HomeMy WebLinkAboutPipe Dream Cupcakes - Routine - Mobile - Inspection - 1661 GREAT POND ROAD 1/17/2023 m... m- 0 ,wJ
I"Ills C.OMMC:)NWIII,ALTTIH O M,A`aSAC:'IttlSl`"I""I's,
„y Wit. TOWN OF NORTH ANDOVTi. R 120 Main Street.
MAS(tiAf'H@,S6:7"°'I'41)E1"Xit"1" U'iAi"C"CNIM Pkri51.IC,HE At"rtl
North 01845
Division nt'f000d and Drugs phone-978.688.95 0
FOOD ESTABLISHMENT INSPECTION REPORT Fax- 978.688.9542
e-ntail: healtlidePtCat>ttcprthatadoverma.►ov
arr►e o I talrlish u�t Date�� p 1""yiav 0170per Orion v) 7'vpe of Inspection
E] Food Service Routine
,Address Risk Level ❑ Retail KRe-inspection
���� ❑ Residential Kitchen Previous Inspection
Telephone5�7(3_ 7- 7 Mobile Date:
t:)a tR er hlAt"("I c 1"enap>aar<►ay E] Pr -operation
V / N F1 caterer n suspect Ippran
> e, Bed&Breakfast n General C'caa7aPlaaant
Person-in-Charge(I 1C� �ame � ❑ I-Ia�C"��"I•
In: p�.J k"c„<tr r
Inspector �l� a 1 , ❑Cthea_
. p p Out: :W _._.._.._..........
Each violation cheWd requires an explanation on the narrative page(s)and a citation of specific provision(s)violated.
Non-compliance with:
\iidaatio ns Wapted tft_Foodborin lIln ss kit rventions aaind R' k Fact rte"I. ) Anti-Choking 59009tE1 0Violations marked may pose an imminent health hazard and require immediate corrective action as Tobacco 5s 009(F) M
determined by the Board of Health. Allergen Awareness 5se.0ee (G)E]
FOOD PROTECTION MANAGEMENT 112.
1; � IHan Prevention of
Fact�nrtrrtpsnation frooaa Hands
�:] 1. PIC Assigned/Knowledge��able/Duties
EMPLOYEE HEALTH
PROTECTION FROM CHEMICALS
�. 12. ]Reporting of Diseases by Food I""wrarnptoyee and R
.. 14.Approved F'rpcpd or Ctptrrr•Acldrtl'ves
�. . . Personnel with infer ions Restricte f/ForcWded
�..� 15.4"cpzpc CherrplrW:als
FOOD FROM APPROVED SOURCE
4. Food and water born Approved Source TIMEaI*EMPERATURE CONTROLS(Potentially Hazardous Foods)
�. a ITeceivingfC oindltuon l '16" C'oolcnng Temperatures
E. Tags/Records/Accuracy of Ingredient Stratcanwrits � 17. Reheating
( f 7. Conformance with Approved Proceduires/HACCP FNans �� 18. Coobntl
PROTECTION FROM CONTAMINATION E] 19. I"fot and Cold HoW4)
S.Se paraatiion/Seam,re •atlori/Pw,o�tectioi,i LA 20. 71me as a Pubhc Health Control
.
REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP)
N Food Contact Crarfacmes,Cleaning and Canll:iaprat) El 21. Food and Food Preparation for HSP
Ej 'f 0. Proper Adequape I-landwa;ap°pprprl
CONSUMER ADVISORY
k '11. Good Hygienic Practices �_�.� 22. Posthig of Consumer Advisories
Violations belated to Good Detail Practices(Bette Items) Number of Violated Provisions Related To
Critical (C) violations marked must be corrected immediately Foodborne lilrpesses lipiei v(.intioins and Risk
or within 10 Clays as determined by the Board of Health. Factors (Red Items 1- 2):
Non-critical (hJ) vielations must be corrected immediately or Official Order for Correction.eased 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
t' r�
23, aarn ac)e rraewr t aar7d t-'e¢sorai°ieI ,-ar,taa ,r rra„/I report,when signed below by a Board of Health member or its agent
4. Food£ and I'ccaa) i"�r>ter;trcrard�-a�( °ear�..r/�a} constitutes an order of the Board of Health. Failure to correct violations
25 yea. t alru�Osrrr're I rr:od p flew^u°as ti r'C r)(`�" ae"�.a) cited in this report may result In suspension or revocation of the food
Water, f�r1 ap°p(J �enc�l aa�ap�e (hC 4)i 51arr rrt°rnrt establishment permit and cessation of food establishment c erations. If
aggrieved by this order,you have a right to a hearing.Your request must
y'f. p lhyw dcral l Qr6Ry ri C-6r(59 ring 7 be in writing and submitted to the Board of Health at the above address
2 r" arse al l to enni'T Toxic II`vtl te6aals eI c �")ef,�o oo8) within 10 days of receipt of this o€der,w a
p. p. re.rI1ents (590,009) OA/'E'O RE-ihSPEC.°:r"1ON..._ .....
3 Other
I IC�°s�l�tpaNar+„. urea ����. Iaa"Int: ,,. �,.�rt d ,,' c10"•
Inspector's Signature.
' t Print: � Iaa�e�.._ ae1 "Pages
Hiolations Relaied to Foodborne fltnesv Interseittioos and Risk ractors
(Reef Itents 1-22)
FOOD PROTECTION AIANAGUNIEN'r
I S90,#(0)f)3' As i" unent of Responsibility* P110TECTION FROM CONTAMINATION
590.003 B D—emonstration of Knowledge* Ccoss-con(Aminatioll
2-103,11 Person in charge-duties 3-302.1 t(A)(1) Raw Animal Foods Separated front
Cooked and RTV floods*
EMPLOYEE HEALTH Contamination from Raw 111gredients
2 59UO3(C) Responsibility of the person in charge to 3-302.11(A)(2) Raw Anitnal Foods Separated f(orn Fach
require reporting by food employees and Other*
r A> lfcants� .3 Contamination front the Environment
( ) p p W003F Resonsibility Of A flood E.Inloyee Or An :��-3021 1 A� Food Protection*
Applicant To Report To The Person]it 3-302.15 NVashing Fruits and V5 etatnles
ChroXe* 3-304.11 Food Contact Nvith Equipment and
590X03(G) Re2orting by Pcrson in Charge* Utensils*
L3 590,003LD 'Aclusions anti Restrictions* Contamination from the Consumer
3.306,14(AAB) Retumcd rood and Reservice of Food*
59003(E.) Removal ol'Exclusions and Restrictions
Disposition ofA(Iullerafed ot,
FOOD F.ROINI APPROVED SOURCE Comenninated Tbod
L4 Food and Water Front Rcgidatcd Sources 3-701.11 Discarding or Reconditioning Unsare
590.0()4 A-B) Compliance Nvith Food Law,* Food*
3-201A2 Food in a I lermet ic�l ncr* 9 Food Contact Surfaces
3-201.13 Hold Milk and Milk Products* 4-50 1.I I I Manual Warewashing-Hot Water
3-202.13 Shall Eggs* S,,ttiitizatioji'ret)iiicrattjrcs*
3-202.14 Eggs and Milk products,Pasteurized* 4-50L 112 Mcchanical NVnrewasbing-I-lot Water
3-202,16 lee Made Front Potable Drinking Water* Sitiitizatioit'f'eniperotLires*
5_101AI Drinking Water from an Approve jjX steno*_ 4-501.114 Chemical Sanitization-(crnp.,p1l,
ottic 1 concentration and hardness,
�2LO06(,AL` ±j�watcr*_ 4-601,11(A) Equ pment Food Contact Surfaces and
5W()06(B) Water Meets Standirds in 3 10 CMR 22�0* 1
Shelffislk and Fish From air Approved Utesik Clean*
Soarce 4-602.11 (1caning Frequenoy of'Equipment flood-
