HomeMy WebLinkAboutAndover Forest Post Acute Care Food Inspection 1-17-2025 - Inspection - 1801 TURNPIKE STREET 1/17/2025 North Andover Health Department
Food Establishment Inspection Report 120 Main Street, North Andover MA 01845
Tel. (978) 688-9540 Fax (978) 688-9542
Email: twolfenden@northandoverma.gov
Name: Andover Forest Post Acute Care Center Inspection Date:01/17/2025 Number of P and PF Violations ^
Address: 1801 Turnpike Street Time In/Out: 09:50 am / 11:06 am (Items 1 though 29): 1
Phone: 978-688-1212 Permit No.: Number of Repeat P and PF O Email: Risk Category: 4 HACCP: No Violations(Items 1 though 29):
Owner: Stern Type of Operation: Food Service
Person-in-charge: Walter Rodriguez Type of Inspection: Routine Previous Inspection Date:
Inspector: T.Adell Date of Re-Inspection: 01/27/2025 or After
FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS
In =in complaince Out =out compliance n/o =not observed n/a =not applicable Cos =corrected on-site r =repeat violation
Compliance Status IN OUT N/A N/O COS R Compliance Status IN OUT N/A N/O COS R
Supervision Protection from Contamination
1 Person-In-Charge present, Out cos 15 Food separated and protected In
demonstrates knowledge, and 16 Food contact surface; cleaned Out
performs duties and sanitized
2 Certified Food Protection Manager In 17 Proper disposition of returned, In
Employee Health previously served, reconditioned
3 Management, food employee and In and unsafe food
conditional employee; Knowledge, Time/Temperature Control for Safety
responsibilities, and reporting 18 Proper cooking time &temperature n/o
4 Proper use of restriction and exclusion In 19 Proper reheating procedures for hot n/o
5 Procedures for responding to vomiting In holding
and diarrheal events 20 Proper cooling time and temperature n/o
Good Hygienic Practices 21 Proper hot holding temperature n/o
6 Proper eating, tasting, drinking, or In 22 Proper cold holding temperature In
tobacco use 23 Proper date marking and disposition In
7 No discharges from eyes, nose and In 24 Time as a Public Health Control n/a
mouth Consumer Advisory
Preventing Contamination by Hands 25 Consumer advisory provided for raw/ n/a
8 Hands clean and properly washed In under cooked food FF
9 No bare hand contact with RTE food Tn
Requirements for Highly Susceptble Populations
10 Adequate handwashing sinks properly 26 Pasteurized foods used; prohibited In
supplied and accessible foods not offered �17
Approved Source Food/Color Additives and Toxic Substances
11 Food obtained from source In 27 Food additives; approved and n/a
12 Food received at proper temperature n/o properly used
13 Food received in good condition, safe, In 28 Toxic substances properly identified, In
and unadulterated stored and used
14 Required records available, shellstock n/a Conformance with Approved Procedures
tags, parasite destruction 29 Compliance with variance/ n/a
OFFICIAL ORDER FOR CORRECTION: Based on an inspection specialized process/HACCP plan
today,the items marked"OUT'indicated violations to 105 CMR 590.000 and applicable sections of 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,
or non-renewal pursuant to 105 CMR 590.000 you may request a hearing before the board of health in accordance with 105 CMR 590.015(B).
