HomeMy WebLinkAbout- Inspection - 18 HIGH STREET 12/1/2022 T]]E c:O t tf)]'s WEAL"t H OF MASS Ct fUSE1"I'S
TOWN OF NORTH H ANDOVER 120 Main Street
North Andover,Massachusetts01845�
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Division of Food and Drugs Phone.-978.688.9 a4t;l
FOOD ES'I"'A13LI HMENT INSPEC"TION REPORT Fax-978.688.9542
e naa . eat (.le t )uortl ndoverrraa. ov
Naane of Establishment Date 7"' e r� 0 eralion s 1° o Inspection
F�71 Food Service 7'Routine
Address o-ka t Risk Level ❑ Retail 0 lac inspection
Tale.'�hcrra�, c,, . ® l�e:a,identialLtiitc°laea�t /'rr.�riuu�Tirxpr�rrr;ue�
� _ !��'r�tnnlu �
Owner � ��� � 11A(�:(�,'1': � Temporary 17aarnaY ❑1 Date:
n
~�, I eras
"J as 7"ratan / N ❑ Caterer � suspect Illness
1'erscrn in-C.har a(11C"� � ❑ lied&, Breakfla�st R General Complaint
1'aaspaaetor 0 2 ❑Other
nm�.r.' ,M C>ut. &an year:
Each violation the a requires an explanation on the narrative page(s)and a citation of specific provision(s)violated.
Non-compAprice with:
Vkfla�fio ns ReWe�d(p Foodborne lllrn ss Mrn erveirntlonsaandmRi µ Factor ,(Ftra V!gg � Anti-Choking 590.009( ) C7
Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacto 590.009(F) 0
determined by the Board of Health. Allergen Awareness 590.009 lal 177
FOOD PROTECTION MANAGEMENT �... 12. Prevention of Contanitnation from Hands
[ ..1 t. PIC Assigned/'Know ledgeable/C uties
t . t�landr�aasQ°nGnct I"~aa„IiN�utia�s
EMPLOYEE HEALTH
_.. 2. Reporting of Diseases by good Employee and PIC PROTECTION FROM CHEMICALS
C..F 14, Approved Food w Color Additives
El .'t. Personnel with Infections Restricted/Excluded F..w� t a,Tosir.Cha*rrrnloalaa
FOOD FROM APPROVED SOURCE
J 4. Food and water from Approved Source TIMEJEMPERATURE CONTROLS(Potentially Hazardous Foods)
5. ReceNinrd/Condition .. 16 Cooking Temperatures
d' Ea. Taarts/Reco¢rds/Accuracy of Ingredient Statements 17, Reheating
a". Conformance mance wifl.n Approved Procedurr°es/HACCP Na ns 'tit.CoolNurau
PROTECTION FROM CONTAMINATION
C 19, Hot and Cold 1•oIding
El fi. Sepau�awtrron/SePregatiori/f2rotection C...F 20. 'rime are a Public Health Control
REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP)
S. Food Contact Surfaces Cleannng and Sanitizing E.F fit. Food and Food Preparation for HSP
tU Proper Adertanate Hnandwaashin°ng
CONSUMER ADVISORY r�
�. 11.Good Hygienic Practices ( f ��t. Po. tine ref 4'onsurner Advisories
Violations Related to good Retail Practices(Blue Items) Number of Violated Provisions related To
CriticaY CL violations marked must be corrected immediately Foodborrte Illnesses Interventions and Risk
or within 10 days as determined by the Board at Health. Factorq'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 vitiations of 105 CMR 5 0.000/federal Food Code.This
23, P' arnagerr )eat arid Petso nlhuel Q4�C-2)(99a.003� report,when Signed below by a Board of Health member or its agent
CAd. f rrrrral and Food 6 rrr,tea..tiirn�°t .,r,(r� c n/n, ) conStAltes an order of the Board of Health.Failure to correct violations
au. C rtinolni°inrrinl and I aNC�rnt iV » �� r r)(�,ti�� nrrri�k( cited in this report may result in sus ension or revocation of the food
6C Waatei,, f�LNribia°ngl and Waste 0-C. s.,)�R}acn. rri`F)
establishment permit and cessation of food establishment o erations.If
aggrieved by this order,you have a right to a hearing.Your request must
27 N IiiysEcall f anc ibly (FC c,)(a,ina a`ai'7 be in writing and submitted to the Board of Health at the above address
28, Poisonous �rn�'Ti c x c� aler rai n ( c, /')i ��an�t/rn,t) within 10 days of�receipt of this order.