Contact Surfaces andOtensils*
.3-201.14 Fish and Recreationally Caught Molluscan
sheltfish* 4-702.11 Frequency of Sanifization of Utensils and
.3-201,15 M01111scall ShOlf1sh from NSSP Listed rood Contact S
Sources* 4-703,11 Methods of Sanilization-Hol Water and
11"7(1-11
Grame oncl Wild jihts1wooms,41)jxo%-ed by Chemical*
10 Proper,Adequate flandwasbing
Re ulotoi, Aulhw-io� [:::E
Y 2-301,11 Clean Condition-hands and Arms*
3-202.18 Shellslock Identification Present*
52 2-301A2 Cleaning Procedure*
LOO4d Mushrooms
AC2 Wil_
3-201.17 Game Animals* r 2-301 14 When to wash*
1 5 Receiving/Coadition LLt_— Good llygienWpractices
3-202,11 Pf I Ps Received at Prol)rr'l'e imeratures 2-40 1 11 Fating,Drinkin orUsingTobacco*
3-202.15 Package Integrity* 2101.12 Discharges From the Eyes,Nose and
3.101.11 Food Safe and thiadolterated Mouth*
3-301.12 Preventing Contamination w1m),
1_6 Tags/Rccords-Shellstock
_ tian
3 12 Trevention of Contajoh�ation from
3.202-18 Shellstock Identification*
flands
3-20112 Shellstock Identification Maintained* 590.004(E) Preventing Contamination front
nmlneciwels:F01i Pmducts Emplaces*
3402 11 Parasite Destruction* 13 flandwash Facilities
3-402,12 Records,Creation and Retention* Conve� aijd Accessible
590,00,t(i) S-201 11 Numbers and Capacilies*
Labeling of Ingredients* 5-204.11 Location and and
7 ("onfortuance with Approve() 5-205,11 Accessibility,Operation and Maintenance
Procedures/IIACCP Plans Supplied vchth Soap and Hand Drying
3-502.11 Specialized Processing Methods* I Devices
3-507,12 Reduced can plicka 6-30 L I I [land%vashing Cleanser,Availability
8-103.12 6ourormance wilh Approved Procedures* 6-301A,2
Denotes critical itern in the federal 1999 Food Code or 105 CMR 5%000
-7,37 1
Est
a tishment Name. late: _ of .'
Item code C-Critical Item DESCRIPTION OF VIOLATION f PLAN OF CORRECTION Date
No. Reference R-Red Stem PLEASE PRINT CLEARLY Verified
� I-!"tea -4
1
Aq
i
r
(€( x
l
Discussion With Person in Charge: Corrective Action Required: No ❑ Yes
wr Voluntary Compliance ❑ Employee Restriction I
Exclusion
Re-inspection Scheduled ❑ E ercency Suspension
Embargo ❑ Emergency Closure
❑ Voluntary Disposal ❑ Other.
1
Violations Related to Foodbornelitness litter ventlons air(/Risk
fi'liclors(Reel Items 1-22) (Co)tt) REQUIREMENTS FOR IIIGHLV SUSCEP111ILK
PROTECTION FRONM CIJENrHCALS P01,11,11,X JONS QjSLP)___
14 Faml or Color'W(fitives 21 3-80L I I(A) Unpasteurized Pre-packaged Juices land
BeveraLes with WaEnjIj&jabols*
3-202.12 Additives* 3.801.11 LB) Use of Pasteoriz2d
3-302.14 Protection from Unapproved Additives* 3-80 1.11(D) Raw or Partially Cooked Animal Flood and
1=5 Poisonous or,roxic substaxices Raw Seed Sprouls Not Served.*
dentif 3-��j I �j -served,
_L_ _1_11��ood Package Not Re
7-102.11 Common Name-Working Containers'
7-201A 1 Se arku on--Storrs e CONSUMER ADVISORY
7-202,11 Restriction-Presence and Use* 22 3-603,11 Consumer Advisory Posted for Consumption of
7-20112 Conditions or Use* Animal Foods'l hat are Raw,Undercooked or
7-203.11 Toxic Containers-Prohibitions* Not Otherwise Processed to Eliminate
7-204.11 Sartilizers,Criteria-_Chemicals* patt2ccl)_'�0 kffewAv I/p/M
7-204,12 Chemicals for Washing Produce,Criteria" 3-30113 Pasteurized Eggs Substitute for Raw Shell Eggs*
7-20,1.14 A cxats Criteria*
7-205.11 Incidental Food Contact,Lubricants* SPECIAL RI.91 I RIENNI FNTS
7-206.11 Restricted Use Pesticides,Criteria* 590,009(A)-(D) Violations ofSection 590,009(A)-(]))711-1
7-206.12 Rodent Bait Stations* entering,mobile rood,ternporary and residential
7-206.13 Trucking Powders,Pest Control and kitchen operations should be debited under the
i0_Iut0ril19* appropriate sections above ifrelated to
roodborne illness interventions and risk factors.
