HomeMy WebLinkAboutResidential Kitchen - Inspection - 117 BRIDLE PATH 2/22/2022 ° —,5 ,
'I'llh,C OMCwtONWF^,A'L'I'l I Ot:,MASSAC 141IsF.'ns
TOWN OF NORTH A,NDC)VER 120 Main Street
MASSAC`I31iSE ITS I►L°t"ARTNiEN°r t'F PtJltlrlt.". i`.Al,,'['H North Andover,Massachusetts 01 45
Division of Food acid Dnags Phone-978.688.9540
FOOD IDS"CABLI HMENI" INSI`ECTION RLTORl" Fax - 97 .688.9542
e-rail: hexaltlide4 pnorthandovernta. r.ry
Nane of lstablishnaent r,, °in„t �nm r ;f. .' .;,n Date ,: . 1 of 07eration(„w:) 1 , te c> '1'nc ecrrr'.on
Food Service Routine
Address Risk level clad ❑ Re-inspection
eResidenlial Kitchen rlreviouR Inspection
Telephone r r, ¢'- Mobile IJretr.
C:Iwner s IIAC'C ' l ❑ Pre-operation
�. :T: � "i"c:nn au°nraa-y
dfN a"r. ❑ �,tasPcct fllncss
V / N C,atcrer
Genc
Inspector
13cd& Breakfast ❑ I1AC al ��crrw�nl�nlaint
—Person-in-Charge(i It ) Trine
.� out: �`:6 i��.,,��.� "Year.
❑other _ .w..__......_w..._.
Each violation the, ed requires an explanation on the narrative pages)and a citation of specific provision(s)violated.
Non-cairn fiance witIt:
oatlantna)nso
.F odbor'rne ftess nterveintuoil.�n.. .rd Rts ._(a ter ..(.Red R) ' ) anti-Choking 590.009(E) 171
Related 4p ,
Violations marked may pose are imminent health hazard and require immediate corrective action as Tobacco 59#i009(F) ❑
determined by the Board of Health. allergen awareness 590.009 ( )Ip
FOOD PROTECTION MANAGEMENT 12. Prevecnticarn of Contanr,niirmat'ion frorn°n Hands
[.-j f. PIG;;As ignedfKnow Iledgeablie/Dutic
13. Han
EMPLOYEE HEALTH atwashlnr aacllitles
PROTECTION FROM CHEMICALS
2, HeporU nq of Diseases by Food IEirrnpIoyee and II�OC
14.Approved Food w CoIor Additives
3. PersonnrnO with Infections Restricted/Esciudect
°t ."t"osic CIinernvncrals
FOOD FROM APPROVED SOURCE
. Food and Water from Approved Socurce TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods)
�....� . Rece'MnglConnd'ifiorn .. 16, Cc.uokfiit3'fc*rr peratnarc s
C. Tags/Records/Accuracy of IIngredlient St atenients
17. Rr,i4ncacafliic"uR
C To Conformance with Approved Procedures/HACC'P IFiauns 18, Cooling
PROTECTION FROM CONTAMINATION �` 1ft. Hot and Cold HoIdlraal
r� 8. isle:an°atlomnf5emdreuatia°znnlPrcntecatiora
El 20,Time as any Public l.lealth Control
REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP)
nt. Food Coact Surfaces Cleaning avid Sanitizing ..� 2'1. Food and lc.00d Preparatlonn for HSP
E. 10. Prow Adecfuacnte Hanndwoa0wi nq
CONSUMER ADVISORY
11. Good l3ygiennic, Practices � ..� 22. Posting of Consumer Advarso ies
Viotations Related to Good Retail Practices(Bice iter"rns) Nurrnfaer of Violated Provisions Related To
Critical (C) violations marked must be corrected immediately F'ooddorne Illnesses Interventions and Risk
or within 10 days as determined by the Board of Health. Factors (Fled Items 1-22P �..