291 C tidal Re u&E. r nernta �a°a) DATL�'O RE-iN+;PEC N`ION'._, � t
u w
her
Inspector's Signature: Print: r "
1'1Cs Signature: Print:x iaat» i`:"� "_ fla e... .oat �a Pages
11olations Related to Foodborne 116tess littermitioirs and Risk Factors
(Red Items 1-22)
FOOD PROTECTION MANAGENIENT
I 590.003(A) I Assiguincrit of ResponsibilitX* PROTECTION FROM CONTAMINATION
590.003(B) Demonstration of Knowledge* 8 ("ross-couraillillation
2.103,11 Person in charge-dutics 3-302.1 l(A)(1) RuwAnhuril Foods Separated from
Cooked and RT11.Foods*
EMPLOYEE HEALTH Contamination frovin Raw loigredients
590.003(C)— Responsibility of(lie person in charge to 3-302,11(A)(2) Raw Animal Foods Separated from Bach
require reporting by fbod emptoym and Other*
a ficants* Coil lorn illation from the E "nt nvironme
11 It
59UO3(f) Responsibility Of A flood Employee Or An 3-302,1 1(,A) Food Protection*
Applicant'I"o Report To The Person Ili 3-302.15 Wasl etables
Chark,0 3-304.11 Food Contact mlith Equipment and
590,003(0) Reporting by person in Charge* Utensils*
—,I 520,003LI)) Exelmions and Restrictions* --Contamination franc the Consumer
590.0030't) 1 Removal of Exclusimis and Restrictions 3-306,H(A(B) Returned Food and Rescrvice of Food*
Disposition ofA dulterwed or
FOOD FROM APPROVED SOURCE Comandrioled F'ood
Food and Water From Regulated Sources 3-701A 1 Discarding or Reconditioning Unsafe
590,004LA-13) Compliance with Food LaNy* 1.000
3-201.12 Food fil it I 1crilletic ner* 9 Food Contact Surfaces
3-201.13 Fluid Milk and Milk Products* 4.501,111 Manual Warewashing-'Hot Water
3-202.13 Shell Eggs* Sonitizatioii'reiiil)er-,ittircs*
3-202.14 band Milk 11roducts:I Pasteurized* 4-501.112 Mcchanical Warewaslibig-Hot Water
3-202.16 1 1 .... — Sindtization Temrit ures*
1.5-1011 lee Made From Potable Drinking Water* pe
4-50L 114 Chemical Sanifization-'Ictlip.,PH,
Drinking Water from air Approved System* concentration and hardness.
sLqmyAj Bottled Drinking Witter*
590,00yjI) Water Meets Standards in 310 CNIR 22V 4-601,I I(A) Equipment Food Contact Surfaces and
Utcnsils Ckan*
Shellfish and Fish Front an Approved 4-602�11 Cleani.ng Frequency of Equipment Food-
Source 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�f 1�quipLnent*
T201.15 Molluscan Shefifish from NSSP—Usted 4-703.11 Methods of Sanitization-Hot Witter and
Sources*
Game and Wild Alushrooms Approved by 10 - Proper,Adequate flandwashbig
Regidatory A lithority 2-301�I I Gean Condition-Hands and Artris"
3.202,18 Shellstock Idervification,Present* 2-301A2 Clerining Procedure*
590,00ge) Wild Mushrooms*
3-201.17 Game Animals* I t 2-301.14 When to Wash*I
Reteivilm/coudition L-L1— Good Hygienic Practices
3-20111 PlIT's Rcceived a urce 2-40L 11 Eating,Drinkill.or U1 higrobacco*
3-202,15 Packs fntefgri * 2-401,12 Discharges Fro the Eyes,Nose and
3-101,11 Food Safe and I hindukerited Mouth*
Taps/11ccords.Shellstock 3-301,,12 Preventkig contamination men'rastine
3-202,18 Shellstock Identification* 12 Prevention orcontarnination from
3-203,12 Shellstock Identification Maintained* Unods
7'cMs,/Record,v:Rsh Products 590.004(E) preventing Contamination from
Eingloyces*
.3-402.11 Parasite Destruction* 1-3 Iforidwash Facilities
3-402,12 Records,Creation and Retention* -ni
590,004(J) Corive, end fc kated and Accessible
5.20111 Numbers and Capacities*
Labeling of Ingredients* 5-204,11 Location Slid Placement*
Conformance with Approved 5-2K 11 Accessibility,Operation and Maintenance
Procedures/.IIACCP Nam Supplied Avith Soap and Hand Drying
3-502.11 Specialized processing Methods* Devices
3-502.12 Reduced-q:xjUlpacka in criteria*' 6-301A 1 1 flandwashing Cleanser,Availability
8-103A L. I Tontbroirince with Approved Procedures* 6-301 12 1 Hand Drying Provision
Denotes critical item in the federal 1999 Food Code or 105 CNIR 590.000.
Establishment Name. £h. Date:® page: of
fte s Code 1 C-critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date
No. Reference R-Red Stem PLEASE PRINT CLEARLY Veered
j
3 � _
L
t g �
$$(( 3
7iscu ion With Person in Charge; , CorreefivoAction Required: 0 No Yes
a =i Ir VoluntaryCompliance 0 E loyee estnction/
to P R � .
