HomeMy WebLinkAboutFood Est - Sams Mobil Mart - Inspection - 12 MASSACHUSETTS AVENUE 7/24/2024 Fown of North Andover
Board ofHealth FOOD ESTABLISHMENT INSPECTION REPORT R-10
Inspection Number Date Time In/Out Inspection Type Client Type Inspector
Sams Mobil Mart D8020 7/24/24 9:37 AM Routine Retail Market S.Pierce
12 MASSACHUSETTS AVENUE 9:53 AM
NORTH ANDOVER, MA 01845 Permit Number Risk Variance Priority Pf Core Repeat
65067 1 Violation Summarv: 0 1 2
IN=in compliance OUT=out of compliance N/O=not observed N/A=not applicable COS=corrected on-site during inspection Repeat Violations Highlighted in Yellow
............
Supervision IN OUT T"N'A IN 0 Protection from Contamination(Cont'd) IN OUT NA IN COS
...............
1.PIC present,demonstrates knowledge,and performs duties V 15.Food separated and protected V
2. Certified Food Protection Manager V 16.Food-contact surfaces;cleaned&sanitized
------------ ........................... E, ploy 17 Proper disposition of returned,previously served,
m ........................................ ...
reconditioned&unsafe foods V
3. Management,food employee and conditional employee .................................................................................................................................................................................................................................................................................... c
knowledge,responsibilities and reporting V Time/Temperature Control for Safety IN OUT NA NO
4. Proper use of restriction and exclusion V 18.Proper cooking time&temperatures V
5. Procedures for responding to vomiting and diarrhea)events V 19.Proper reheating procedures for hot holding
...........................................................................................................................................................................................................................................................................................................
Good Hygienic Practices IN OUT NA NO COS 20.Proper cooling time and temperature
6.Proper eating,tasting,drinking,or tobacco use V 21.Proper hot holding temperatures V
7. No discharge from eyes,nose,and mouth V 22.Proper cold holding temperatures V.......... ...... ....................................................................................................Preventing �nitiirrii I:tat i 6i- aridi.................iI OUT......N.A N.0 COS....
V 23.Proper date marking and disposition
8. Hands clean&properly washed
V 24.Time as a Public Health Control;procedures&records
9 V
No bare hand contact with RTE food or a pre-approved
alternative procedure properly allowed Consumer Advisory IN OUT m NO COS
10.Adequate handwashIng stinks SLApplIed and accessible 2 V V 25.Consumer advisory provided for raw/undercooked food V
....................................................................................................................... i�W Source.................................................................................................................................
IN OUT NA NO COS iqw usceptue PopUlatlonS IN OUT m NO COS
11.Food obtained from approved source V 26.Pasteurized foods used;prohibited foods not offered V
........................................................................................................................................................................................................................................................................ ....12.Food received at proper temperature Food/Color Additives and Toxic Substances IN OUT NA N cos
13.Food in good condition,safe&unadulterated V 27.Food additives:approved&properly used V
14.Required records available:shellstock tags,parasite V 28.Toxic substances properly identified,stored&used V
destruction,
Conformance with Approved Procedures IN OUT NA11066s]
............Repeat Violations Highlighted in Yellow 29.Compliance with variance/specialized process/HACCP
NONE=
Safe Food and Water IN OUT NA NO COS Proper Use of Utensils IN OUT NA NO C�OS
30.Pasteurized eggs used where required V 43.In-use utensils:properly stored
31.Water&ice from approved source 44.Utensils,equip.&linens:property stored,dried&handled
32.Variance obtained for specialized processing methods V 45.Single-use/single-service articles:properly stored&used
Food Temperature Control IN OUT NA NO COS 46.Gloves used properly
