HomeMy WebLinkAboutFood - Residential - Routine - Inspection - 117 BRIDLE PATH 2/16/2023 # 5a�o9
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 REPORT Fax- 978.688.9542
e-mail: healthdept@northandoverma.gov
Name of EstablishmentQ � /`� / Date Type of Operation(s) Type of Inspection
li `i /70 j 2_ 12, J 0o)_ �.� ❑ Food Service ®Routine
Address !17 L f Risk Level ❑ Retail ❑ Re-inspection
Telephone Residential Kitchen P)rreeevious Inspection
978 - 233 - /X? 7 Mobile
Owner HACCP: ❑ Temporary ❑ Pre-operation
y / N El Caterer ❑ Suspect Illness
Person-in-Charge(P C) Time ❑ Bed&Breakfast ❑ General Complaint
tom.i Sl �c� ❑ HACCP
/ In:j Z•:(Cr- El Other
Inspector STe v� �C1� �' Out: l Z �-3 M year: '`) '
Each violation checked requires an a lanation 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 ❑ 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: /V/
30. Other
Inspector's Signature: � - Print:
PICs Signature: Print: I L.� Sj Yvl PS(�/V Page 1 of�` Pages
Violations Related to Foodborne Illness Interventions and Risk Factors
(Red Items 1-22)
FOOD PROTECTION MANAGEMENT
1 590.003(A) Assi nment of Res onsibilit * PROTECTION FROM CONTAMINATION
590.003 B Demonstration ofl(nowledge* 18 Cross-contamination
2-103.11 Person in char e-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*
a lieanlS* 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(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 ojAdulterated or
FOOD FROM APPROVED SOURCE Contaminated Food
4 Food and Water From Re ulaled 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* Sanitization'Penn eratures*
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.,p11,
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 Froze 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*
Re ulato►• A►Rhorit, 10 Proper,Adequate Handnvashin
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 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
*
Em to ployees ees
3-402.11 Parasite Destruction* 13 H 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 Plans Supplied with Soap and Hand Drying
3-502.11 Specialized Processing Methods* Devices
3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Handwashin Cleanser,Availabili
8 ]03.12 Conformance with A roved Procedures* 6-301.12 Hand Drying Provision
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
Establishment Name: L./7 9!!S� ��� <�-I J� 54C9 Date: CO Page: of
Item Code C—Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
No. Reference R—Red Item PLEASE PRINT CLEARLY Verified
�SoJYIn¢_iir owl
i °�. cam¢. acc.+A�1���.�ac�.•�sf-wss s uu
t
Ad-w�e ,,a1 i s�� -� 1� 1-e . 061a►,.�..
O b ftcI�RES WS�v►t�-l�f� Qx to-4n.J Aeol rf
Le&0 -fir AAAWb s� s �,k + e�11,�ra c 1 rJt4� Zuir 6r w
�'-oc cQtsl.,vf.sl.�,t, t✓t��-u -,rc.S2. �-c�
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 ❑ Other
d d
Violations Related to Foodbor ne Illness Interventions and Risk
Factors(Red Items 1-22) (Cont.) REQUIREMEN'rS 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* 3-801.1 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 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 3-603.11 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.I1 Sanitizers,Criteria-Chemicals* Pathogens.*fff""^"r///No/
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 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.
TIME/TEMPERATURE 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(l)(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 see.* 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,Stuffed PHFs, Illness interventions and riskfactors listed above,can be found in Ile
Stuffing Containing Fish,Meat,Poultry or following sections oftle Food Code and 105 011?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. Mana ennent and Personnel FC-2 .003
Microwave 165°F* 24. Food and Food Protection FC-3 .004
3-401.11(A)(1)(b) All Other PflFs-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 l65°F 15 see.* 28. Poisonous or Toxic Materials I FC-7 1 .008
3-403.11(B) Microwave- 165°F 2 Minute Standing 29. 1 Special Requirements .009
Time* 30. 1 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 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/45°F
Within 4 Hours*
3-501.14(C) PliFs Received at Temperatures
According to Law Cooled to 41°F/45°F
Within 4 Hours.*
E193-501.15 CoolingMethods for PHFs
PHF Hot and Cold Holding
3-501.16(B) Cold PHFs Maintained at or below
590.004(F) 41°/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