Non-critical (N} violations must be corrected immediately or Official Order for Correction:used on an inspection today,the items
within 90 days as determined by the Board of Health. checked indicate violations of 105 CMR 500.000/federal Food Code.This
21 an nwat)c,nnnc,�unt Knocl l'can�ucnirnnnr�:.P a!E, r.a)�>k,ur Urn,:n) report,when signed below by a Board of Health member or its agent
dd Food and Food f"mfec,do n (s t ,)(590 00 ) constitutes an order of the Board of Health.Failure to correct violations
25 E.aln.nil m,,rrt and Ute na iu s (Fn, oO,-uj cited in this report may result In suspension or revocation of the food
26 Water, Plu.aosndimg and Waste it C establishment rmit d cessation r f food nshment rt If
aggrieved by this order,you have a right to a hearing,Your request must t
27. Physic;a I d ac;lity (FC' 6)(59()C 7) be in writing and submitted to the Board of Health at the above address
8" Poisonous oo .t oxic I aatern aais nl G rr)r^�t^c.r n,rMra) within 10 days of receipt of this order,
29. t.at»e¢'.4 C*,qu..fIil[(,nments (1590009) DA7'E0F"RE-INSPEC"A°/!)"vt....
30, Other
Inslaccic 's tipnature ,w tG0 M.�w.,�-'"' M'rir71: lf-t l ��
I1JC;'s Si xnalnarc: II �. ., Print `)'I I'ak3c_ ...<of,..._ Pages
VialationsReIrried to f"oodborne Iffitess Interventions and Risk Factors
(Red Ions 1-22)
FOOD PROTEMION AIANAGEiNIENT
I 590M3(A) I Assignment of ResponsibilitX* PROTECTION FROM CONTAMINATION
5901M30 I Demonstration of Knowledge* Cross con lamination
2-103,11 Person in charge--duties 3-30111(A)(1) Raw Minial Foods Separated from
Cooked and R'l 1 11 Foods*
EMPLOYEE HE LTH Contamination frorn Ram:111gq Ltients
596,60-3(Q Responsibility of the person in charge to 3-302.11(A)(2) Raw Animal Fortis Separated from Bub
require,reporting by food employees and Other*
appliCA1110 Contamination from the Environment
590,003(F) Responsibility Of A Food Employee Or Air 3-302.1IJA)_ _ Food Protection*
Applicant To Report To The Person In 3-302M Washin Fruits and Vegetables
Charge* 3.304,11 Food Contact with fiquipment and
Reporting by Person in Charge* ljterlsijs*
.3 590,003 1)) Exclusions and Restrictions* Contamination from the Consumer
522..0�01F Removal of'Exclusions and Restrictions 3.306,14LA(B' Returned Food and Reservice orFood*
Disposition qfAdulterated or
FOOD FROM APPROVED SOURCE Contaminated Food
E4 ---F---ood and Water From Regulated Sources 3.701.I I Discarding or Reconditioning Unsafe
5",004(A-B) Complinnee with Food Law* F000
3-201.12 Food in a I lermelically Scaled Container* 9 Food('011tut Slit-facts
4-501.111 Manual Warowashing-Her Water
3 201,13 Fivid Milk and Milk Products*
3:57,I—I Shell Vegs* — Saiiitiztitioii'rer)iperitures*
3-202.14 E as and Milk Products,Pasteurized* 4-501J12 Mechanical Waremshing-flot Water
3-202,16 fee Made From Potable Drinking Water' Sanitization Temperatures*
5-101.11 Drinkitig Water from an Ap2rowd System* 4-501,114 Chemical&'alitizalion-tern~.,Pit,
—52q,006�A Mottled Drinking Water* -- coneetitration and hardness.* —
5%006(B) Water Meets Standards in 310 CN41k 22.0* 4-60LI I(A) l3quipment Food Contact Surfaces and
Shellfish slid Fish Fronk an Approved Utensils Clean*
Source 4-602,11 Cleaning Frequency of Equipment Food-