Inspector: - Person In Charge:
Page 1 of 4
Food Establishment Inspection Report MoJiN Solutions, LLC
Establishment: Andover Forest Post Acute Care Center Date: 01/17/2025 Page 2 of 4
GOOD RETAIL PRACTICES AND MASSACHUSETTS-ONLY SECTIONS
In =in complaince Out =out compliance n/o =not observed n/a =not applicable Cos =corrected on-site r =repeat violation
Compliance Status IN OUT N/A N/O COS R Compliance Status IN OUT N/A N/O COS R
Safe food and Water 48 Warewashing facilities: installed, Out
30 Pasteurized eggs used where n/a maintained, and used; test strips
required 49 Non-food contact surfaces clean
31 Water and ice from approved source Physical Facilities
32 Variance obtained for specialized n/a 50 Hot and cold water available;
processing methods adequate pressure
Food temperature control 51 Plumbing installed; proper Out
33 Proper cooling methods used; In backflow devices
adequate equipment for 52 Sewage and waste water properly
temperature control disposed
34 Plant food properly cooked for hot n/o 53 Toilet features; properly,
holding constructed supplied,and cleaned
35 Approved thawing methods used n/o 54 Garbage and refuse properly
36 Thermometer provided and accurate disposed; facilities maintained
Food Identification 55 Physical facilities installed,
37 Food properly labeled: original maintained, and clean
container 56 Adequate ventilation and lighting;
Prevention of Food Contamination designated areas used
38 Insects, rodents, and animals not Massachusetts Requirements
present M1 Anti-choking procedures in food In
39 Contamination prevented during service establishment
food prepa ration,storage and M2 Food allergen awareness In
display M3 Caterer
40 Personal cleanliness M4 Mobile Food Operation
41 Wiping cloths: properly used and M5 Temporary Food Establishment
stored M6 Public Market; Farmers Market
42 Washing fruits and vegetables M7 Residential Kitchen; Bed-and-
Proper Use of Utensils Breakfast Operation
43 In-use utensils properly stored M8 Residential Kitchen: Cottage Food
44 Utensils, equipment and linens: Operation
properly stored,dried, and handled M9 School Kitchen; USDA Nutrition
45 Single-use/single-service articles: Program
properly stored and used M10 Leased Commercial Kitchen
46 Gloves used properly M11 Innovation Operation
Utensils, Equipment and Vending M12 Frozen Desert
47 Food and non-food contact surfaces Local Requirements
cleanable, properly designed, L1 Local law or regulation
constructed and used L2 COVID-19
L3 Reserved
Andover Forest Post Acute Care Center Date: 01/17/2025 Page 3 of 4
DESCRIPTION OF VIOLATION
Fail Code
Discussion Employees state chage in name and ownership since last
routine inspection, new name and owner documented on first page of
report.
bserved "Sutton Hill Center" food permit posted with an expiration date
of 3/1/2024 . PIC unable to provide current food permit. PIC to contact
the health office regarding current food permit status and obtain
physical copy. PIC to ensure the current food permit is posted in
compliance.
Correct On Site OBSERVATION: Employees unable to verify a person in charge (PIC) upon
arrival for the inspection. PIC arrived in the middle of the inspection.
PIC to ensure there is an assigned PIC on site at all times and ensures
they are performing their duties specified under FC 2-103.11.
2-101 .11-Pf REGULATION: Item 01 PIC present, demonstrates knowledge, and perform
duties -- Assignment PIC
OBSERVATION: Observed a few stored knives in wall mounted rack with slight
accumulation of food debirs on the blades . PIC to ensure knives are
cleaned and sanitized prior to storage.
4-601 .11 (A)-Pf REGULATION: Item 16 Food contact surface; cleaned and sanitized --
Cleanliness of FCS and Non-FCS
OBSERVATION: PIC unable to provide an irreversible temperature measuring
device. Reviewed examples with PIC, including 160°F sensor stickers, dish
plate thermometers, and water-proof maximum registering thermometers. PIC
to supply and routinely monitor utensil surface temperatures.
4-302 .13-Pf REGULATION: Item 48 Warewashing facilities : installed, maintained, and
used; test strips -- Temperature Measuring Devices, Manual and Mechanical
Warewashing
OBSERVATION: Observed hand sink adjacent to ice machine with faucet
leaking water when knobs are turned off. PIC to ensure plumbing systems
are maintained in good repair using approved methods and materials.
5-205.15 REGULATION: Item 51 Plumbing installed; proper backflow devices -- Water
System Good Repair
Discussion Hood sticker dates 8/13/2024, in compliance.
Closing Correct Priority Item and Priority Foundation Item violations immediately;
Core Item violations within 10 days. Correct all violations in entirety
and maintain. Train and supervise staff. Failure to correct all
violations and maintain corrections may result in administrative action
and or fines. The text in this report is an unofficial version of the
state regulations. Official version of the state regulations may be found
at www.mass.gov/dph/fpp or by contacting the State House Book Store.
In Compliance Observed cooked pasta at 38°F and tilapia at 36°F both in
walk in refrigerator. Observed QAC sanitizer measure 200 ppm via PIC's
test strips; high temperature dish machine achieve a utensil surface
temperature of 169.1 via inspector's dish plate thermometer. PIC able to
explain symptoms and diagnoses requiring restriction and exclusion for
food employees, in compliance.
Andover Forest Post Acute Care Center Date: 01/17/2025 Page 4 of 4
DESCRIPTION OF VIOLATION
Fail Code