HomeMy WebLinkAboutFood - Inspection - Routine & Pre operation - Inspection - 39 MAIN STREET 1/23/2023 THE COMMONWEALTH OF MASSACHUSETTS
•.. m'k . 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
-mail: healthdeptC&nort andoverma.gov
Name of Establishment Q Date f TI&of Operation(s) TXle o Ins ection
/!,31L 3 M Food Service Routine
Address to , Risk Level ❑ Retail ❑ Re-inspection o s Inspection
P
El Residential Kitchen
Telephone 6�-r ��12 ❑ Mobile Dare:
t,..
Owner HACCP: ❑ Temporary Pre-operation
y / N ❑ Caterer ❑ Suspect Illness
❑ General Complaint
Person-in-Charge IC) Time El Bed&Breakfast
Year
In: ?I--1s.., n ❑ HACCP
Inspector C /511.3 ❑ Other
�- • Gcsr Out: 1 �° ,�
Each violation the 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 TIME/TEMPERATURE CONTROLS Potential) Hazardous Foods)
❑ 4. Food and Water from Approved Source (Potentially
❑ 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 (5419. 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 Sign ure: �� Print:
PICs Signature: Print- Page-of z-Pages
Violations Related to Foodborne Illness Interventions and Risk Factors
(Red Items I-22)
FOOD PROTECTION MANAGEMENT
1 590.003(A) Assi nment of Res onsibilit * PROTECTION FROM CONTAMINATION
590.003(B) Demonstration of Knowledge* 8 Cross-contamination
2-103.11 Person in charge-duties 3-302.I l(A)(1) RawAnintal Foods Separated from
Cooked and RTE Foods*
EMPLOYEE HEALTH Contamination front Raw In redients
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(G) Reporting by Person in Charge* Utensils*
3 590.003 Exclusions and Restrictions* Contamination front 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 Contaminated Food
4 Food and Water From Regulated Sources 3-701.I I 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* Sanitization'l'em eratures*
3-202,14 Eggs and Milk Products,Pasteurized* 4-501.112 Mechanical Warewashing-Hot Water
3-202.16 ice Made From Potable Drinking Water* Sanitization Tern eratures*
5-101.11 Drinking Water front an Approved System* 4-501.114 Chemical Sanitization-temp.,pIi,
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!Wild Mushrooms Approved by Chemical*
Reizidatwy Authorit l0 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 I1 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
590.004(E) Preventing Contamination from
Ta s/Records:Fish Products Employees*
3-402.11 Parasite Destruction* 13 11andwash Facilities
3-402.12 Records,Creation and Retention* Conveniently Located and Accessible
590.004(J) 5-203.11 Numbers and Ca pacifies*
Labeling of Ingredients* 5-204.11 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 S ecialized Processing Methods* Devices
3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Hand%vashfng 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.
r�o1- (5 �-( ZIIL3 ( i
Establishment Name: Date: Page: of
Item Code C—Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
No. Reference R—Red Item PLEASE PRINT CLEARLY / Verged
3 /Cj• 010-i Gawl�ra• 23 I OLC44 ar 1.•e C141n. �'
Are, ivc..a 3
U.✓►+S1 o,f cjcejh,,A ,.tn;eecX. Ala 4wQ or Tou a e te. 1 4
Discussion With Person in Char e: p Corrective Action Required: ❑ No Yes
9 d (�(n ( •Inn a i ru
Sv �tGK Voluntary Compliance ❑ Employee Restriction/
Exclusion
❑ Re-inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary Disposal ❑ Other.
', y V
Violations Related to Foodborne Illness Interventions and Risk
Factors(Red Items I-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
POPULATION'S LISP
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* 3-801.1 l(B) Use of Pasteurized Eggs*
3-302.14 Protection from Unapproved Additives* 3-801.1 t(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*
7-201.11 -Separation-Storage* CONSUMER ADVISORY
7-202.11 Restriction-Presence and Use* 22 3-603.I 1 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.*f,�eanr rnimor
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 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.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.
TI\IE/TFUNIPERATURE 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°P 15 Sec.
Requirements.
E s-tuunediate Service 145°Fl5sec*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* i'IOLATiONS RE,LA TO GOOD RETAIL IRACTICCS
3-401.11(13)(1)(2) Pork and Beef Roast- 130°F 121 min* (Blue Items 23-30)
3-401.11(A)(2) Ratites,Injected Meats-l55°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 rlskfactors listed above,can be found in the
Stuffing Containing Fish,Meat,Poultry or following sections of the Food Code and 105 CdlR 590.000.