H _ Exclusion
= 0 Re4ns e ion Scheduled 0Emergency Suspension
ki
ZI Embaroo Emergency Closure
� ❑ Voluntary Disposal 0 01ther
Notations Related to Foodborn e Illness littersentiony and Rtvk
Factors(Red Items 1-22) (Cont.) REQUIREMENTS FOR 111GIlLYSUSCEPTIBLE
POPULATION'S_T811)
PROTECTION FROM CHEMICAIS
I R11 Food or Color Additives 3.801 11(A) U P npasteurized re-packaged Juices and
Beverages with Warning Labels*
3-202,12 Additives* 3-80 1 1 IK19 Use of Pa%teorizedji *..
3-302.1<11 protection from UjLn�rove�d Adtfitivcs* 3-801 1 I(D) Raw or Partially Cooked Aninial Food and
1E____ Polsonous or Toxic subs(fortes Raw Seed
_.-Sprouts Not Served.
7-101A 1 Identifying Information-Original ContaincrO L2-80 LI I(C—UnopenLd Food Package Nast Re-serve&
7-102�I I Cm omon Name-Work in�Conjaiaers* Lj_
7-201.11 Senstlainn--Rio e* CONSUNIER ADVISORY
_7462_71 I Restrictimi-Prescuce and Use* 22 3-60111 Consumer Advisory posted for Consumption of
7-202J2 Conditions or use* Animal Foods'Ifial are Raw,Undercooked or
7-203,11 Toxic Containers--Prohibitions* Not Otherwise processed to Eliminate
7-20C 11 Sanitizers Criteria-Chemicals* Pathogens.*
7-204A2 Chemicals for Washing Produce,Criteria* 3-302.13 Pasteurized Egs Substitute liar Raw Shell Lgks*
7-20414 I s riteria*
Asats-L
7-205.11 Incidental flood C,orttnctLubrlourds* SPECIAL REQ1 IREMENTS
7-206.11 Restricted Use Fleslicides,_Criteria* 590.009(A)-(D) Violations of Section 59500—WAJ-4-1))It)
7-200.12 Rodent Bait Stations* entering,mobile rood,temporary and resideatiol
7-206.13 1racking Powders,Post Control and kitchen operations should be debited under the
Monitorine— appropriate sections above if related to
fbodbotne illness interventions and risk factors.
TIME/1'UMPERATURE CONTROLS Other 590,009 violations relating to good retail
Li—6 Proper Cooking Temperat tires for 111 IN practices should be debited under 929Special
1-461.1 IA(l)(2) figps- 155T IS See. Requirement&
rggs-limn diate Service 14 501ll 5sec"
3-401 11(A)(2) Comminated Pish,Meats&Game
Animals- 155*17 15 see.* VIOLATIONVRELATED 7*0 GOOD REYAIL PRACIXTS,
3-401 11(B)(1)(2) Pork and Beef Roast-130*Tl 121—min* (Blue Items 23-30)
Ratitns,Ti1jected Meats-I55*F 15 sec. Criticed andnon-crifleal violations,Wilch(to nod ellile to f1jejbodhorne
3-40 1.11(A)(3) Poultry,Wild Come,Stuffed 1:1111ls, Alen interventions and riskfactors listed above,can be found ill the
Stuffing Containing Fish,Meat,Poultry or jothm,lng sections of the Food Code and IOS Cilfi?590,000.
Ratites-165*11 15 see.
3-401jl(C)(3) tooks 145T 11"0011 Retail Practices W 39(X1...0#0
. ......... .....3-401.12 Raw Animal floods Cooked ill a 21 lanaV os nient and Peonnet Ile 2 .003
Microwave t 65*11 and floo-d Protection IC 3 .004
25, _F�juiptucut and Utensils 4 Ms
3401.I l(A)(1)(b) All Other Piffis-1454'15 sm
17 Relienting for liot Holding wrlatcr PC 5 006
27, FC, 6 .007
1403AKAA(D) PHFs 165OF 15 soo. 28, poisonous or'roxic Materials I FC-7 ,008
3-403.11(fl) Microwave- 165"F 2 Minute Standing 9. R equirements .009
Time* 30, Other
JAW.1 I(C) - C'ornmerciafly Processed RTR flood-
140*F*
.3-4'3.11(E) Remaining Urtsliced Portions office Denotes critical item in the Weral 1999 Food Code or 105 CWR 5900)0.
Roasts"
1-8 Proptr Cooling of Pi i FS
Coaling Cooked 111117s rrom 140*17 to 70*11
Withia 2 Hours and From 70*Fto
4 1 T/45T Within 4 Hours.*
3-50 1 H(B) Cooling Pl4Fs Made From Ambient
Temperature Ingredients to 41 OF/45'P
Within 4 lloors"
3.50 1 i.,i(C Pill's Received atUrIperatures
According to Law Cooled to 41 Thl 5T
Within Hours.*
F3-501 15 Coaling Methods for Pill's
g: Pill?Hal and Cold Holding
3-SOI,16(i3) Cold PI IF's Maintained at or below
590.004(f) 4 I'M 5*F*
3-501„16(A) 1101 Pfff's Maintained at or above 140T.
3-50L16(A) Roasts I leld at or above 1304".
[_2O7 rjule as a public licalth Control
3-501.19 fil-1110-o"s'a—pubho—health—control*
Variance lZccEIIEI!Snt
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