'rimiTtru.mPERATURE CONTROLS Other 590,009 violations relating to good retail
EL Proper Cooking'I'vinjitratures for PHVs practices should be debited under#29 -SPecial
3-401.1 lA(l)(2) Elllgs- 155*11,15 Sec. Requirements.
li, s-Immediate Service 145'Fl5sec*
3-4 01"I I(A)(2) Comminuted Fish,Meats&Grune
Animals- 155T 15 sec.* il lqOLATIONSRELATED TO GOOD REY'All.11RACII(TIS
.3-.,01.11(il)(1)(2) Pork and BeefRoast-1301F 1 ([Blur[(cuts 23-30)
3-401.11(A)(2) _Ratites,h ctcd Meats 155*1,'15 sec, CrItIcat and ltem-critical violations,which do notrelate to theftodborne
3-10LI I(A)(3) Poultry,Wild(ionic,Stufl`d PlVs, illness interventions and risk factors listed above,can be found in the
Sluffing C(Unflioift Fish,Meat,Poultry or following sections of ripe Vood Code and 105 CiVIR 590R 000
Ratites-165*17 15 see,
.1-4 0 ,I I(C,' Whole-mosele,Intact Beel'Sleaks 1459" Ilelif Good Recall Procrices 'T-i": .59am;
' _
3-401.12 Raw Ardnial Foods Cooked in a 21 MariaaVrnent and Peisoitnel f'U-2
Microwave 165T 24� rood and Food IF,-3 .004
3-401. b) All Other PfIJ:s-145*F 15 sec, 25. iu�pt and Utensils FC-4 005
26, kvater�PI and Waste FC-5 M6
17 Rellealing for Hot Holding 2T i!211�11
FCr 6 007
3. L(A_)�_T_) j"flFs 165"F IS see. 28. Poisonous or'roxic Materials 1 7
3-403AI(B) Microwave- 1650 F 2 millute SmIlding
Tinle* ------
Commercially Processed RTE.Food-
14 OOF*
3-403.1 I(E) Remaining Unshced Portions officef Denotes critical item in the federal 1999 Food Code or 105 CIVIR 590,000,
Roasts*
Pro per Cooling of P I I les
3-501.14(A) Cooling Cooked PI 11"s from 140T to 70T
Within 21 knus and From 70'F to
4 1*F/4511F Within 4 Hours.*
3-50 1.14(B) Cool i 1%PI IFs Made From Ambient
Temperature ingredients to,l
Within,l Hours*
7 75 0_—I , j:)i tFs Recei ved at Temperatures
According to Law Cooled to 41'F/45'F
Within 4 flours.*
Cooling Methods for PJ4F,.;
LII) PUP Hot and Cold Holding
.3..SO 1.16(l 1) Told IPs Maintained at or below
590,004(l`) 41 V450 F*
3.50L16(A) Ilot PJ,fFs Maintained at or above 140*1,'.
3-50L16(A) [toasts Held at or above 130'F,
2=0 Thoe,as a Public Health Contral
3-501.19 Time as_a_Public Health Control*
............
590.004(ljl_ Vnriance Requirement