Ratites-165°F 15 sec.*
3-401.1 I(C)(3) Whole-musele,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 OtherPH-Us-145°F IS see.* 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 IGS°F 15scc.* 28. 1 Poisonous or'foxicMaterials FC-7 1 .008
3-403.11(B) Microwave- 165°F 2 Minute Standing 29. Special 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 PHFs from 140°F to 70°F
Within 2 Hours and From 70°F to
41°F/45°F Within 4 flours.
3-501.14(B) Cooling PHFs Made Front Ambient
Temperature Ingredients to 41°F/45°F
Within 4 Hours*
3-501.14(C) PI IPs Received at Temperatures
According to Law Cooled to 41°F/45°F
Within 4 Hours.*
E193-501.15 Cooling Methods for PHrs
PI1F 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 Hcalllr Control
3-501.19 Time as a Public Health Control*
590.004(11) Variance Requirement
Establishment Name: z /-6 Date: C 2"3 Page: of
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
No. Reference R-Red Item PLEASE PRINT CLEARLY Verged
rWA s2&Aiu^cl v*'1<6s10 _ e16 Ito wl
/'1 i L'L." 4 •f C.�245 rcvesy• /r rG!n•Ic�ln ./lG C�.�j�.! �:,+ -lG v.�
viaIL/7n al 3T i T.
y�' �I-Sc I I1 CvCe. S�.� IKS.�.1, �►� ?� �I 1V L e, /�+r.4 !J 4 z-1 Z4, 1�� 1
3� 3 ���I.�� (:� ��� n�strw-1�+bcswe� �r�anrr �� 0 r ! vC C ��G 1 ;"S L�41YAiCIn4Y
�S evl enu,no ! +c'!n int�5. Ha.Z NU-,W " /z� 23.
�a ZIZ� z3 as IZ ,N.•
Discussion With Person in Charge: Cor ctive Action Required: ❑ No Yes
ff Voluntary Compliance ❑ Employee Restriction/
Exclusion
❑ Re4nspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
❑ Voluntary Disposal 0 Other.
Violations Related to Foodborne Illness Interventions and Risk
Faclors(Red benrs I-22) (Cone) 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(B) Use of Pasteurized Eggs*
3-302.14 Protection from Unapproved Additives* 3-801.1 l(D) Raw or Partially Cooked Animal Food and
I5 Poisonous or Toxic Substances Raw Seed Sprouts Not Served.*
7-101.11 Identi ,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
7-202.11 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.*PJ"'rnawl
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 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.
TIMEITEMPERATURE CONTROLS Other 590.009 violations relating to good retail
16 Proper Cooking Temperatures for PUN practices should be debited under#29-Special
3-401.IIA(1)(2) Eggs- 155°F 15 Sec. Requirements.
E gs-Immediate Service 145*F15sec*
3-401.1 I(A)(2) Comminuted Fish,Meats&Game
Animals-155°F 15 sec.* 111OLATIONSRELATED TO GOOD RETAIL PRACTICES
3-401.11(11)(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 tine foodborne
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, Illness interventions and riskfactors listed above,can be found in line
Stuffing Containing Fish,Meat,Poultry or following sections of lire Food Code and 105 CdIR 590,000.
Ratites-165°F 15 sec.*
3-401.1 l(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 see.* 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
3-403.1 I(A)&(D) PHFs 165°F IS see,* 28. Poisonous or Toxic Materials I FC-7 1 .008
3-403.11(13) Microwave- 165*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 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 PI1Fs from 140°F to 70°F
Within 2 Hours and From 70*F to
4I*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.I6(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 1 Time as a Public Health Control*
590.004(11) Variance Requirement
Establishment Name: " `"'I-CS Rj� Date: (/Zy/2'3 Page: ' of t
Item Code C—critical item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
No. Reference R—Red Item PLEASE PRINT CLEARLY Verified
Al l C(MAt 3►.2"�'. EPA s �Q �1-t�►u, ice.
Discussion With Person in Charge: Corrective Action Required: ❑ No Y Yes
Voluntary Compliance ❑ Employee Restriction/
Exclusion
❑ Re-inspection Scheduled ❑ Emergency Suspension
❑ Embargo ❑ Emergency Closure
13 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 CHT\IICALS 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
I5 Poisonous or Toxic Substances Raw Seed Sprouts Not Served.*
7-101.11 ldenti6,ing information-Original Containers* 3-801.1 l C Unopened Food Package Not Re-served.
