Re-inspection IA-A-- ❑ Residential Kitchen Previous Inspection Telephone � � � Z El Mobile Dale' Owner / HACCP: ❑ Temporary Pre-operation Y / N El Caterer HE, Suspect Illness Person-in-Charge (PIC) �-©� �� s cs� Time ❑ Bed& Breakfast ❑ HACCPGeneral Complaint In: ❑ Inspector Other Out: Year: ❑ Each violation checked requires an explanation on then rrative page(s)and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 590.009(F) ❑ determined by the Board of Health. Allergen awareness 590.009 (G)❑ FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwashing 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 TIME/TEMPERATURE CONTROLS(Poten ially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatu ❑ 6. Tags/Records/Accuracy of Ingredient ents ❑ 17. Reheating ❑ 7. Conformance with Approved Pr ns ❑ 18. Cooling (C7L, r PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding 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 Critical (C) violations marked must be corrected immediately Foodborne Illnesses Interventions and Risjk2 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 Official Order for Correction:Based on an inspection today, the items within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 590.000/federal Food Code. This C N 23. Management and Personnel (FC-2)(590.003) report, when signed below by a Board of Health member or its agent 24. Food and Food Protection (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 25. Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing.Your request must 27. Physical Facility (FC-6)(590.007) be in writing and submitted to the Board of Health at the above address 28. Poisonous or Toxic Materials (FC-7)(590.008) within 10 days of receipt of this order. 29. Special Require nts (590.009) DATE OF RE-INSPF,CTION: 30. Other Inspector's Signature: Print: PICs Signature: Print: Jo�n N, a�J S of Page_of Pages Violations Related to Foodhorue Illness Inlerverrdons and Risk Factors (Red Items I-22) FOOD PROTECTION MANAGEMENT 1 590.003(A) Assi nment of Res onsibilit * PROTECTION FROII CONTAMINATION 590.003(B) Demonstration of Knowied e* 8 Cross-contamination 2-103.11 Person in charge-duties 3-302.11(A)(1) Raw Animal Foods Separated from Cooked and RTE Foods* EMPLOYEE HEALTH Contamination from Raw Ingredients 2 590,003(C) Responsibility of the person in charge to 3-302.11(A)(2) Raw Animal Foods Separated from Each require reporting by food employees and Other* applicants* Contamination from the Environment 59UM(F) Responsibility Of A Food Employee Or An 3-302.11 A Food Protection* Applicant To Report To The Person In 3-302.15 Washing Fruits and Vegetables Charge* 3-304.11 Food Contact with Equipment and 590.003 G Rep2rting by Person in Charge* Utensils* 3 590.003(D) Exclusions and Restrictions* Contamination from the Consumer 590.003E Removal of Exclusions and Restrictions 3-306.14 A 13 Returned Food and Reservice of Food* Disposition ojAdulterated or FOOD FROM APPROVED SOURCE Contaminated Food 4 Food and Water From Regulated Sources 3-70L11 Discarding or Reconditioning Unsafe 590.004 A-B Compliance with Food Law* Food* 3-201.12 Food in a I lermcticall y Scaled Container* 9 Food Contact Surfaces 3-201.13 Fluid Milk and Milk Products* 4-501.111 Manual Warewashmg-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501,112 Mechanical Warewashing-Hot Water 3-202.l6 1 lee Made From Potable Drinking Water* Sanitization'renn eratures* 5-101.11 Drinking Water from an Approved System* 4-501.114 Chemical Sanitization-temp.,p13, 590.006(A) Bottled Drinking Water* concentration and hardness.