3.201,I4 Fish and Recreationally Caught Molluscan — Contact Surfaces and Utensils*
Shellfish* -T-7—02.11 Frequency or Sunitization of Utensils and
3.201.15 Molluscan Shellfish from NSSP Usted --- Food Contact Surfaces of Equipment*
sources" 4-703,11 Methods of'Sanitization—I lot Water and
Game and Wild Itushrooms e4gwoveel kv — Chemical*
Re'ulatory'4utlmrifj� to Proper,Adcquate liandwashing
Shellstock Identification Present* 2-301.11 Clean Condition—Hands and Arms*
590.004(Q Wild Mushrooms* 2-301,12 C!eauin�w I'Irqvedurc*
3-201.17 Game Animals* 2,-301.14 Whcu to Wash*
5 Receiving/condition EIC Good nj&!SRLe Pratticts
3-202.11 Pill's Received at Pro per Temperatu res—. — 2.401,I I Enting,Drinkin or Usingrobacco*
3-202,15 Parka IntegritX* 2-40L12 Discharges From the Eyes,Nose and
Mouth*
3-10L 11 Food Safe arid I Imadulterited 3-301,12 I wfmnja�—
csntartpirpssfiort
'I'm/Records:Shellstock '
Prevention of Contamination from
3-202,18 Shell stock Identification*
3-20112 Shelislock Identification Maintained* . . .. .. ........... Hands
7—ecoreh:Pfsh Products 590,004(L) Preventing Contamination front
Eingloyces*
3-402.11 Parasite Destruction* Ilandwash Facilities
3-402,12 Records,Creation and Retention* Conveniently Located and Accessible
590,004(J) -3.2 33.11 Numbers t d�,a
--�i i I)acj tes*
Labeling of Ingredients* 5-204,11 Location arid Plaecrtrent*
Conformance with Approved 5-205,11 AccessibRity,Ope ration.and Maintenance
F- roProcedures/11ACCP Plaits Supplied with Snap and Hand Drying
3.502,11 Specirdized Processing Methods* Devices
3-50112 Redocedj men ha criteria* 6-301.11 Ilandwashing Cleanser,Availability
8-10112 Conformance with Approved Procedures* 6-301.12 Ilarid�Dr,� R provision
Denotes critical item in the federal 1999 Food Code or 105 CMR 590M0.
Establishment Name: = Date: Page: of
Item Code C—Critical item DESCRIPTION OF VIOLATION!PLAN OF CORRECTION Date
No. Re#erenee R—Red Item PLEASE PRINT CLEARLY VeriFed
.sty,• _ in `- ', _' ';'
I
ri
&-'s - f -_= `ram
I
i I
Discussion With Person in Charge; Co ct"sve Action Required: No ❑ Yes
Voluntary Compliance Employee Restriction 1
Exclusion
0 Re-inspection Scheduled o Emergency Suspension
❑ Embargo O Emergency Closure
i
❑ Voluntary Disposal ❑ Other
' r,
Violations Related to fioodborne Illness Interventions and Risk
Factors(Red Items 1-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
PROTECTION FROM CHEMICALS POPULA! IONS(11811)
21 3-901.11(A) Unpasteurized Pre-packaged Juices and
14 Food or Color Additives BeveraLes with Warning Labels*
3-202.12 Additives* 3.801A I) Use of flasteurized Eggs*
3-302.14 Protection from Unapproved Additives* 3-80L 1 I(D) Raw or Partially Cooked Animal Food and
_nd
1 15 Poisonous or Toxic Substances - Raw8ced Sprouts Not Served,*
7-101.11 Identi6,ing Inrormation-Original Containers* 3-901."11(C) - Unopened Food Package Not Re-served,
7-102,I I Common Name-WorkinE Containers*
7-201,11 _§eRarftfiojl-Storage* CONSONIER ADVISORY
7-202,11, Restriction-Presence and Use* 22 3-603.11 Consumer Advisory Posted ror Consumption
7-20112 Conditions ofUse* Animal hoods"Thai are Raw,Undercooked or
7-203.11 Toxic Containers--Prohibitionst Not Otherwise Processed to Eliminate
7-204.11 Sanitizers,Criteria-.-Chemicals* Pathogens."