7-102.11 Common Name-Working Containers*
7-201.11 Separation-Storage* COiN'SUAIER 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.*"J"'"""mof
7-204.12 Chemicals for Washing Produce Criteria* 3-302.13 Pasteurized Eggs Substitute for Raw Shell E99s,
7-204.14 Drying Agents,Criteria*
7-205.11 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* entering,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.
TUNIE/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.I tA(1)(2) Eggs- I55°F 15 Sec.
Requirements.
E gs-Immediate Service 145°F15sec;
3-401.1 l(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)
3-401.1 i(A)(2) Ratites,Injected Meats-155°F 15 sec.* Critical and non-critical violations,iMich do not relate to the foodborne
3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, illness interventions and rlskfactors listed above, can be found in the
Stuffing Containing Fish,Meat,Poultry or folloivingsections ofthe Food Code and 105 GbIR 590.000.
Ratites-165°F 15 sec.*
3-401.11(C)(3) Whole-musele,Intact Beef Steaks 145°F* Item Good Retall Practices FC S90.000
3-401.12 Raw Animal Foods Cooked in a 23. Mana enient 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
27. Physical Facilit FC-6 .007
3-403.11(A)&(D) PHFs l65°F 15 sec.* 28. Poisonous or'foxic Materials FC-7 1 .008
3-403.11(B) Microwave- 165°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 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 P11Fs 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) 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 1 Time as a Public Health Control
3-501.19 Time as a Public Health Control*
590.004(1 i) Variance Requirement uirement
Establishment Name: J ✓°� Date: /(L�'��; Page: 4— of L'
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
No. Reference R-Red Item PLEASE PRINT CLEARLY Verified
sina..�jn 1>s� ✓w,ieiQ�1.,�.-�D�lav�t.
<..L. z,,d+u f ,.0 ��Q. R 600, : sf-� st y
�k.9� 1-5e1.1 (3 "'�' li✓af1C9n f�1�1�1' ,,,,,tetsv aS 3°�', c�tc.�C:o.. � s' �� a1-+��l�v.o„-��-o••.
4% Z- Z s 1b.
� va lwui�c� t S G.. `` wi^�. '��. •S I^ c�-�ttitt,a� ° � .r.�
s° 74
-1-3 L- -50►1 Co�P- 0ac 3 16 51,. (UY,
��`� I. -�i[`L•,� /��sC4r /GC CJ( VIt l�Lt v,^/JL.��,
y y` 1jZ.•13 l.A �. I/. Lu Q C,e�.�i Q<aH'aC. wv,.�. UUr-x�S C•L I� CtSL ir, ' ��4.. G •�,
M..1.1_t, 1b0 CGwu�.
® 3-5 0� �1 �ce. c ��.•co.,1 vw.�it r,c�o.0 .�le� I' rw,.k.t a I T
s1� . P tis - 1 e._ A.,OO t s.
W!Il L v� II-Li Ivs L J ..e �,cL,c l,. �W41lCv
li�1�t 4*1-5 40 11
Discussion With Person in Charge: n Corrective Action Required: ❑ No Yes
❑ Voluntary Compliance ❑ Employee Restriction/
`1011 a C Exclusion
❑ Re-inspection Scheduled ❑ Emergency Suspension
❑ Embargo O Emergency Closure
❑ Voluntary Disposal ❑ Other.
Violations Related to Foodbor ne Illness Interventions and Risk
Factors(Red Items I-22) (Cont.) REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
POPULATIONS IISP
PROTECTION FRO1I 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(B) 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.*
7-101.11 ldenti ,ing Information-Original Containers* 7801.11 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.*t�/ranr rn�mor
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 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.
TI\IEITEAIPERATURE CONTROLS Other 590,009 violations relating to good retail
16 Proper Cookhtg Temperatures for Mrs practices should be debited under#29-Special
3-401.11A(1)(2) Eggs- 155*F 15 Sec. Requirements.
Eggs-Immediate Service 145°F15sec*
3-401.11(A)(2) Comminuted Fish,Meats&Game
Animals- 155°F 15 sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-401.11(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 sec.* Critical and non-critical violations,which do not relate to tie 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 CjVR 590.000.
Rntites-165°F 15 sec.*
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
3-403.1 l(A)&(D) PHFs, 165°F 15 sec.* 28. Poisonous or TOXIC Materials FC-7 1 .008
3-403.11(B) Microwave- 165'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 Beef Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
Roasts*
I8 Proper Cooling of PIIFs
3-501.14(A) Cooling Cooked PI1Fs 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) PIlFs Received at Temperatures
According to Law Cooled to 41'F/45°F
Within 4 Hours.*
3-501.15 Cooling Methods for PHFs
h_9 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