33.Proper cooling methods used;adequate equip.for temp. f Utensils,Equipment and Vending IN OUT NA NO COS
control 47.All contact surfaces cleanable,properly designed,
34.Plant food properly cooked for hot holding constructed,&used
48. Warewashinq facilities:installed,maintained&used;test
35. Approved thawing methods used V strips
49. Non-food contact surfaces clean
36. Thermometers provided&accurate
........................................................................................................................................................................................................................................................................................................... Physical Facilities IN OUT NA NO COS
Food Identification IN OUT NA NO COS 50.Hot&cold water available;adequate pressure
37.Food properly labeled;original container 51.Plumbing installed;proper backflow devices
Prevention of Food Contamination IN OUT NA NO COS 52.Sewage&waste water properly disposed
38.Insects,rodents&animals not present 53.Toilet facilities:properly constructed,supplied,&cleaned
39.Contamination prevented in prep,storage&display 54.Garbage&refuse properly disposed;facilities maintained
40.Personal cleanliness 55. PhysIcal facilities Installed,maintatned&dean V
41.Wiping cloths;properly used&stored 56.Adequate ventilation&lighting;designated areas use
42.Washing fruits&vegetables
60. 105 CMIR 590 violations/local regulations
Official Order for Correction:Based on an inspection today,the items marked"OUT"indicated violations of 105 CMIR 590.000 and applicable sections of the 2013 FDA Food Code.
This report,when signed below by a Board of Health member or its agent constitutes an order of the Board of Health.Failure to correct violations cited in this report may result in
suspension or revocation of the food establishment permit and cessation of food establishment operations.If you are subject to a notice of suspension,revocation,or non-renewal
pursuant to 105 CIVIR 590.000 you may request a hearing before the board of health in accordance with 105 CIVIR 590.015(B).
Follow Up Required: Y Follow Up Date:
S.Pierce Ian Patria-Expires
Certificate#:
FOOD SAFETY INSPECTION REPORT Page Number
2
Sams Mobil Mart Inspection Number Date Time In/Out Inspector
12 MASSACHUSETTS AVENUE D8020 7/24/24 9:37 AM S.Pierce
NORTH ANDOVER, MA 01845 9:53 AM
• - • _ • • • - • Emw
Repeat Violations Highlighted in Yellow
Preventing Contamination by Hands
Adequate handwashing sinks properly supplied and accessible
10 6-301.20 Disposable Towels,Waste Receptacle -Restrooms -
CO C Employee bathroom without paper towel.
Code:A handwashing sink or group of adjacent handwashing sinks that is provided with disposable towels
shall be provided with a waste receptacle.
......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
10 5-205.11 Using a Handwashing Sink- Dry Storage -
COS Pf Handwashing sink blocked by box. Code:A handwashing facility shall be maintained so that it is
accessible at all times for employee use and may not be used for purposes other than handwashing. An
automatic handwashing facility shall be used in accordance with manufacturer's instructions.
......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Physical Facilities
Physical Facilities installed, maintained & cleaned
55 6-501.12 Cleaning. Frequency/Restrictions -Restrooms -
C Vent dirty in employee bathroom. Code: The physical facilities
shall be cleaned as often as necessary to keep them clean.
Except for cleaning that is necessary due to a spill or other '
accident, cleaning shall be done during periods when the least
amount of food is exposed such as after closing.
......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
•
Area Equipment Product Notes Temps
°F
North Andover Board of Health: 120 Main Street, North Andover, MA o1845 (978) 688-954C
FOOD SAFETY INSPECTION REPORT Page Number
3
Sams Mobil Mart Inspection Number Date Time In/Out Inspector
12 MASSACHUSETTS AVENUE D8020 7/24/24 9:37 AM S.Pierce
NORTH ANDOVER, MA 01845 9:53 AM
• - • _ • • • - • Repeat Violations Highlighted in Yellow
Establishment Misc. Half and half 40 OF
-1..�.�............................................................................... .-......................... �..................
Temperatures in RED identify items in the temperature danger zone. See the report notes for specific details.
North Andover Board of Health: 120 Main Street, North Andover, MA o1845 (978) 688-954C