HomeMy WebLinkAboutFood Est - NA Middle School - Inspection - 495 MAIN STREET 10/18/2023 Town of North Andover 120 Main Street
Health Department Tel. (978) 688-9540
FOOD ESTABLISHMENT INSPECTION REPORT
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aofperatcni )Establishment Date: T p e of Inspection
Food Service temporary Routine Suspect Illness
Address: Risk level Retail, Caterer Re-inspection rl chrriplaint
Mobile F1 B&B Pre-operation [I HACCP
Telephone: HACCP Y/N Re siden6ai Kitchen Other
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Owner: --—----- ii b—er of'F_o oc-i b—o r;;W t
ut: Illness-Related Food
Illness-
'701- N tated.y�qLj�ti
umber of Illness
Inspector: Re-inspection Date:
PIC.-AA ..........____..........
IN=in compliance OUT=rant o �qrnp N =I t a NIO riot observed COS=corrected on-site du�.iE2 ton violation
_I ,jian e
Col IN )i N/A I COS R Conn hance status IN OU I C OS R
W
I P arge present, demonstrates V Compliance with variance specialized
and performs duties recess/HACCP plan
2 C, I Protection Manager
111 30 Pasteurize
Lfflm�� ....,. .��e slused whe�Ere�reutre,d
3 Management,food employee and 31 Water&ice front approved SOI
conditional employee; knowledge,
iesponsLqi t es and repor!i 32 Variance obtained
4 use_EE2per use of restriction and exclusion
............ 33 Proper cooling methods used;adequate
5 Procedures for responding to vo e(L i er t to I erature control
and dial events ......
_11JI NIA I CO3 R
and dial"he'
M 34 Plant fooc!_2Lopp
M Na methods used�pp!qy�
P t ......
t6Proper eating
36 Thermometers rovided and accurate
tobacco use
�7 No eye,no 3,7 Food I I b I d I t
-da.n.ds-clean a!!��pjqptE!y was�t M E
38 Insects,rodents,&animals n present
9 Na bare hand contact with RTE food 39 Contamination prevented during food
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ells Ia
1 10 Adequate/supplied handwashing sinksaar storaq��_and
JIM 40 Personal cleanliness
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41 ..�Y�j loths:p!pp ,A,Md stared
11 Food obtained from a 'oved Source .11 _L �tl - —
V 42 Washing fruits and ve eI bles
12 Food receive t r9 V11—
P temperature
r ture
13 Food received in good condition,safe, 43 In-use I r9p
and unadulterated
.......... 44 Utensils,equipment and linens:properly
girl stared
14 Required records available:shelilstack stored, dried,arid handled
tat
s, arasite destruction
45 Single-use/single-service articles:
V jLrop.!!Y stated and used
15 hood
separ ated angprotected 46 Gloves used property
16 Food-contact surfaces cleaned&
sanitized V
----—----- —"-'.......... Food and non-food contact surfaces
17 Proper disposition of returned, cleanable,properly designed,
previously served,reconditioned and constructed and used
unsafe food 48 Warewashing facilities:installed,
ME
maintained,and used;test s!E!ps
18 -P 0 Cc I 9_Llrn�qn4jt=atures 49 Non-food contact surfaces clean
- 122tr— 9
.. ........
19 Proper reheating procedures
20 Pro me aqq�!�rripe°rature 5 0 Hot arid cold waftl 9q2_q"jL-�res� 1L_
I—__ . _ _ I/ _V_
21 Props, ral 51,
1- _ - _..Lhq� V4 ... .,_.P1u1.1._,n backflow
22 Proper 52 S a e&was e water disp
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23 Praye
r arxd disposition 53 Toilet features
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24 Time as a Public Health Control 54 Garbage and refuse properly disposed;
facilities maintained
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advisory rovided V 55 Physical facilities installed,maintained,
and clean
26 Pasteurizedfoods used;prohibited 56 Adequate ventilation and lighting;
offeredfoods not I nated areas used
M1 Antt c oki g_p es�....
27 Food additives In n
................ ....... M2 Food aller wanness
28 Toxic substances re.......
Official Order for Correctici Based on an inspeefion today,the iterns marked"OLP"Indicated violations to 105 1590.000 and applicable sections of the 2013 FDA Food Code,
This report,when signed below by a Board of Health member or ohs agent constitutes an order of the Board of Heafth.Failure to coIrrect violations cited In this report may result in
suspension or revocation of the food es,Aabhmilllpt Md arid cessation of food estabIrshirnent operations.If aggrieved by this order,you have a right to a hearing.Your request must
.ea ia ea above ad ress within gay 2Ln�i�ttp
be in wrtfinjand submitt to th J e b d k this order,
�lrhs
c's signature: Date: /49
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7_ 2 f
pector's sir re:: Cate f
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Food stabfishrnenEstablishment Inspection Report — Town of North Andover
,7,k,� Page of
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Tepiperature Observations is
Item I Location Temp(OF) [—,Fte�/'_Locafio,n
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Item i Location Temp(�OF ,,,_)
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ZL�aw jq
Observations and/or,Corrective Actions
�iolation�sc4ed in this far 1 n Section 8: -6 T)1-1-'o-f t'h—e F_'ood_'C__Code
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art bo� s stated b6ow_�orrected within ft time frame,
Itern Section of Code Description of Violation Date to Correct By
Numb
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Signature of Person:-i-n_zha;:ge7-`
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Signature of Inspector:< / Date:
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