7-204,12 Chemicals for Washing Produce,Criteria* 3-302,13 Pasteurized l3ggs Substitute for Raw Shell Rggs*
7-204.14 Drying Agents,Criteria*
7-205.11 Incidental Food Contact,Lubricants* SPECIAL REQ I it E N11 ,N"IS
7-206.11 Restricted Use Pesticides,Criteria* 590.009(A)-(D) Violations of Section 590A09(A)-(1))in
7-206.12 Rodent Bait Stations* entering,mobile food,temporary and residential
7-206,13 Tracking Powders,Post Control and kitchen operations should be debited under the
Monitoring* appropriate sections above ifrelated to
roodborne illness interventions and risk factors.
TIMEn'UMPERATURE CONTROLS Other 590,009 violations relating to good retail
16 Proper Cooking Temperntures for Pi I Fs practices should be debited under#29Special
3-40 1.1 1A(l)(2) Eggs- 155T 15 See. Requirements.
Eggs-lumn diate Service 14 50171 Ssec*
3-401,11(A)(2) Comminuted Fish,Meats&Game
Animals- 155T 15 sec.* VIOLATIONS REIA TEL)TO GOOD RETAIL]IRA C77CES
3-401 11(B)(1)(2) Pork and fleefRoast-130°F 121 min* (Blue Items 23-30)
3-4 01 11(A)(2)_ Ratites, Critical andnon-ci-iflml violations,which do not retwe to fliefijodborne
3.401A I(A)(3) Poultry,Wild(ionic,Stuffed I'llf's, Whess iiitei-vetitiotisaitdt-iskfactot°s Ustedabove,can lie foundin the
Stuffing Containing Fish,Meat,Poultry or following sections of the hand Code and 105 C'X/R 590,000.
Ratites-1651F 15 sec.*
3A01,1 I(C)(3) Wholc-musctq,Intact Bcef$tcaks 1459' ften;__ Good Retall ProWces IT S90 000
3-401,12 Raw Animal Foods Cooked in a _13. �nt and Personnel FC-2 003
Microwave 165*17 24. Food and Food Protection FC 3 '004
3-40 1.11(A)(1)(b) All Other PflFs-14ST 15 see. AM
26, Water,Plumbing'and Waste Fe-5 .006
17 Relicaling for Hot Holding
21 Physical Facility FC 6 .007
3-403.11(A)&(])) PlJFs 165117 15 see. 28. Poisonous or,roxic,Materials I I C 7 O0R
3-403.11(B) Microwave-165°F 2 Minute Standing Requirements
ents
Time* 30, Other
3.403.1 I(C) Commercially Processed R'n.,Food
- 1,10,F*
3-403.11(1-) Reuntining Unsliced Portions of Beef Denotes critical item in the federal 1999 Food Code or 105 CMR 590,000,
Roasts*
I in Proper Cooling or PI Fs
3-5 0 1.H(A) Cooling Cooked PI-IFs from 140411 to 704F
Within 2 Hours and From 704T'to
4 VlF/45*F Within 4 Hours.*
3-501,14(B) Cooling Pfff's Made From Ambient
Temperature ingredients to4 14F/45*F'
Within 4 llottrs*
3-501.14(C) PlIFs Received at Temperatures
According to Law Cooled to 4 IIF'/45'1'
Within,l Hours.*
F3-501.15 Cooling Methods for 111lFs ig Pill?Hot and Cold Holding
3-501.16(f3) Cold Plif's Maintained at or below
590.004(F) 410/450 F*
3-501.16(A) Hot PTlFs 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*
590.00,1(11) Variance Requirement