* 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-601.11(A) Equipment Food Contact Surfaces and Shellfish and Fish From an Approved Utensils Clean* Source 4-602.11 Cleaning Frequency of Equipment Food- 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces and Utensils* Shellfish* 4-702.11 Frequency of Sanitization of Utensils and 3-201.15 Molluscan Shellfish from NSSP Listed Food Contact Surfaces ofEquipment* Sources* 4-703.11 Methods of Sanitization-Hot Water and Game and II'ild Mushrooms Approved by Chemical* Re ulator Awhorit i 10 Proper,Adequate Handwashin 3-202.18 Shellstock Identification Present* 2-301.11 Clean Condition-Hands and Arms* 590.004 C Wild Mushrooms* 2-301.12 Cleaning Procedure* 3-201.17 Gannc Animals* 2-301.14 When to Wash* 5 Receiving/Condition 11 Good Hygienic Practices 3-202.11 PHFs Received at Pro er Temperatures* 2-401.11 Eating,Drinking or Using Tobacco* 3-202.15 Package Integrity* 2-401.12 Discharges From the Eyes,Nose and 3-101.11 Food Safe and Unadulterated* Mouth* G Ta s/Rccords:Shellstock 3-301.12 Preventing Contamination When Tasting* 3-202.18 Shellstock identification* 12 Prevention of Contamination from 3-203.12 Shellstock Identification Maintained* Hands Tags/Records:Fish Products 590.004(E) Preventing Contamination from Employees* 3-402.11 Parasite Destruction* 13 I ash Facilities 3-402,l2 Records,Creation and Retention*590.004(J) Conveniently Located and Accessible 5-203.1 t Numbers and Capacities* Labeling of Ingredients* 5-204.1 t Location and Placement* 7 Conformance with Approved 5-205.1 I Accessibility,Operation and Maintenance Procedures/HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.1 I 1 Hand vishing Cleanser Availabili 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. REGULATORY HEALTH AUTHORITY COMPLIANCE REVIEW CHECKLIST Insufficient Satisfactory Unsatisfactory N/A Information 1. Finish Schedule [ [ ] [ ] [ ] Kitchen [ ] [ ) [ ] [ ) Warewashing [ ] [ J [ ) [ ] Food Storage [ ] [ ] [ ] [ l Other Storage [ ] [ ] [ ] [ ] Toilet Rooms [ ] [ ] [ ] [ ) Dressing Rooms [ ] [ ) [ ) [ ) Mop Service Area [ ] [ ] ( ) [ ) 2. Insect&Rodent Harborage 3. Garbage and Refuse 4. Plumbing 5. Water Supply 6. Sewage Disposal [ J [ ] S. Separate Toxic Storage 9. Laundry Facilities 10. Linen Storage 11. Exhaust Hoods [ [ ) [ J [ J 12. Hand Sinks 13. Dishwashing&Pot Sinks 14. Lighting 15. Ventilation [ ] [ ] [ ] [ ] 16. Grease Traps [0 [ ) [ ] [ l 17. Employee Restrooms Location ( ] [ ] [ ] [ ) Nurr, Soap [ ] ( ] [ ) [ ] Hand Drying [ ) [ l [ ] [ J Lavatories ( ) ( ) ( ) ( ) Water Closets [ ) [ ) [ ] [ ) Urinals [ ) ( ) ( l [ ] Waste Receptacles [ ] [ ] [ ) [ ) 18. Patron Restrooms Location Number l Soap [ ) [ ) [ ] Hand Drying ( ) [ ] [ ] [ ] [ l Lavatories [ ] [ ] [ ] [ ) Water Closets [ ] [ ] [ ) [ ] Urinals [ ) [ ] [ ] [ ] Waste Receptacles [ ] [ l [ ] [ ] 19. Kitchen Equipment Space between units or wall closed or adequate space for easy cleaning [ ] [ ] [ ] [ l Aisles sufficient [vJ [ ] [ ] [ ) Storage 6"off floor [ ) [ ] [ ] [ l Countertops&cutting boards of suitable material Self serve food area adequately protected Built-in external temperature gauges or provision for separate internal thermometers noted for each piece of refrigerated equipment [ ] ( l [ ] [ ] Utensil&Kitchen Storage Clean C ] [ ] [ ) { ] Soiled [ ] [ ] [ ] [ ] Counter mounted equipment []/ [ ) I I Floor mounted equipment [ [ ] [ ] [ ] Vacuum packaging equipment /(p 4 ( ] [ ] ] Bulk food [ ] [ ] ( ) [ ] Self service Salad 014 Hot/Cold Buffet 20. Food Preparation Review [ [ ) [ ] [ ] Raw food prep table(s) [ ] [ ] [ ] (as menu dictates) Raw food prep sink(s) (as menu dictates) Adequate refrigeration Adequate cold holding facilities Adequate hot holding facilities Adequate hot food preparation equipment [ ] [ ] [ ] [ ] Vacuum packaging 6t A HACCP plan �/ COMMENTS: (Explain why any item was noted"Unsatisfactory,") Reviewer Signature Date Reviewer Title APPROVAL: DATE: DISAPPROVAL: DATE: REASONS FOR DISAPPROVAL: