THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF ?ames/a Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date Tips ofOperatlon[s] oilns action gull/9?? 149/3779 ?7 Food Service (D?oullne Address Risk Retail Rea-inspection 95 @f/E 12?) Level Residential Kitchen Previous inspection Telephone Mobile Date: Temporary Pro-operation Owner 75am :0 f/Ie/m?i/g/d HACCP YIN Cl $33833; kl gospeclt ?1085? I Ti rea as enera ompan Person in Charge (PIC) ?cf-H75: {m We! In?z.?30 El HACCP InSpector Mark 1444: fa: Out: Permit No. CI Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations marked may pose an imminent health hazard and require immediate correctiva 590-009lFl Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.009 (E) action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned l' Knowledgeable I Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC Personnel with Infections RestrictedIExcluded FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. ReceivinglCondition 8. TagsIRecordslAccuracy of Ingredient Statements CI 7. Conformance with Approved ProceduresIHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violagigns Related to Good Retail Practices (Blue Items] Critical (Ci violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water, Plumbing and Waste 27. Physical Facility (menswear) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Allergen Aweronesa 590.009 (G) Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives U15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) CI 16. Cooking Temperatures CI 17. Reheating [318. Cooling {5/10 10. Hot and Cold Holding 410? 35"3 5'6? 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY POPULATIONS (HSP) El 21. Food and Food Preparation for HSP CONSUMER ADVISORY . CI 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): Official Order for Correction: Based on an inspection today. the items checked indicate violations of 105 CMR 590.000IFederal 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. "aggrieved by this order. you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF RE-INSPECTION: [/3/319/9 Inspector's Signature: abut/1&2? "rm? {hr/A. Ill/i 45- 131/3; bios Lil/M A. Print: He?m U91 AM MA TOWN OR CITY OF THE COMMONWEALTH OF MASSACHUSETTS Establishment Name: 45/137? Date: Page: 7? of item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference -Recl Item - PLEASE PRINT CLEARLY alarmed $75] ?74 ?Ig?m War/?mew? {44" 7?71; {ire-(UV {415250 I gold. ?nd wk? tiff-1225* .9065 (31" 195E f? c. I s. ?329:ij 19M #reczer 117mm" caught, a? {cg Jp/o?. TWIN: ?-aam? nam?; 1? 4c: ample?! and um? mac-sis we 44c: "fumed Meant?! (4614357er Ain?t:? 754:. I Mei/Pas?? male drawer! 0v J?zh/ m??/Am (a?f??JI/r ml! ?cc-?Cf 7% View war 6513751153? 54am? Wag?(I (sf/H76 75/65 dVC?r 7%6. midi/3?12?? ?zacr )Ims. jam!" lasso I hill," In?d?' i ?3in Laljnne +2Ie? Inna?: o??i?f ?ew WW ram: 12.: {than jets In?r- lair?r111 I V77 IUI I "lg-I war}: McNeil/ED rial? @bon 4 7} 7.8410 Discussion With Person In Charge: Corrective Action Required: No Ell? Yes Cl Vqunlary Compliance Exclusion ill/Re-inspeclion Scheduled I I Embargo Voluntary Disposal Other: Employee Restriction I Emergency Suspension Emergency Closure Form 734 8 AM. Sulkin 00., Charlestown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Magus/W/f Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Z): Date to eration fins action 5:66 af?x/1 .lt' DEE oodlService Routine Address . lsit' Retai Re?inspeciion I 25- Level Residential Kitchen Previous Inspection 9 eI3 0'16 Mobile Date: 0 25/ git?MY! 5,21 {194/923 ACCP YIN Temporary Pre-operation wner Zita/i ~2ng a Caterer Su5pect Illness . Bed 8: Breakfast General Com Iaint Person In Charge (PIC) [mm/r I: HACCP Inspector W74t5/g. Out: Permit No. El Other Each violation checked requires an explanation on the narrative pagets) and a citation of specific provisionts) Vlolated. Non-compliance with: Viotations Related to Food borne Illness interventions and Risk Factors (Red Items) Anti-Choking 59000905) Violations marked may pose an imminent health hazard and require immediate corrective WImm 590-009IF) action as determined by the Board of Health. Allergen Awarenesa 590.009 FOOD PROTECTION MANAGEMENT El 12. Prevention of Contamination from Hands 1. PIC Knowledgeable I Duties El 13? Han dwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives CI 15. Toxic Chemicals 2. Reporting of Diseases by Food Employee and FIG 3. Personnel with Infections RestrictedlExcluded FOOD FROM APPROVED souace 4' Food and Water from Approved Source TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) 5. ReceivinglCondition 515- Cooking Temperatures CI 6. of Ingredient Statements D17- Reheating T. Conformance with ApprOVed ProceduresIl-iACCP Plans 18' a PROTECTION FROM CONTAMINATION C119- Hot and Cold Holding '3?6 1/0 8. 20. Time AS a WWII: Health COMFOI 9_ Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP El 10. ProperAdequate Handwashing . CONSUMER ADVISORY 11? 600d Hygienic Practices 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical violations marked must he To Foodborne "messes immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1.22); of Health. Non-critical (Ni violations must be corrected IOrd rr tio :Based immediately orwithin 90 days as determined by the Board a or 9? (ma mm" today, the items checked indicate violations of 105 CMR 590.000lFedaraI Food Code. This report, when signed below by a Board of Health member or Its agent constitutes an :2 glancegergint PerSEnnel order of the Board of Health. Failure to correct violations 0?00" cited in this report may result in suspension or revocation of 25. Equipment and Utensils the food establishment permit and cessation of food 26. Water, PlumbIng and Waste establishment operations. It aggrieved by this order. you 27- Physical Facility have a right to a hearing. Your request must be in writing 23- POISONOUS 0" TOXIC Materials and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other caries RE-INSPECTION: Inspector 5 Signature: Mai? ?76! Print: M?f?k Md? 9er l/C? I IC 5 rite/141.1 "{ther HEHWEE f?HHK?l?fi FORM 734A AM SULKIN CO CHARLESTOWN MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: 4V??l 51/705/ Date: 5/51/39? page: of Item 0066 - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference R-Red Item PLEASE Palm. CLEARLY Veri?ed (75' fC-lt? TAL Ad, 02.? aj? Leaf-2L inert/F (70 ~64: magi/Ii 21/5: act's" 4/14? 5. 25/ 1'35; '77} 13. 790: game 1351,?) gy?g?r 6743-7: 7?24: 3AM: Jana/L I . dun/n 7?4; Eh c" 67? #341; blr'nf' 7:4; Re cm 795: 6.4.2.: 07/9 +Ac mn? 774$ Java/5% 0197545 {#011 ream need 7?50 156' Igafgjierd Cf (anankt?l; Discussion With Person in Charge: Corrective Action Required: El No CI Yes El Voluntary Compliance El Employee Exclusion Re-inspeclion Scheduled El Emergency Suspension Embargo El Emergency Closure Voluntary Disposal CI Other: Form 734 AM. Sulkin Co.. Charlestowu. MA THE COMMONWEALTH TOWN OR CITY OF (jAs/mm??n/ OF MASSACHUSETTS Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name 51 Date oft) tlon S75- 2 Q7 Food Service CI outine Addresa? Risk Retell Fte- r525? Wfp?? {212/ Level a Residential Kitchen Previous inspection Mobile Data: Temporary Pro-operation Owner Zita/V? HACCP YIN CI Caterer Suspect Illness i . 11 Bed Breakfast General Complaint "Chart?? i HI (.1th InInlazM?S? ?1599030" #7715 Out: Permit No. Other Each violation checked requires an explanation on violated. Violet 5 Related ood orne illnes Interventi us a Violations marked may pose an imminent health action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. FIG Assigned i Knowledgeable! Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections RestrictediExcluded FOOD FROM APPROVED souncs 4. Food and Water from Approved Source CI 5. ReceivingKtondition El 5. TagsiRecordsiAccuracy of ingredient Statements 7. Conformance with Approved Proceduresil-iACCP Plans PROTECTION FROM CONTAMINATION El 8. 9. Food Contact Surfaces Cleaning and Sanitizing CI 10. ProperAdequato Handwashing 11. Good Hygienic Practices Violations Belated to 9999 Retail Practices (Blue Items) Critical (Ci violations marked must be corrected Immediately or within 10 days as determined by the Board of Health. Non?critical [Ni violations must be corrected Immediately or within 90 days as determined by the Board 23. Management and Personnel ch-ziiseosce} 24. Food and Food Protection rec-anemone) 25. Equipment and Utensils rec-insecure) 25. Water. Plumbing and Waste Physical Facility :Fc-snseoson 23. Poisonous or Toxic Materials {Fc-riiseosesi 29. Special Requirements {serious} 30. Other hazard and require immediate corrective the narrative pagets) and a citation of specific provision(s) Non-compliance with: Anti-Choking so soon (E) Tobacco 590.009 1F) Allergen Awareness 590.009 (GI Isk Fac ors (Red items) El 12. Prevention of Contamination from Hands {3 13. Handwash Facilities PROTECTION FROM CHEMICALS [j 14. Approved Food or Color Additives CI 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures El 17. Reheating El 18. Cooling D19. Hot and Cold Holding @127 57? El 20. Time As a Public Health Control CONSUMER Advisonv El 22. Posting of Consumer Advisories REQUIREMENTS FOR HIGHLY POPULATIONS (HSP) 21. Food and Food Preparation for Number of Violated Provisions Related To Foodborne Illnesses interventions 0 and Risk Factors (Red Items 1-22): Of?cial Order for Correction: Based on an Inspection today, the items checked indicate violations ot105 CMR 550.0liillFederal 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 aggrieved by this order. you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. HIE OF 87/? inspector?s Signature: 2? (Lif?t (ff; PlC?s Signature: i L, A5 C?(?LiLrt Print: ??f'?rrk fey/(J Print: ff] [4 Ir" (t R: (Li, 41. FORM 734A AM SULKINGO CHARI MA THE COM ONWEALTH OF MASSACHUSETTS TOWN OR CITY Establishment Name: @6664 Ic?ad/ Date: Ipl/Ia/{K page: of Item Code C-C??cal Item DESCRIPTION OF PLAN OF CORRECTION Date No. Reference - Red Item PLEASE CLEARLY Verlfle 52:7- z?-o We 7&1; m. mime. 62ng 714/? 5 Mme cf 24mm, . ?fr?/?i?ei 74$ 1/ Til/af?i??i?jz?r (?41m: e/ rife 423/ pr Embargo El Voluntary Disposal DDEICID Discussion With Person in Charge: Corrective Action REqUire'i: NO a; Yes Voluntary Compliance Employee Exclusion Re-inspection Scheduled Emergency Suspension Emergency CIosure Other: Form 734 AM. Sulkin 60.. Charlestown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date eratlon of ins action fly-5A?? DI i Food Service Eli Routine Addros's Risk Retail Re-inspeciion Mark ?24 25" Level Residential Kitchen Previous Inspection Telephone Mobile Elite: . Temporary Pre-operation Owner deg!? 47/ (:11 cf 43; {day HACCP YIN El Caterer BSuspectiliness person In Char . Time Bed Breakfast General Complaint 9 [aorta 555000 hydra" EIHACCP Inspector 147(2/14 M43849 Quiz/7: Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violatiogs Related to Foodborne illness nterventions and Risk Factors (Red Items) Anti-Choking 590.009IE) i: Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590909 IF) action as determined by the Board of Health. ?mg? I: FOOD PROTECTION MANAGEMENT El 1. PIC Assigned i Knowledgeable i Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with intentions RestrictediExcluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. ReceivinglCondition El 6. TagsiRecordslAccuracy of Ingredient Statements El 7. Conformance with Approved ProceduresiHACCP Plans 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or ColorAdditives Cl 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures El 17. Reheating [313. Cooling PROTECTION FROM CONTAMINATION El 8. 9. Food Contact Surfaces Cleaning and Sanitizing (Mfr/ii El 10. ProperAdequate Handwashing 11. Good Hygienic Practices Violations Rotated to Good Retail Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water, Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other 19. Hot and Cold Holding I 5?90 20. Time As a Pubiic Health Control CONSUMER ADVISORY 22. Posting of Consumer Advisories REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Food Preparation for HSP Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): Official Order for Correction: Based on an inspection today, the Items checked Indicate violations of 105 CMR 590.00IJIFederaI 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. it aggrieved by this order. you have a right to a hearing. Your request must be in Writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF RE-INSPECTION: inspector?s Signature: Matti Print: [774732 Ma?a/x3 Signature: fir/m FORM 734A A SULKIN GO CHARLESTOWN. MA Print: Lair-re: THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: Date: ?7 Page: 2' Item Code - Ilom No. Relerance - Red Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Dale Vorll'led PLEASE CLEARLY 567? 755.9% 751m; :95. Ari/70' shim-?3 4K hm" miffe?l? 0K 57?5?7cf?cf 6?15 .s??wz 42? we her/1? ms :91? 51w; Jam? miame {eff/75? Mme; M: 14m 447 Jar/?e ?nge/ arm:- Imirro if! ?if? #7 z. 5 ?-fbs S?frr?dg AK I Kala/{m C/fa? 20?? ofq?mvao? {04?s a??r?as AM: Lom?'wf? Ina/wad? Wm 61% we; 190 75a t/Gi7??. 7759. {Egg-w]? rod 551 417;, most? dc?IZbJ-zlen are free!? 351723? i/ Discussion With Person in Charge: Corrective Action Required: No El Yes Cl Volunlary Compliance Re-inspection Scheduled 00000 Embargo Voluntary Disposal Other. Employee Restn'ctionf Exclusion Emergency Suspension Emergency Closure Form 734 AM. Cm. Cha?ostown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY chi/{241mg f?fc/ Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name I Data Win?Hist. (Iva/i 1? Se. Food Service Address [6 . Riak' . [3 Retail I Re?inspeciion Level Residential Kitchen Previous Inspection a Mobile Date: . Temporary Pro-operation Owner Ad?y?? (55/ (?Ag/en; HACCP YIN Caterer Suspect illness Person I Cha 5 . Time Bed 8. Breakfast General Complaint '9 ?Xm 4/5! (an/L [may HACCP Inspector 77 Out: Permit No. Other Each violation'checked requires an explanation on the narrative pagels) and a citation of specific provisionls) violated. Non-compliance with: Violation Related to Foodborne illness nterv tie a and RI Factors (Red Items) Anti-Choking scanners} Violations marked may pose an Imminent health hazard and require immediate corrective action as determined by the Board of Health. 590309? FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands l3 1. FIG Assigned i Knowledgeable! Duties 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives 15. Toxic Chemicals EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with infections RestricterIIExcluded FOOD FROM APPROVED souece El 4_ Food and Water from Approved Source CONTROLS {Potentially Hazardous Foods) 5. ReceivingiCondition E115- Cooking Temperatures El 6. TagsIRecordsiAcc uracy of Ingredient Statements '3 17- Reheating . 7- With Approved ProceduresiHACCP Plans [318' Cooling 57' 3 9 0 PROTECTION FROM CONTAMINATION U19. ?Pt and COM ?960 5" 3" El 8. El 20- Time A5 a Public Health Control Ci 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY FOPULATIONS CI 21. Food and Food Preparation for Cl 10. Proper Adequate Handwashing CONSUMER ADVISORY 11' G??d Hygienic Practices 22. Posting of Consumer Advisories Violations Related to Good Beta" Practices (Blue Number of Vioiated Provisions Related a Items} Critical (C) violations marked must be corrected To Foodborne illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red items 1.22); of Health. Non?critical violations must be corrected Of?cial 0rd Corr ction: Based on an ins ectio immediately or within EIU days as determined by the Board today, the items checked indicate violations Ol105 CMR 590.DODiFedera Food Code. This report. when signed below by a Board of Health member or its agent constitutes an order oithe Board of Health. Failure to correct violations . cited in this report may result in suspension or revocation of 25' Equlpment and menus the load establishment permit and cessation of food 26. Water, Plumbing and Waste tFC-5Il590.006i establishment operations. if aggrieved by this order, you 27- Physical Facility (FC-Eii590.007i have a right to a hearing. Your request must be In writing 28. Poisonous or Toxic Materials and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within days of receipt of this order. 30. Other DATE OF 23. Management and Personnel tFC-Zit590.003) 24. Food and Food Protection inspector?s Signature: if Print: /77 M.) ?05 SignatumHM1Af\\??Crnr?< Print:L r; at?: Lat, i PnchoLLl?ngcs Ansuurw'co. BOARD OF HEALTH Establishment Name: Date: Page: 2?01 2" Item Code, c- Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION pm No. Reference - Red Item ?m5 mm ELEM Verified E2 ?7 I?M/cf 7776 Ida/? n5? 7775f It: and/I- 77546 pog/ an?/ (3 63/6 car a Peat?s err (vi-r73: fol/K wi? rats fry/77 7"7? 74/7?; fer/Hip ?we 27? I m/aaX/g. ?ag h?z? 742% 7439?!) 4:4 fc/ ?m?f car-2: 56795er 49.4: Al?e/f dean m4? ?rw?r??r?r ?Jm/Lz sz?m Discussion With Person in Charge: Corrective Actlon Required: 0N0 Voluntary Compliance CI Fle-inspectlon Scheduled Cl Embargo CI Voluntary Disposal Cl Employee Restriction; Exclusion Emergency Suspension Emergency Closure DUB Other FORM 7343 (REV. 712000) HOBBS WARREN, - BOSTON This Form Approved by the Department of Public Health THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Deparhnent of Public Health Division of Food and Drugs - FOOD ESTABLISHMENT INSPECTION REPORT Name . [let ofD eraiion fins eclion (9/779 5?2534 3 gg?L?W Service DHROUIIM Address . Risk Retail Re-inspeotion 125/ Level Residential Kitchen Previous Inspection Telephone Mobile Effie: Temporary Pro-operation Owner 07?? C75 fat/N HACCF YIN Caterer [3 Suspect illness Bed 8: Breakfast General Corn taint Person In Charge (PIC) Idlittit ?aw Smog?; HACCP Inspector Wag I Cut: Permit No. El Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provisionis) violated. Violations Related Foodbor Ii] ess In erventions and Risk Factors (Red Items) Violations marked may pose an imminent health hazard and require immediate conective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned i Knowledgeable! Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC l] 3. Personnel with infections RestrictadiExcluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. ReceivingiCcndition 6. TagsiRecordsiAccuracy of Ingredient Statements CI 7. Conformance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practigs {Blue items} Critical violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical violations must be corrected immediately or within 90 days as determined by the Board th. 23. Management and Personnel 24. Food and Food Protection irc-anssocoa) 25. Equipmentand Utensils (Po-opossum 26. Water, Plumbing and Waste 27?. Physical Facility 28. Poisonous or Toxic Materials Non-compliance with: Anti-Choking 500.009 (E) Tobacco 500.009 (F) Allergen Awareness 550.005 (8) D12. Prevention of Contamination from Hands D13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Food or Color Additives El 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures Cl 17. Reheating 18. Cooling [319. Hot and Cold Holding 1'4?3' 5?25 7? 20. Time As a Public Health Control 58" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories Number of Violated Provisions Related To Focdborne Illnesses interventions and Risk Factors (Red Items 1-22}: Official Order for Correction: Based on an inspection today. the items checked indicate violations oi105 CMR 590.000iFederaI 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 aggrieved by this order, you have a right to a hearing. Your request must be In writing and submitted to the Board of Health at the above address FORM 734A AM SULKIN CO LEE-STOW him/J 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF REE-INSPECTION: Inspector?s Signature: [77:53 Print: ??fk Signature: Print: MW. liaganLlegos THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: Date: Page: 2 of 2.. Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item PLEASE CLEARLY Verm ed 1; F69 7/56 4/ 9/10): caviar f/agr 4m? - ?rile ?at/fS??o/rld Mfr? 9pm} 4149"?! dj/pr/ We G?r?a/e 7955/5 Mr Adm? C/c mm? 6/5? My .. "tr/be ,1 I . ?1/10 arc (6:1er (5:51 71c $7ng ncz/ 7?3 x? Cub-F (Plhi EH577/54. raf/c/r?m 7&7an ?/ecc fu?lrr m4 (956/ l0 3? aw} c947; 0115/ grim #1 if 5,1451% (cf 57477 {Mr-2'5 dbkh, Kenya/r 7?44 Ff?mf?gafof 79k rm? M764: If 7?42 Mfm?? ?rcr?? far/aged. parallels: [max/(r ixzd 764:? . #6640 Discussion With Person in Charge: Corrective Action Required: El No 3? Yes Voluntary Compliance [3 Employee Restriction! a/ Exclusion Re-inspeclion Scheduled Emergency Suspension El Embargo El Emergency Closure El Voluntary Disposal Other?. Form 734 3 AM. Sulkln 00.. Chadeslown. MA THE COMMONWEALTH OF MASSACHUSETTS i TOWN OR CITY OF (?AP/Ianc?a?vci? Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Nammfd 5:17.601? 1/ Pit} 5310i? FangServl?em ET?goutlne 0 Address 5?5" #135?? E51, szgailgeniial Kitchen Telephone Mobile Date: Owner 1/ ,0 #75? (Via/?ll: 74 172/ HACCP YIN $222332?, giggling; person in Charge (plc, Mt Pill/Q. 336/; 3r Bed Breakfast El Complaint Inapector Permit No. Other checked requires an explanation on the narrative pageis) and a citation of 352:1: vii?i?ati I Rel Fo db [line 5 Intorve tio nd Risk Fac are (Red Items) Anti-choking sweeter-E: Violations merited may pose an Imminent health hazard and require Immediate corrective ?but? 590-009 in action as determined by the Board of Health. seems El FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1] 1. Pic 13' Handwash Facilities EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC mztifmi?: Add'i' 3. Personnel with infections RestrictedlExcluded CI 15: ?zcoghemicalj a FOOD FROM APPROVED sounce 4. Food and Waterfront Approvad Source TIMEHEMPERATURE CONTROLS (Potentially Hazardous Foods] 5. I D15. Cooking Temperatures [j 6. TagisecordsiAccuracy oilngredientSiatements 17- Reheating 7. Conformance with Approved Proceduresli-lACCP Plans 0? FROM 1319- ?Di and COM Holding 7 35% [7?0 8. 20' Time As a Public Health Control El 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PaPtiumous (HEP) El 21. Food and Food Preparation for HSP El 10. ProperAdequate Handwashing CONSUMER 11? Good Hygienlc Practices CI 22. Posting of Consumer Advisories '3 ?d Pmt'cma'? Number oiViolated Provisions Related Items] Critical to) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as dotennlnod by the Board and Risk Factors (Red Items 1.22); of Health. Non-critical (N) violations must be corrected 1 I i immediately or within 90 days as determined by the Board a? on an nspection today. the Items checked indicate violations of 105 CMR 590.??liiFederal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an 23' gligjigzz'gzz) order of the Board of Health. Failure to correct violations cited In this report may result in suspension or revocation of 25? Equipment and Utensils the food establls hment permit and cessation of food 25' Water, Plumbing and Waste establishment operations. It aggrieved by this order, you 27- Physical Facility lFC-Bli590-007i have a right to a hearing. Your request must be In writing 28. Poisonous or Toxic Materials (Fe-711590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. IanL?ciorts Signature: . [c2 (34/ Print: ?7 Ax ?13? ;e SignatumkM Print: U11 I LL [kl-aim Pnge..Loi_LPagcs FORM AM. SULKIN CO. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Mamet-'W" $71.7: Qf?fef? Date: (2/7744? Page: of 2- ltem Code ?9m DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No- Reference R-Red Item PLEASE From CLEARLY Veri?ed r277 744/ 53/50 re fags Arm/e 57 (1352-7724567? foo/7? a?rrgz??r?a r: fa?ra- 71m? ?ruxz-? 171957? pry/x 9/4. a? x47: WM ?y?n?y 754, g; ?aw/l fc/gn 447/ x: 7477? H. 7 5' 764:; PIC 29 ?fe-'17? ?7752:6767?, I ?/ro qu/ 7% ermcmiw?rr 5 Mfr? /Jx?er/' x7 5.1/76 741*: ?Err! 7356/ (067$? #57" J4: fir/W?q?? :53; a? ?7er zaua: 74/ - 5-17? 4 ?l?p/C 47/? ($77 7779?471/37? ff?zf Corrective Action Required: No Discussion With Person in Charge: CI Voluntary Compliance Q/Re?inspection Scheduled El Embargo Volunlary Disposal Exclusion Olher. Employee Resirfc?on 1' Emergency Sospension Emergency Closure Form ?34 8 AM. Sulkin Chadastown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date of oration at Ins i 52.4.29/ lg Food Service Di iRoutine Address I Risk' Retail Re-inspection ?47] Level Residential Kitchen Previous Inspection Telephone Mobile Elle: . Temporary Pro-operation Owner 75 an) aha/mfg, I'd HACCP WM Ci Caterer Suspect illness Person in Char a PIC - Time Bed&Breakiast General Complaint 9 Ema? El HACCP inspector Wing ?743.1647?? Out: 4,7535" Permit No. [3 Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provision(s} violated. Non-compliance with: Viol ?ons lated to Foodhorne Illness Interven ions an Risk Factors (Red items) Anti-Choking I: Violations marked may pose an Imminent health hazard and require immediate corrective 590-009iFi action as determined by the Board of Health. A'le'ge" 590-009?! 8 FOOD PROTECTION MANAGEMENT El 12. Prevention of Contamination from Hands El 1. PIC Duties D13. Han dw ash Facilities eic? EMPLOYEE HEALTH PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives C115. Toxic Chemicals 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with infections RestrictediExcluded FOOD FROM APPROVED SOURCE 4_ Food and Water from Approved Source TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) CI 5. ReceivingICondition 15- Cooking Temperatures El 6. TagsiRecordsiAccuracy of Ingredient Statements 17- Reheating CI 7. Conformance with Approved ProcedureslHACCP Plans 18- PROTECTION FROM CONTAMINATION El 19. Hot and Cold Holding jg! 15:7 a .929? ?7 8. 20- Time A5 a PUbiic Health Control 9. Food Contact Surfaces Cleaning and Sanitizing .300 [90/0 10. ProperAdequate Handwashing . . CONSUMER 11' 60"" Hygienic Practices El 22. Posting of Consumer Advisories Violations Reiatgd to Gogd Retail Practices (Blue Number of Violated Provisions Related items) Critical (C) violations marked must be corrected To Foodborne illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1.22); of Health. Non-critical (N) violations must be corrected Order for Correction: Based on an ins ection immediately or within 90 days as determined by the Board today. the items checked indicate violations of 105 CMR . 590.000iFederal Food Code. This report. when signed below by a Board of Health member or its agent constitutes an 23' Management and Personnel order of the Board of Health. Failure to correct violations 24. Food and Food Protection (Fe-anemone cited in this report may result in suspension or revocation of 25' Equipment 39? Utensils the food establishment permit and cessation of food 25- Water, Plumbing and Waste establishment operations. it aggrieved by this order, you 27- Physical Facility lFC-Gil590-007i have a right to a hearing. Your request must be in Writing 28. Poisonous or Toxic Materials and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF FEE-INSPECTION: 7 inspector's print: [mi-51?3?? l?lC?s [Um 1 {(qu lir- Print: ?luv. nu I?Ilttill?ul'll?nitcs FORM 734A A SULKIN ?1 1? THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: ghm! Date: 57371.? Page: 2. of Item Code - Critical Item DESCRIPTION OF PLAN OF CORRECTION Date No. Reference - Red Item PLEASE PRINT CLEARLY Veri?ed 57500? ?5&6 0 {Mg/rm ?yr f?/I a an 7" on/ Asap/1.5mm (69 776 73.291; Mar-L57" {are m" 35? Am 4/4: Xi/a 7? 3594? 5:114 ##Jeprqw?v?m #g?gi Agni mgr/5 49A: I my 1.7275?? 59.15. Mn; Sr?argrfa cur/4 v, I ?44901 prize-?x; 7pf??t?'df? J10 7:1" {4:45 {312. Sz??r?ee 5k Ike")? 77" {$49915 {Lia/5 e982"; gt! ,r Discussion With Person in Charge: I Requ?md: "0 ?5 Yes Voluntary Compliance El Employee Restriction I Exclusion Re?inspection Scheduled 0 Emergency Suspension El Embargo El Emergency Closure Voluntary Disposal Other: Form 734 AM. Sulkin 00., Chaleslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name . . . Dat tO oration St/700/ Food Service oullne Address Risk Retail Re-Inspection 345M girl-fl dfdt'rt? Level Residential Kitchen Previous Inspection Telephone Mobile lgains: Temporary Pro-operation Owner 0/ 4 79 HACCP YIN a Caterer Person in Char Pic .. Time Bed 8? Breakfast General Complaint 9 I I n. (Du-(q HACCP Inspector Maw. j; (gr/jg; Dug: Permit No. Other Each violation checked" requires an explanation on the narrative page(s) and a citation of Specific provision(s) violated. Non-compliance with: Violations Related to Foggborne Illness Interventions and Eisk Factors (Red items) Anti-Choking contrasts) Violations marked may pose an Imminent health hazard and require Immediate corrective Tobin? 590-009iF) action as determined by the Board of Health. 590.009 FOOD Paorscnou MANAGEMENT El 12. Prevention of Contamination from Hands El 1. PIC AssignedfKnowledgeableIDutIes C113. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS D14. Approved Food or Color Additives D15. Toxic Chemicals 2. Reporting of Diseases by Food Employee and Pic 3. Personnel with Infections RestrictedIEonude-d FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) El 5. ReceivingIConditlon [315* Temperatures El 6. TagsIRecordslAccuracy of ingredient Statements 1317' Reheating El 7. Conformance with Approved ProceduresfHACCP Plans 18' Cooling 535 PROTECTION FROM CONTAMINATION H?t and 365?? ?5?5 8. El 20- ?lime A5 a 30""0' REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 9. Food Contact Surfaces Cleaning and Sanitizing Cl 21 Food and Food Preparation for HSP Cl 10. ProperAdequate Handwashing . CONSUMER ADVISORY 11' Good HygienIc Practices El 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical (C) violations marked must be OOl'l'BCth To FOOdbOl?l?lB Illnesses nterven?ons immediately or within 10 days as determined by the Board and Risk Factors (Red Home 1.22); of Health. Non-critical (N) violations must be corrected O?'ici 0 cleri tion: ad I cti Immediately or within 90 days as determined by the Board as on an ?Spa on today. the items checked Indicate violations of 105 CMR 590.00IJIFederal 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. It aggrieved by this order, you 23. Management and Personnel 24. Food and Food Protection (Fc-ausstmon 25. Equipment and Utensils 26. Water. Plumbing and Waste (so-summons) 27- Physical (FC-5lf590-007i have a right to a hearing. Your request must be In writing 28. Poisonous or Toxic Materials and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: Inspector's Signature: [77cm If: Print: #4 fig; 1r:- PlC's Signature: fit/M 7 W1 f? Print:? ,0 (LR Pagciole?ngcs . 1 FORM 734A AM SULKIN CO .MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY or: a?e/ms?r/ Establishment Name: x4575 gc/x??z Date: Page: 2. of 1 item cw? Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item PLEASE PRINT CLEARLY Verified ?of ?rst! 71mm; 0/4 ?g farm; (91? [Mr/51k 7?641/ gin/?? s?r?/xn yd?t??ix (14/ 4/2; dry {xiv/4? 06 5/4 x210 Eff/7 (72/ 09/ny 1?5 #c?rige/K/ lax/(cg ?The rav?iaerm??w/ EVE/?cmc? e7?7?45 5692?? 7/55 ?rm/222; neat/f MHZ 1514:5ef47?1m3nme 154w 71/1? 5%prcz/p: Lu/ Met-1e more? 52/17? 743x 5mm: ge? sarz?irm, Me 6/120 ?64? 7?0 Ad/ 57/) ex? 9/ Me. Amman ?fz'y?mm Mr" 242m 44!; Art?CJ?l?l? and I Discussion With Person in Charge: ?/an I do?? [1/265 130' 71.. 1?7 Corrective Action Required[15:11 chom I Y?c?f ??lm?s [1147/1 El Voluntary Compliance El $5309: Restriction I 070,5 Juli-15:6 miri' lei? 543? A El Rte-Inspection Scheduled El Emergency Suspension El Embargo El Emergency Closure :1 Voluntary Disposal El Other. Form 734 AM. Sulkln 60., Charleslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF c?e?ne/Em/ Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date T?ge oi Operation(s] ollns action 611 i? AWE (/74 :1 ?6 S?s-Acui/ lit/1f 5? Food Service gi?oulme Address Risk Retail lie-inspection ?14 I an" (.47) 2e 5/ Level Residential Kitchen Previous Inspection Telephone Mobile Data: Temporary Pro-operation Owner i HACCP YIN Caterer Su5pect Illness Person in Charge (plc) Time Bed 8? Breakfast General Complaint HACCP Inspector [774:9?74 Out: Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Violations R?i?i?d to Foodborne Illness interventions and Risk (Red Items) Violations marked may pose an imminent health hazard and require Immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT El 1. PIC Assigned I Knowledgeable I Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with infections RestrictediExcluded FOOD FROM APPROVED SOURCE E) 4. Food and Water from Approved Source El 5. RecalvingiConditlcn 6. TagsiRecordsIAccuracy of Ingredient Statements El 7. Conformance with Approved ProceduresIHACCP Plans FROM CONTAMINATION El 8. 9. Food Contact Surfaces Cleaning and Sanitizing zoo ?an) Cl 10. Proper Adequate Handwashing 11. Good Hygienic Practices WW (Blue items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board of Health. 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils (FC-4H590.005) 26. Water. Plumbing and Waste (Fc-silseoaos) 27. Physical Facility (menswear) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Tobacco 590.009 (F) Allergen Awareness 590.009ia) Non: compliance with: (312. Prevention of Contamination from Hands (3 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) CI 16. Cooking Temperatures D17. Rehaating ?fb Elia. Cooling 52? U19. Hotand Cold Holding Eff .20 32?s 370 CI 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) CI 21. Food and Food Preparation for HSP CONSUMER ADVISORY 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red items 1-22): Official Order for Correction: Based on an inspection today, the Items checked Indicate violations of 105 CMR 590.00iJiFederaI 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 oi the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF RE-INSPECTIDN: inspector' li Signature: Writ/(1i; Lid/ Iii-int: IM/irk Md ?Cu, Siglliilulcfb \Ei? [h QQA ILUII l?iichqui'ligcs FORM 734A A. SULKIN CO I?rinl: Lilmim QAHM 590.009 (E) THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF Charm/5rd Establishment Name: (As/m?rd 5?1/1? 47/ Date: Page: 2. of Item Code -6rltical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date NO. Reference R-Red Item PLEASE mm. CLEARLY Verified My} ?oc/ on: (6/4 i?u/ ?nyfz'? 67/4? 5781366 and {5741.13 540,1; rpm/l S??m 0? 213:; 1/ arm ak' o?gu? 7?2) #0746 My 5?51: 5/ 477 :1 127/5 #28 an a" /c1"e'r2? (ff-i rm jarz??c seam/{J LA arm a r. /3 Con: 7521?!? Inndice-cf C??lf-l?lur a: AV ?rm-Ir af?dfftif? cussion With Person in Char e: Correctlve Action Required: 0 No I Yes 15 5th? 73/36 - . El Volunlary Compliance El Employee Restriction! Amara/(5 7?71 c' ff; 75/47!" 0/ m/ 1/ Exclusion I Re-inspeclion Scheduled El Emergency Suspension 0 Embargo El Emergency Closure El Voluntary Disposal El Other: Form 734 AM. Sulkln 00.. Charleslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF (J/la/pts/?i?/ Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date Type)! Operationisj of ins ecti did/1'25 {gt/oi #19514 12.09%! ood Service Eli?ouline Address - . . Risk Retail Re-inspeciion 965 ah ?r (if/JG ?7 Ed Level Residential Kitchen Previous inspection Teiephone Mobile Site: Temporary Pris-operation Owner kg?) gal/I. {41/15 by; gqu/ HACCP YIN Caterer El Suspect illness Bed 8. Breakfast General Complaint Person In Charge IQYM Em}; 5:20 HACCP Inspector 1144 g? 43/329513.) ft? 0 Out: Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provision(s) violated. Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items} Violations marked may pose an imminent health hazard and require Immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned! Knowledgeable! Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RestrictediExcluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. ReceivingiCondition 6. Tags/RecordsIAccuracy of Ingredient Statements 7. Conformance with Approved Proceduresll-iACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 05' a El 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 0 23. Managementand Personnel 24. Food and Food Protection 25. Equipment and Utensils (Po-411590.005) 26. Water, Plumbing and Waste 27. Physical Facility irc-auseocor) 28. Poisonous or Toxic Materials 29. Special Requirements (590.0091 30. Other Non-compliance with: Anti-Choking 590.00915} I: Tobacco 590.009 (F) Allergen Awareness 590.009 (G) 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures El 17. Reheatlng El 18. Cooling W0 As? 35? 3 El 19. Hot and Cold Holding (90 ?90 f5- El 20. Time As a Public Health Control - CONSUMER ADVISORY El 22. Posting of Consumer Advisories REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Food Preparation for HSP Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): Official Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.000!Federal 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. lf aggrieved by this order, you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF Signature: 0.1% . Print: [774.04, [7235/6/45 HC 5 higlillitlrc: . 11,} or THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Che/?15 19/0/ Establishment Name: {ql?a/1n57gkr/ 545.5 5: Ear?!) Date: Page: 21f 1 Item Code - Critical "Gm DESCRIPTION OF VIOLATION I PLAN OF CORRECTION 9319 No. Reference R-Rodllom PLEASEPRINTCLEARLY Verlflod mo 79' We #al- 14}sz Jews one card re?voe?'j?a' #nr/ +3 mp5 4/4 (24% 1771/0516 :3 (34K :5 gr new ram! ngmf?s A??fxfii 31.53511 nix/?3. jammf 9K (Or/c 63?. ?59 25? Ada/C- 914. Jam'l/ n?y??hi?j 79/1 w? Jest/rt?: are qeprw?k?? S?s-mic: Discussion With Person In Charge: Corrective Action Required: El No Yes Me if?? 7?7 a my 727664 5? El Voluntary Compliance El Employee Restriction! .45er "73? 217:: f6 mama-tr? 4/541 ?miD/erir? Exclusion Re?inspeclion Scheduled Emergen Su ension A: Get ?7746? qifz?tp? fraud (?c513 .4: J?d?yccri?a/ Cy Sp El Embargo El Emergency Closure m7?" 773/6 5% jzif?: r/{rcxt Voluntary Disposal Other. Form 1'34 8 AM. Sulkin Co., Cha?ulawn. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date ion ?gs El Food. Service Di gamma Address - . sir Relal Re~lnspection 69570 189/? ?/5647 for, Level Residential Kitchen Previous Inspection Telephone Mobile Dale: Tamporary Pro-Operation own" 711/4 J/rc?? HACCP w" gaff; USU-metres? I [c 11 a rear as enera ompan Pmm'" cram", L??ll ml ,Yijunar Inga-W El HACCP Inspector 724.57: [77633; 0 Out: Alt?? Permit No. DOther Each violation checked requires an explanation on the narrative violated. Viol lions I ted to Foodborn Illness Risk Factors (Red items) Violations marked may pose an imminent health hazard and require immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. FIG Assigned lKnowledgeable Duties EMPLOYEE HEALTH Cl 2. Reporting of Diseases by Food Employee and [3 3. Personnel with infections RestrictedlExcluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source El 5. ReceivingiCondition El 5. TagisecordslAccuracy El 7. Conformance with Approved ProcedureslHACCP Plans PROTECTTON FROM CONTAMINATION El 8. El 9. Food Contact Surfaces Cleaning and Sanitizing CI 10. Proper Adequate 11. Good Hygienic Practices Violations Related to good Retail Practices (Blue items) Critical (0) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as detennlned by the Board 23. Management and Personnel ti-ziiseoaosi 24. Food and Food Protection 25. Equipment and Utensils (commences) 25. Water, Plumbing and Waste (PO-sirens?) 27. Physical Facility Irceiiseomri 25. Poisonous or Toxic Materials (Fe-711590.003] 29. Special Requirements (590.009) 30. Other pageis) and a citation of specific provision(s) Non-compliance with: Anti-Choitlng 590.000 Tobacco 59030913 Allergen Awareness 590.009 (O) 12. Prevention of Contamination from Hands [3 13. Handwash Facilities PROTECTION FROM CHEMICALS CI 14. Approved Food or Color Additives El 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) El 16. Cooking Temperatures U17. Reheating U18. Cooling E119. Hotand Cold Holding 3 a 5" 37 El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSOEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne illnesses Interventions and Risk Factors (Red items 1-22): Of?cial Order for Correction: Based on an Inspection today, the items checked indicate violations of 105 CMR 590.000lFaderai Food Code. This report, when signed below by a Board at 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 oi the food establishment permit and cessation of food establishment operations. If aggrieved by this order. you have a right to a hearing. Your request mUst be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE or neiuseecnou: (?37/7 $227k West?s/lb inspector?s Signature: 04 A7 NW PlC's Signature: ?954.? rh I II lune-In up a meZ??lirz THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF ?lling/274" Establishment Name: 677/5 Date: Page: of L- ltem Code Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Reel Item PLEASE CLEARLY Val-med 4.4 f0 Md, 442: aye/?, cam/7f zf/mr ma; ?7 /?f6}5 A, k/ 17/ 74: 4:79 i 16/007? [4/30 7546 50 4 79365 r/luf cpl/g inc/HIT" I - Ehuf? l/dcw/J ?e 4:727 179 and! 764M 5/7779 M776. Ara-dz: dud 7556 (79:75 795.7 mtg-477190777377 Mrs-727 2?11; (.2 7427? Zane/4.5 575' ?f/C /e 79:17 742621! (lg/km {more 7/7 7477? x4776: (gaff/7?? I 5222/ 4791775. 0475277 47 7/777; Asa/W {dz?57?? 7.223 $571.5; (/70 7944. fr5?57rx" 7/ 12.6. 247/990 u/o?r/ 767/23 777.: 95-737? [7/57/75 and Team}. 205466 43:1! 4917/ ng?zz?: 44c" [1772/2 497/3 5/ ?fe ram/27,7 ?ne 757.0: @4772?th 7w; 707% 2/291? ?7,177? 28? Ed 105? d'xMJ?/ 77?: {5,5737% 19/405307! 73 .0115 7" fr?a??ccd if erJV?d?/ prep $1712 (Se/z 7/64 577/7? 7/ 7,61: 27/7- 2725? ?51777} Say-.727 Discussion With Person in Charge: Corrective Action Required: No lat/Yes El Voluntary Compliance Employee Restriction! Exclusion D/Re-inspection Scheduled El Emergency Suspension El Embargo El Emergency Closure El Voluntary Disposal Other. Form 734 AM. Sulkin 00.. Chenestown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF WW ?44. Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name - . Data . Ogeratlonisi fins ction 7t! fix/m: r} 7639 67 rat/.3 7' Food Service Ul?gouline Address Risk Retail Fla-inspection Level Residential Kitchen Previous Inspection Ci Mobile . Date: Temporary [3 Pro-operation owner/W?m2m {:19 3? 0/677 i] Caterer Deuspect Illness Person In Charge (pl?f . . Time El Bed Breakfast General Complaint 6mg Sauna/em In; mil/5 Inspector ?49/234 [17757)in Out: Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provision(s) violated. Non-compliance with: Viola i ns Related to Food orne Illness Interven ions and Risk Factors (Red Items) Anti-choking 590.0095] Violations marked may pose an imminent health hazard and require immediate corrective Tobaccu 590-009lFi action as determined by the Board of Health. Nielsen Maren!? 59?11'39?? 1: FOOD PROTECTION MANAGEMENT 1. PIC .iissignedIi Knowledgeable i Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RestrictedIExcluded FOOD FROM SOURCE El 4. Food and Water from Approved Source [1 5. ReceivingICondition 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) El 16. Cooking Temperatures El 6. TagisecordsIAccuracy of Ingredient Statements El 7. Conformance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION El 8. El 9. Food Contact Surfaces Cleaning and Sanitizing Ci 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items} Critical [Ci violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel 24. Food and Food Protection (Fe-anseoow 25. Equipment and Utensils iFC-4ii590.005) 26. Water, Plumbing and Waste iFC-Sii590.006) 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other 17. Reheating El 18. Cooling 19. Hot and Cold Holding 3&3 .. 7?3 20. Time As a Public Health Control CONSUMER ADVISORY 22. Posting of Consumer Advisories REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red items 1-22): Official Order for Correction: Based on an inspection today, the items checked Indicate violations of 105 CMR 590.000iFederal 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. It aggrieved by this order. you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF RE-INSPECTIDN: Inspector?s Signature: .25 Pm": IllC?sSignIIiurc: 9.11; "rm" (31ml Sande l'il?cLHf?L Page}: FORM 734A AM SULKIN CO CHARLESTOWN MA Establishment Name: THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF 477,035, for? I 011 Date: {0/37/1 Page: ?Z/of Date Item Code C-crilicalltem DESCRIPTION OFVIOLATIONIPLAN OF CORRECTION Reference PLEASE PRINT CLEARLY Veri?ed 72 24' 2141/ /r4//4/r7 can/er? ?mr 91 (i Lymv?u 7645' Al?s/Jam {Mar am? we? 4/ 6 ?ag E?e 15? s?r??t/o?m 2?5 4,74%. sin/rm ?hq? m9? 7/76 5/56/2244? #11751? MW: 7/74 (y/ghpqaj/vrr wad 795g 3mm: ?925/r5- rtwqu?I-q 7046 74/16 zdzg?il? fer/7r, [ml/2571' #47316fo i?r?fr??m {2:514 c/c?S? 7?10 7?5 F??f?r 747/- if}? rqu/ Erl?f??f?tf' 4/144 Discussion With Person in Charge: gel/10011?? 4 4/195 [65? f; Corrective Action Required: El No a Yes 4mg? 71/74:" 74"; Veg/'4 1?62? ?dd/L 07? 7?Aa vallfmary (fompmme SEES: Resumm, 59" 1119/2! 71 El Re-Inspecllon Scheduled El Emergency Suspension El Embargo El Emergency Closure 0 Voluntary Disposal Other: Form 734 3 AM. Sulkin 00.. Charlestown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name . Date Wei 1' tin action 1?73 Food Service ?outine Address I - Risk Retail Re?Inspection 7?7 Edit, Level Residential Kitchen Previous Inspection Telephone Mobile Erie: Temporary Pro-operation '73er rot/ms?m "Amp game; kf Elguspeciglnessii Pe on in Char 'Plc . Time a rea as enera ompant '3 9" 637?; [m rte/'32! HACCP Irrepector ?(pf/4 ?71:912.: 29%? Out: Permit No. EIOlher Each violation checked requires an explanation on the narrative violated. Violations Related to Foodborge lness Interventions and Risk Fagtors (Red items} Violations marked may pose an imminent health hazard and require immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT El 1. PIC Assigned i Knowledgeable i Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and FIG 3. Personnel with Infections RestrictediExciuded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source El 5. El 6. TagisecordsiAccuracy oi Ingredient Statements El 7. Conformance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION El 8. 9. Food Contact Surfaces Cleaning and Sanitizing El 10. PreperAdequate Handwashing Cl 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue items) Critical (0) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as delennined by the Board 23. Manaement and Personnel (Fc-znseccoa) 24. Food and Food Protection 25. Equipment and Utensils (FC-4li590.005) 26. Water. Plumbing and Waste iFC-Sii590.008) 27. Physical Facility (Fe-enseocor) 28. Poisonous or Toxic Materials (Fc-rirseocoe) 29. Special Requirements (590.009) 30. Other pageis) and a citation of specific provision(s) Nan-compliance with: Anti-Choking 590.000 (E) Tobacco 590.0 09 (F) Allergen AWaraness 590.009 (I) 12. Prevention of Contamination from Hands El 13. Handwash Facilities anorecnon FROM OHEMIOALs E114. Approved Food or Color Additives E15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) Cl 16. Cooking Temperatures 17. Reheating D18. Cooling 19. Hot and Cold Holding 0 0 .24 i 37' Cl 20. Time As a Public Health Control REQUIREMENTS FOR susc EPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories Number of Vlolated Provisions Related To Foodborne illnesses interventions and Risk Factors (Red items 1-22): Official Order for Correction: Based on an Inspection today, the Items checked indicate violations of 105 CMR 590.000iFederal 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 aggrieved by this order. you have a right to a hearing. Your request must be in writln and submitted to the Board of Health at the above ad ress within 10 days of receipt of this order. DATE OF Mitzi/11% ?in" mm ?fax/19 1/0 PiC?s Print: (57/761 (Sr'il' idle?; PageLoLLi?ugea FORM 73M AM. CO. CHARLESTOWN. MA THE COMMONWEALTH OF TOWN OR CITY OF ASSACHUSETTS Establishment Page: 2. of Item Code Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference R-Red Item Verlfled a7? QTIM eizr??rn 74/98!" I - I I {fir/f get/1" af/ 799': ram 4434? ?/adr- @5 I LL- ZZa?f}? @377ch ff: {Hf-Ell: drg?nzg of? ado/?; [744/ I M5 474:. keg my 7454:" we f7) :h?a 775w: F21: Algae. dram-4515 9/15; cf; ?ue. 79:34 idf'mzc fawn xix// I Die/(Me ?ap/>7 45/976 1214* ?re-?Mr! c? mam-H? {reef 749/ m/ze- (13,4250 7%?rfg?? Mn? Jake r/W/Va @231:- zrgezc. gang 766:2? 7% 7440/ x3? 45% 04rd Hafiz-?4? q?oM/Ap m0 of/ 26/50/775 Jenni dye/f 11$er ?1 I Gigi/?3? .- 1 r9 Corrective Action Required: No EV Yes Discussion With Person in Charge: I 7Lq/?c?/ 0N4) +61 biqum? geld m:z? dw?hbes? 01%? e190 meaw Compliance Fla-inspection Scheduled 7%7/4' 7476 Drew?? new" [meg cae?vie c/eea?rf 4ea7f/- c/ Embargo El Voluntary Disposal Employee Resl?clion Exclusion Emergency Suspension Emergency Closure Other: Form 734 AM. Sulkin Co., Charlaslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY or: Grid/ms $.cm Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Dat T?g?f Operationlsi ofln action 42/7457? 1' dig/?3' El Food Service Ia?P?oulin-e Address Risk Retail Re-inspeclion 76? .?J/ff?n 3/ Level Residential Kitchen Previous Inspectlon Telephone Mobile Data: Temporary Pro-operation Owner dyer/n CA4 HACCP YIN a Caterer Illness pal-son in Char A Time Bed 3. Breakfast General Complaint 9 {?n/taper 53% ,m miss/r El HACCP Inspector Marv/95" Out: Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of Specific provision(s) violated. Non-compliance with: Viola ns Related to Foodbor Illness Interventions and Risk Factors (Red Items) Violations marked may pose an imminent health hazard and require Immediate correCtlve action as determined by the Board of Health. Allergen Awareness seo.ooe(e) I: Fe PROTECTION MANAGEMENT 12. Prevention oi Contamination from Hands 1. PIC Assigned i Knowledgeable i Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and FIG 3. Personnel with Infections RestrictedlExcluded FOOD FROM APPROVED SOURCE El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives C115. Toxic Chemicals 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) 5. ReceivingiCondition Cl 16- Cooking Temperatures 5- TaQSIRecordslAccuracy of Ingredient Statements El 17- Reheating 18. Cooling 30:53:23: ProceduresiHACCP Plans 519. Hot and Cold Holding 7@ 3.60 3769 ?0 El 3. El 20. Time As a Public Health Control (3 9, Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) Cl 21. Food and Food Preparation for HSP 10. Proper Adequate Handwashing . CONSUMER ADVISORY 11' 60? Hygienic Practices 22. Posting of Consumer Advisories Violations Reiated Em (Blue Number Of Violated Provisions Related Items) Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions 2 immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1.22); of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board He Official Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.000lFederal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an 32' $2333.33: order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of 25? Equipment and Utensds (Fc'4?l590'005? the food establishment permit and cessation of food 26- Water, Plumbing and Waste establishment operations. If aggrieved by this Order. you 27- Physical Facility ti-Bll590-007l have a right to a hearing. Your request must be in Writing 28. POISOHOUS TOXIC Materials lFC-7ll590.008l and submitted to the Board of Health at the above ad rose 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: 5y Inspector's Siginrturcj??I/q ?ll/K I?rinthlgnuiury?M?mfi 9 I at; 1? f4} FORM 734A A THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF d??a?ys?r/ Establishment Name: K771777777 $7 22/11/677 ($77.71? Date: ng/fg' page: of ?Gm C0119 ?3 Critical DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Dal? No. Reference RoRadlthI PLEASE PRINT Verified ?57 It" 77777:: 7 7?am7? 7 7775 77?7?" #7777 7/7? 574774 pig/M 734.; 77797477 ?777 7.7.1.: X7 .7 AW: 797 drab/75?, 7/ 7/47 77/7774? 77:77 57?5" 7 C. 776% 774??:6 7?7/77r71m7?e?f 7 7'75 275%?? 77/757747? Hm?rd/ sz7n?7?7f?f .7777 7%?77/ a ?75/ 7?77?? 743: 7/7 7171/ 753/70 a? 7951: #957/M77/m77?} 1" ?7799 73.13:: r/I/ 77777" Am?? knaruVr?t/G? 7/79 (:74 fit/5 5/7 Svaa? g/ 11705 /7f/.4 77" 797 4777/ 7?2?7777- 7777/ 7?9077? 9774/37: 7777:: 7:7 707$ 77:7 777/772 7:77 A777: MW (/7777 . 77572. car/77:77:77 7/ 7774777 77757? ?su 7117/7770? 7174 7?22 72% 7777? 777: .7714 1?77 ?7 (fa/72.077771771- 54/7756 7132777 f/J?f? SIawfgk? sz? 2? 5377777 7?2 7777?; 7 7/77 X7 71:77? 7?7 ?92? 4727/ 7477777777777? 7?77 (?277/7f 7777: 4/77/7475] 777?7777 7/ 7477/71? //?I7757?774??f?77? 7?7/7 (73472:! 17747770117757 12477.2 70/777757 v?fl?dL/?/Eff/JM 7J2 fir/?7572777 94.7 f7?w/y 7.2 {7 7 7" 7/ Discussion With Person in Charge: Corrective Action Required: No Ia" Yes El Voluntary Compliance 0 Employee Restriction I Exclusion Scheduled El Emergency Suspension El Embargo 0 Emergency Closure El Voluntary Disposal El Other: Form 734 A M. Sulkin Co_. Charlestown, MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF dAa/maig?/ Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Nam - Date of oration fine action 57.0% 9 :ll?iLFood Service I?goutine Address - Risk Retail Re-Inspeolion 553/ Level Residential Kitchen Previous Inspection Telephone Mobile Date: - . Temporary Pre-operation Owner/d1 ,y I 75%, J6 4oa/ HACCP YIN [j Caterer Suspect Illness Person In Charge Time Cl Bed Breakfast 3:23 Complalm . In: Inspector Wf/k @5712? ,1/0 Cute/2W: Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provisionts) violated. Violatigns Related to Foodborne Illness Interventions and Risk Factors (Red items) Violations marked may pose an imminent health hazard and require immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT El 1. PIC Assigned I Knowledgeable I Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections RestrictedIEchuded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. ReceivingIConclitIon 6. TagsIRecordslAccuracy of Ingredient Statements El 7. Conformance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing Cl 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items) Critical (Ci violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Managementand Personnel (Foalissomai 24. Food and Food Protection 25. Equipment and Utensils (FC-4N590.005) 26. Water, Plumbing and Waste (PC-sirseunuai 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Non-compliance with: Anti-Choking 590.0095) I: Tobacco 590.009 (F) Allergen Awareness 59030903) I: 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives El 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods} 16. Cooking Temperatures U17. Reheating 18. Cooling [119. Hot and Cold Holding 33-0 10" 20. Time As a Public Health Control CONSUMER ADVISORY 22. Posting of Consumer Advisories REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): Of?cial Order for Correction: Based on an inspection today. the items checked indicate violations of 105 CMR 590.000I?Federai 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 aggrieved by this order, you have a right to a hearing. Your request must be In writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE inspector?s i Ii (5/64 7?4 l'ugciui?il'nges FORM A ("Pr (?l-that THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF die/??z?r/ Establishment Name: Date: Page: 2- llem Code 0-C?ucalmm DESCRIPTION OF VIOLATIONIPLAN OF CORRECTION Data No. Reference R-Rad Item Verified (7/37 15% 7404/ 7/1. a/o? 74% m: Aonr/ M17516 r/?vfmn p/r. fir?? 5/514 x; 75 04:: re; 4&7; 11/3 3" Tag?? of 495; 7% at. p/Mjr??i/We? 0" avg/rm?? Moe-swag a? ?op w: (rye/rd {22? x9310} 94:16-53 an! ?775i arr/V/ ?aw/c? err j?x/ na7? :27 (Ez?f/ib?ci 757mg? 745w! 249/5" ?jmpf?rr 35F Srr/ 3 ?c adrmp??rs ?ffd? 7?0 A: #7 70/} foigb/?d??f 74.4w? ga??ja? 7463?. 5.147001? ngQSa/T Discussion With Person in Charge: Corrective Action Required: El No a Yes Voluntary Compliance Employee Restriction! Exclusion El RE-inspection Scheduled El Emergency Suspension El Embargo El Emergency Closure :3 Voluntary Disposal Other: Form 734 8 AM. Sulkin Co.. Charlestown, MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date a erstion fins ec ?1 "l fut/[05% {it and Service i?%ouline Address Risk Retail Rte-inspection ?2.11; wad?d?? 2% Level Residential Kitchen Previous inspection Telephone Mobile Data: Temporary Pro-operation Owner- 714/17 0/ (A HACCP VIN Caterer Suspect Illness person in Char a pic i Time Bed 8. Breakfast General Complaint 9 Jim 0 "1ng HACCP inspector 307/75! 12 Out: Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Belated to Foodborne Illness interventions and Risk Factors (Red Items) Anti-Choking 590.009 is) l: Violations marked may pose an imminent health hazard and require immediate corrective T053000 590-009lF} action as determined by the Board of Health. ?mg? ?mm? 590-009 i: FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1. PIC Assigned Knowledgeable Duties D13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicais EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and FIG 3. Personnel with Infections RestrictedlExcluded FOOD FROM APPROVED SOURCE CI 4_ Food and Water from Approved Source CONTROLS (Potentially Hazardous Foods) El 5. ReceivingiCondition U16. Cooking Temperatures El 6. TagisecordslAccuracy of ingredient Statements [317' Reheating 7. Conformance with Approved ProcedureslHACCP Plans El 13- . 0 PROTECTION FROM CONTAMINATION E119- ,0 8. 20 Time As a Public Health Control - - - REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSPI 9. Food Contact Surfaces Cleanan and El 21 Food and Food Preparation for HSP 10. Proper Adequate Handwashing CONSUMER ADVISORY El 11' G??d Hygienic Practices El 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical (Ci violations marked must be corrected To Foodborne illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1-22); of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board Of Heal Official Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.000lFederal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an 33? $332333: order of the Board of Health. Failure to correct violations cited in this report may result in su5pension or revocation of 25' Equipment 39d (Fc'4?i590'005? the food establishment permit and cessation of food 26' Water, Plumbmg and Waste (Fc'5ii590-003? establishment operations. If aggrieved by this order, you 27- Physical {Fe-Sli590-007l have a right to a hearing. Your request must be in writing 23- POISODOUS Ol' Materials iFC-7li590.008i and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30, Other DATE OF lnspoctor?sSignuturcL? 377 mg Print: l'lC?s Signature: /J?m HQKW l?riul: 1%0 FORM 734A AM SULKIN CO MA THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF Establishment Name: 7/6 a/ Date: i 0/53"? Page: 2? of 2- ltem Code Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item PLEASE PRINT Veri?ed 2 5' {2/110 '774 .4- /c7/A/ 1W (?M/ff 757663/ (if! 6?44! 4/9 6 ?fe/71?; f9 - FUN Eff 7?55 {50646.5 (7/14/ f?f Woof git/?1; xo/ga/y; 7756 6045,7494 9:77 Woe/907 ff/??p?d 57/ 7946 2467671 nr?f?f?7? (3qu (3:??0zwrr5' (vb/7? 67? 7%6 Mac}? roan? {meal/2% 15/12/27" gay-ram? gig/3% arm I 5051:?; 447/ an, MM x4227 4564': 1% (Agar/5 An??l 7%6 FM $6 an 45/ ?g?tfmm ~74: y/ca (AM {??7?033?fr?5 64/ MC {043/ 0/633?? 1/ Discussion With Person in Charge: Corrective Action Required: El No Yes El Voluntary Compliance L'l Employee Restriction I Exclusion Re-inspeclion Scheduled 0 Emergency Suspension 0 Embargo El Emergency Closure 0 Voluntary Disposal Other. Form 7'34 AM. Sulkin Co.. Charleslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date to oration i tlo /7/4 7?7 7959/3" g/yp?/ Food Service outine Address .4 . . Risk Retail Re-inspection CW 57/7 ,1 &5 Level 8 Residential Kitchen Previous Inspection Telephone Mobile Date: Temporary Pro-operation Owner 7-060 ?7 Che/1?? 51% f1], HACCP YIN a Caterer Suspect Illness - 11 Bed 8- Breakfast General Complaint Person In Charge (PIC) 7*?th 6,119,771.; :30 HACCP Inspector mag 1' )0 Out: Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Vioiations Related to Foodborne Illness and Risk Factogs (Red Items) Violations marked may pose an imminent health hazard and require immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned Knowledgeable! Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RestrictediExciuded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. CI 6. TagsiRecordslAccuracy of Ingredient Statements El 7. Conformance with Approved ProcedureslHACCP Plans PROTECTION FROM CONTAMINATION 8. [j 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good ?otaii Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water, Plumbing and Waste 27. Physical Facility (menswear) 28. Poisonous or Toxic Materials 29. SpecialRequirements (590.009) 30. Other Non-compliance with: Anticholang scanners) l: Tobacco 590.009 (F) AilergenAwarenose scanners) El 12. Prevention oi Contamination from Hands [113. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) Cl 16. Cooking Temperatures D17. Reheatlng El 18. Cooling 19. Hot and Cold Holding 4'0 6?30 370 20. Time As a Public Heaith Control CONSUMER ADVISORY I 22. Posting of Consumer Advisories REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (use) El 21. Food and Food Preparation for HSP Number of Violated Provisions Related To Foodborne illnesses interventions and Risk Factors (Red items 1-22): Of?cial Order for Correction: Based on an inspection today, the Items checked indicate violations of 105 CMR 590.000iFederal 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. It aggrieved by this order. you have a right to a hearing. Your request must be In writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF inspector's Signature: We? ?in? W7 as is PIC?sSignuturc: ?11424!ng Print: Pngc_Lot'_LPiigcs j/q? ?Sim/?t all? FORM 734A A M. SULKIN CO. CHARLESTOWN. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF 44 29/67] 2. Establishment Name: #4 fri?7?9/7 S?C?r/?Kz?g/ Date: [a page: Z, of Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item PLEASE Verlfled 7% xvi/J3 A 4 cJH'n I fag/F}; 34x? ?ar? ?nd? A?m?z/ 2'1ch 41:4 be roman/e J. amt" 11? if 31.; +1 1 J?f/ 07!? 7?1; aerk~ 2?609 Jul-mt?, few?? Ht?f?uj?'yl?r?f?? ?re-n x79 Cd'll?etf" it"ll' 01710 :Hrm?l? Sucrort'lrp/f If 1?17" ?tqpi/e?/ He gem-J 57?/ 77F 19:! fb/Mi?? (f enema} ?ow?f 7?2? Tr: ?rice 7?36 Irma 24-: abs" rwm. Discussion With Person in Charge: Corrective Action Required: No I: Yes CI Voluntary Compliance Employee Restriction I Exclusion Re-inspection Scheduled Emergency Su5pension 00000 El El Embargo 0 Voluntary Disposal Other: Emergency Closure Form 734 3 AM. Sulkin Co_. Cha?estawn. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name -. Date of erat?on it 5 action Sca?aer/ I 8' Elli Food Service Ell? Routine Address - Risk Retail Retinspeclion :8 CIA Gn?f?V?? 0 Level Residential Kitchen Previous inspection Telephone Mobile Date: . Temporary Pro-operation Owner .7369? 0/ /?15 7%an HACCP YIN Caterer Suspect Illness Person in Char -. . - Time Bed 8. Breakfast General Complaint 9 )rri?iiIS?l?Vk aha-1.6L Im/zJ/o HAOCP inspector Mai/7k M4 5 [calf/6;, Out: Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provisionis) violated. Non-compliance with: Violations Related to Foodborna Illness In 9 entlons Risk Factors (Red Items) Anti-Choking 590.0095) Violations marked may pose an imminent health hazard and require immediate corrective 70.36060 590-009lF) action as determined by the Board of Health. ?mam? 590909?) I: FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1. PIC Assigned KnowledgeabIeIDuties D13. Han dwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS U14. Approved Food or Color Additives 15. Toxic Chemicals 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RestrictedlExcluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) Ci 5. ReceivinglCondltion El 16. Cooking Temperatures El 6. Tags/RecordsiAccuracy of Ingredient Statements Reheating Cl 7. Conformance with Approved ProcedureslHACCP Plans 18' . 2) PROTECTION FROM CONTAMINATION E119- and Holding 7? 15b j? 8. 20- Time A5 a Public Health El 9_ Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing . CONSUMER ADVISORY El 11' 600d Hygienic Practlces 22. Posting of Consumer Advisories Viotations Related to Good Retail Practices (Blue Number Of Violated Provisions Related Items) Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red items 1.22); of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board . Official Order for Correction: Based on an Inspection today. the items checked indicate violations of 105 CMR 590.000!Federal 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 23. Management and Personnel 24. Food and Food Protection 25' Eqmpment and Utensils ?Fc'4u590'005? the food establishment permit and cessation of food 26* Water, Plumbing and Waste lFC'5?l590'005) establishment operations. If aggrieved by this order. you 27- Physical Facility iFC-Bli590m7} have a right to a hearing. Your request must be In writing 28. Poisonous or Toxic Materials and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. . 30, Other DATE OF RE-INSPECTION: a/M Signature: Print: ?7/flf/C. . l?lC?s Signature: [gird-5111' Print: 76? l. 1537?} 15+ FORM 734A AM. SULKIN CO CHARLESTOWN MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: go/7ff/ Date: Page: 1" of 1? Item Code 0-C?tlcalltem DESCRIPTION OF OF CORRECTION Date No. Reference R-Redltem Verified {Li/(l f? ?mf 04/ crg?h 1'5 ?37? ?94, (?xfa'?'7fr'EW- . 7A6 Mai/0" 5:40 7403/ {29/17/149/ 56/ ?xz?of f/cm 7 1-7? 164; //26 dxs/?r?wm r?/wdf' be 0427/ My ?Two :24 2?23; j- ?ed pm: Mt? 5 [Fast/1&7 7% a 6717/? Mm 74.x M: 74/? a 5/6 74" eff/?gs 7?2: fame/{J +155 ojfa/n, ?rm/51(73- x4295?" ??gp an? {be a/Wmm/I/M Mam 797/13 ?nd?f/ rziq?toms 53:9 dwrr/ nd?r? 24/5; ?J?VQ?E?eifx?fz ?z?g Max?s/m 6/ 6? 7/7- 2323 Discussion With Person in Charge: Correctlve Actlon Required: No Ei/ {as El Voluntary Compliance El Employee Restriction! Exclusion Scheduled l3 Emergency Suspension El Embargo El Emergency Closure El Volunlary Disposal Other. Form 734 8 AM. Sulkin Co.. Charleslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF ?k/Magra/ Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date to oration oflns action #410? h?o/ 5/21" 4" 9 i?i Food Service D?goutine Address . Risk Retail lie-inspection 2" 30 Ch Ea! Level Residential Kitchen Previous Inspection Telephone El Mobile Data: Temporary Pre-operation Owner Wit/0 0?70 HACCP YIN Caterer El Suspect Illness Person in Charge Car $m . ; 'Ime Bed 8- Breakfast 322%? Complaint :Il- Inspector quy 6/5! 70 Permit No. EIOther Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Violations Related to Foodborne "(ness Interventions and Risk Factors (Red items) Violations marked may pose an imminent health hazard and require immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT El 1. PIC Assigned i Knowledgeable i Duties EMPLOYEE HEALTH I3 2. Reporting of Diseases by Food Employee and PIC CI 3. Personnel with infections RestrictedlExciuded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. ReceivingICondition 6. TagsiRecordsiAccuracy of ingredient Statements Ci 7. Conformance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 26?94? El 10. ProperAdequate Handwashing Ci 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected Immediately or within 90 days as determined by the Board of Health. 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils (FC-4li590.005l 26. Water, Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Nan-compliance with: 590.000 (E) Tobacco Allergen Awareness 590.009 (0) 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods} 16. Cooking Temperatures -. a 17. Reheating 1318. Cooling Ci 19. Hot and Cold Holding u-?zo 355' 20. Tame As a Public Health Control CONSUMER ADVISORY El 22. Posting of ConsumerAdvisories REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Food Preparation for HSP Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): Official Order for Correction: Based on an Inspection today. the items Checked indicate violations of 105 CMR 590.000iFederal 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 aggrieved by this order. you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF inspector's Signature: ?714.jpg ?75.541114? Print: l?lC?s Signature: Qd arms Elmer-T I?IlchuLLI?ngcs FORM 734A AM WN MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: A?/flyifi?red incl/7 (29/ Date: c; Page: of Z. "am Code - cum? DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Rod Item PLEASE anr CLEARLY Verified 593,00? 6 74? ??e/ticn ?wrrm ('35 (111710 Luz 1?72?? :3 ?pf C?mp/r Err/Me The, Hzierean 12qu be". amp/anee 7/5? sew/?7? 54/ 7?56 210/? aspect? Ef?ey/ Cqu?na n6 5:5? ?97? My 7?3 half $43590] 7%}401 c314 in; jfaf?ac 9:5 111% :46 raw?) 9% ?4de zo/?F?J/ 01: .3 25w awe car:? a 527.9415?th 01!- Um?-r dc fl:- ?f4?e 0K QM emanate: ?ver/em: pretence ski 51/ 4mm] 4W4, WC c/omza?fcf?f my?? been LMJehv? 247% amp/1mg 3; Ha ?5am Liam/x7? ?75m No Yes Discussion With Person in Charge: Corrective Action Requlred: 777:: dau+ma [Do/?r r5 2131-5 7?29 til/(0F! 7'71: mfg/77" 5,41" 019 7756 D/Re-inspection Scheduled Voluntary Compliance Exclusion geek? h/W/y 45:1 Ljs??d/i El Ernbargo Other. l:I Voluntary Disposal Employee Restn?ction I Emergency Suspension Emergency Closure Fonn 734 AM. Sulltin (30.. Charlesluwn. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF (?Ac/m s??rs/ Massachusetts Department of Public Health Division at Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT 575+ Ins/0647637 Name - Date of ratio Egg 9: [ggp??gg Us: Kr??rt/ 2757/? Food Service Routine Address ?rst: Retell Flo-Inspection I (If Level Residential Kitchen Previous inspection esp one Mobile Dal Ow 97?? 2? 4&5: ACCP YIN Temporary rot-Operation nor Q?i??lf pug?LA Mb Caterer Suspect Illness Ch 9 11 a Bed 8. Breakfast General Complaint Li'i?igai i? fgc/VW/c?ty 1.130.225 HACCF Inspector ??hxk [A7a5/?c/I?? om; Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: on let to no born In rven ions It a to 5 {Red Items) Anti-Choking Violations marked may pose an Imminent health hazard an action as determined by the Board of Health. FOOD MANAGEMENT El 1. PIC Assigned i Knowledgeable i Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RestrictediExcluded FOOD FROM APr-noveo souecc 4. Food and Water from Approved Source 5. ReceivingiCondition 6. TagisecordsiAccuracy of Ingredient Statements T. Conformance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 11. Good Hygienic Practices U'olatlon eiat Good IlPra Ices (Blue items) Critical (C) violations marked must be corrected Immediately or within 10 days as determined by the Board of Health. Hon?critical violations must be corrected Immediately or within 90 days as determined by the Board 23. Management and Personnel {Postseason} 24. Food and Food Protection (accusations) 25. Equipment and Utensils 26. Water, Plumbing and Waste {PC-successor PhysicaiFacility 23. Poisonous or Toxic Materials 29. Special Requirements {mass} 30. Other require immediate corrective 500.009 (15) 500.009 (F) Allergen Awareness 500.009 to) [112. Prevention of Contamination from Hands Cl 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives U15. Toxic Chemicals CONTROLS (Potentially Hazardous Foodsi D16. Cooking Temperatures D17. Reheating I318. Cooling El 19. Hot and Cold Holding El 20. Tune As a Public Health Control REQUIREMENTS FOR HIGHLY POPULATIONS (HSP) Ci 21. Food and Food Preparation tor HSP CONSUMER ADVISORY 22. Posting of Consumer Advisories Number of Violate-Ll Provisions Related To Foodborne illnesses interventions and Risk Factors (Red items 1-22}: Of?cial Order for Correction: Based on an inspection today. the Items checked Indicate violations of 105 CMR 590.0110iFederal 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 aggrieved by this order, you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF Inspector?s z??z g; Egg; I E. Print: 11: gflkaj/IW/O loss 626576-01 . Page?Luiil?agc: FORM 714A AM. SULKIN I'll'i nuclei/cam In .Ifr.l THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: dtl?i/a/y {754/ 54946"?/ Date: Page: a of ltem Code - Critical Item "m Reference an "em DESCRIPTION OF ?ll?3:113:42? OF CORRECTION 33;? (7497? {st/c? I?cr fawn 24;? 795273.9- 1429594 ?emf rag-166? 67/6 792725 47/7 way/m? 617/ 5/ 717066, pair's-J ?rm/25? (r ?gar/F 5 7?6/ 245-!75 0% 74:9:7/ 9?ch mg 5:397 ?if; No El Yes Discussion With Person in Charge: Corrective-Action Required: ?3 6&1 755/ A: pit/rd Employee Restriction I Exalusion Voluntary Compliance 7% 74/6 ic/Iw/ pL/e/vm'w {396/ Rte-inspection Scheduled Emergency Suspension z? notary; 6? 5 (huff/7?2?? l3 Embargo Emergency Closure EIDCIDD El Voluntary Disposal Other: Form 734 8 kill. Sulkin Co.. Charlestown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF doc/21137994 Massachusetts Department of Public Hearth Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name . . Date of oration a fine action (?jig/J 32/5/71?? 5151/ 7' Food Service In?ouline Address Risk Retail Re-inspectlon 6 [gr/244A! ff Level Residential Kitchen Previous Inspection Telephone q7d-y? Earle: Temporary Pro-operation Owner [?ltl? $1an HACCP YIN a Caterer DSuspeot Illness person in Char PIC Time Bed Breakfast General Complaint 9 I Wind? ZIY Ia may}, HACCP ?745/3545? 0ut:/ 3.70 Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodhorne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.0095) l: Violations marked may pose an imminent health hazard and require immediate corrective T?b?cco action as determined by the Board of Health. 590-009 FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands [3 1. PIC Assigned Knowledgeable Duties CI 13- Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals 2. Reporting of Diseases by Food Employee and PIC CI 3. Personnel with infections RestrictedlExcluded FOOD FROM APPROVED SOURCE CI 4. Food and Water from Approved Source TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) CI 5_ ReceivingICondition U16. Cooking Temperatures 6. TagstRecordslAccuracy of Ingredient Statements 17- Reheating 7. Conformance with Approved ProcedureslHACCP Plans 13' Cooling PROTECTION FROM CONTAMINATION El 19' and ?54 0 8. 20- Time A3 a Health Control 9 Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS El 21. Food and Food Preparation for HSP CI 10. Proper Adequate Handwashing . . . CONSUMER ADVISORY 11' Hygienic Prachces 22. Posting of Consumer Advisories Violations Related to Retail Practices (Blue Number Of Violated Provisions Related Items) Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1.22); of Health. Non-critical (N) violations must be corrected Official dar for Correction: Based on an Ins ection immediately or within 90 days as determined by the Board today, the items checked Indicate violations of 105 CMR Codg. This report, when sligned below a Bear of so mem er or its agent const tutes an 32' ranjgergant ad": Personnel (Fc-2u590.003) order of the Board of Health. Failure to correct violations 0? an 0? a? ton cited in this report may result in suspension or revocation of 25' Equipment and the food establishment permit and cessation of food 26? Water, Plumbing and Waste establishment operations. If aggrieved by this orderI you 27- PWSICBI Facility have a right to a hearing. Your request must be in writing 23- POISOHOUS TOXIC Materials IFC-TIIS9IJ.0OBI and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: Inspector?s Signature: ?fay? l'rinl: Maggi/M I?lC's Signature: i?rint: l?uchoLLl?ngcs I i FORM 7714A A Sill KIN CO CHARI ESIOWN MAI- THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Ck?ng?k/ Establishment Name: SLAoa/j? Cfs??m Datez?f//f//7 Page: of 2. Item Cal-19 DESCRIPTION OF VIOLATIONIPLAN OF CORRECTION ?313 No. Reference R-Red Item PLEASE PRINTCLEARLY Veri?ed b?m? food 74:04.05 at 4 7/247? at. 19W Mas/s of?: wfd?/M/ qurm?-?; 11/ aft 61 ?/Mn AW 35:7?? 07 My [352% as: aw 142291 ?4%?ng 6/ Wq' Jib/r QJ/afaa/x may 7?0 296 J?pm/ ?r?qFZ-rmxf 7&9 dgm?ps?r Ac 79!! ?ea/2" f? FM J3 {Max/e I21 4; wamx?r??g' Maj/m mef/V 4w 6/ m_ (mags: I Discussion With Person In Charge: j! ?7?7?16 7% {a 26; girl? 717/ 4217/ on::iv:Ac;ary omp lance El mplayee estn?ctionl bi [0571'11?6/ I??ff? 79/ Exclusion El had I idly/I 45:2 [3?1 #20 e?Inspec on ue El mergencysuspensmn El ba go El Cl 4} af?rm/an?zvr aw! Ag, 7?5 rag/J +4.9 ~7ch ?14/ "?e'gem? ?we . [3 Voluntary Disposal El Other: Form 734 AM- Sulkin 00.. Charlesluwn. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF Grams/Q4 Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date oration 5 tin action ?76 (err/ivy Wide/I: Food Service Routine Address Risk Retail Pie-inspection Md Ff}, 12% Level Residential Kitchen Previous Inspection I Mobile Date: Temporary Pro-operation Owner him-'7 01'? 67' 6 (5/4 HACCP YIN Caterer Suspect Illness Person in Cha a pm . Time Bed Breakfast General Complaint Wes/2.? the err/ ,m we Inspector Ma? 0 Out: Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provision(s) violated. Non-compliance with: Violation Related to end orne lines into entions a Risk Fa tors (Red Items) Anti-Choking scanners) Violations merited may pose an imminent health hazard and require Immediate corrective Tabla? 590-009 F) action as determined by the Board of Health. 599-009 FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1. FIG AssignediKnowiedgeabieiDuties U13- Handwash Facilities EMPLOYEE HEALTH PROTECUON FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with infections Restricted/Excluded FOOD FROM APPROVED souace El 4. Food and Water from Approved Source CONTROLS (Potentially Hazardous Foods) El 5. ReceivingiCondition [316' ?WP-mm? El 6. TagsiRecordsiAccuracy of Ingredient Statements Reheating El 7. Conformance with Approved Proceduresil-iACCP Plans [318' Cooling ?Io - 7 Peorecnou FROM CONTAMINATION '3 19- H?t H?Iding 35Public Control 9. Food Contact Surfaces Cleaning and Sanitizing 86?: 10. Proper Adequate CONSUMER ADVISORY 11- G??d Hygienic Practices 22. Posting of ConsumerAdvisories Violations Rotated to Gogg Retail Practices (Blue Number of Violated Provisions Related a Items) Critical (0) violations marked must be corrected To Foodborne illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1.22): of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board Of?cial Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.000iFederal 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 23. Management and Personnel (Fc-zuseocos) 24. Food and Food Protection rec-streamer) 25? Eqmpment and Utensds iFC-4ii590.005) the food establishment permit and cessation of food 26- Water, and Waste establishment operations. if aggrieved by this order, you 27- Physical Facility lFC-ell590-007l have a right to a hearing. Your request must be in writing 23- Poisonous Ol' TOXIC Materials tFC-7li590-003i and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. I. . 30. Other one or 7? inspector's Signature-t [Mam/j ?741.2.656: Print: .rZ/?f/J {Cay/c, PiC?s Signature: log-W! Print: Jib .0 H) a? PageLot?Li?ngos FORM 734A AM SULKIH GO (j THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF ??lze/M57?/? Establishment Name: )Wd?f?le hm/ Date: Page: 1 of 1 Item Code - Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference -Red Item amuse CLEARLY Verified 4 R4, "7/56. 1124/13 214M 44"; 4727.: 3 (=an ma?a. ?217 774?; (??z?rza (in: A: r?y . -Hic a) am draped by {0-9 771:. ?07965?? ?9f 7?74: [Hieril? Mfr-4" .. I 'f/?Ie l?ldl?e?f .Ixn 01m?: rs d(mfl?ed Hal/C +4 .510 .975 vii-Ac: fp?d?! It?l/ [ill/I'M? C4 7 . Arm/(n V- I 7/16; (dd/)5 Inside (2'79 791:? Jadlr?cf?? 77m: xii/of}? for?; ?ed/J 7?2? 5651/? I?Erb 7?23 orafrc-f- war/LL: Jr: 'The. (NH-MAE, and rnS?J-fic 010 +176: 4rzm? Side of a (qfafen?a - The +raei-n nan; nced +0 in: gleaned ?Mia/C f7]. 4114' owl-QM: sch/era! +rma (a Week? !IJ/ifgll?? Discussion Person in Charge: Corrective Action Required: El No Yes El Volunlary Compliance CI Employee Restriction I Exclusion Rig-inspection Scheduled El Emergency Suspension El Embargo El Emergency Closure El Voluntary Disposal El Other. Form 734 AM. Sulkin Co.. Charleslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF 74-12% Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name 1 Date Tags ?oorationis) OH action jwikig//? El Eli?lenna t? Address is}; a e- nspec Ion Veer/4 Level Residential Kitchen Previous Inspection Telephone Mobile Dale: Temporary Pre-operation Owner ?fd/ HACCP YIN Caterer DSuspect Illness Person in Charge (PIC) L43. he" Time 9? Cl 39" 3 Breakfast 8 Sig-gt: Complaint I "0 c9 Inspector Permit No. El Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations I ted to Foodb rne illness lnte actions and isk Factors (Red items) Anti-Choking sensuous) Violations marked may pose an imminent health hazard and require immediate corrective Tobacua 590-009IFI action as determined by the Board of Health. 5904309 I: soon PROTECTION MANAGEMENT C) 12. Prevention of Contamination from Hands El 1. PIC Assigned I Knowledgeable i Duties Cl 13. Handwash Facilities PROTECTION FROM CHEMICALS CI 14. Approved Food or Color Additives EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections RestrictediExcluded FOOD FROM APPROVED SOURCE l:l 4. Food and Water from Approved Source 5. ReoeivinglCendition El 6. TagsiRecordsiAccuracy of Ingredient Statements E) T. Conformance with Approved ProcedureslHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing Cl 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related t_o_ Good getail Eractices (Blue Items) Critical (C) violations merited must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Managementand Personnel th-ziissonoai 24. Food and Food Protection 25. Equipment and Utensils 26. Water. Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures D17. Reheating El 18. Cooling [119. Hot and Cold Holding at 330600 -1 8' El 20. TimeAs a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) Cl 21. Food and Food Preparation for HSP CONSUMER ADVISORY 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1~22): Official Order for Correction: Based on an inspection today. the items checked indicate violations of 1H5 CMR 590.090IFederai Food Code. This report, when signed below by a Board of Heaith 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 aggrieved by this order. you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within it) days of receipt of this order. DATE OF 'Sf? 7/3018 Inspector?s Signature: (I .F/l l?rint: Maf?d {/24 cram/lo l?IC?s Signature: . I'rint: (J 047 y?ii v? FORM 734A AM SUI KIN co MA I THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF C?e /m51%rd Establishment Name: ?75 325199] Date: ?/fy/x?g Page: 7" of 2 Item c-Critlcalltem DESCRIPTION OF VIOLATIONIPLAN OF CORRECTION Date No. Reference - Red Item PLEASE CLEARLY Veri?ed F636 36759?? 54/ 756$ ?xer/7 nrw? 7% 7"st Vr/M??e #765454th If] 375/! /n V6495 ?/is?e 7?42: A477: 07p 791:5 Maf/ ?pp?an int-? 21/8 7/1/5? 20/2? :y/A?rr' 25' FZ- 1/ 73,231?? z/erci/c M/?/Z/xh (aw-{31" {Ff? (74m? I 15?? #46. run! my IL/srt? {Mp?r l4 ?i/j 1/7 mags/1?1? 4/1/74? 1946!? 7?66 c?f??ci'f' xix/'74: c7 ?r?ay?y r/g/f? af/ xi? ?1 41/; 795g 75:0 we Amt/J on: atria. boy [ti/57%? 794-: 7624-: 1:30 794:? r2? End :75 7?43: ?ye-9w? [ff/c. din/e 27am!- 7% m! Var/17" c770 l?nfi? ?1,292 (Ill-P .?rd?xn' Fae/?e 47/7 417?? fr/r? [if ?r ?fty/Ad 74:6 raw? fzf-r 63:75.50? 156d? xd/C 77$< 55/ng fed-765 ore alrn?y 77:: Ami?m; turf; Mail/J" ?ve drrv?y )dem (7/7 or! 4:59am 62/? 7?4: 610 7?5: Jean-x? Corrective Action Required: No 1 El? Yes Discussion With Personin Charge?> #?/E?gfq/7La Agni/?6: CI Voluntary Compliance Exclusion Reinspection Scheduled Embargo 0 Voluntary Disposal Other: Employee Restriclionl Emergency Suspension Emergency Closure Form 734 AM. Sulkln 00.. Charlestown, MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF dds/tits grief i' Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name . Dal Ii BE ofOEETaiionis] fins ti ?if. Km?" 7545/ 39% U, Food Service Routine Address . Risk Retail Rte-Inspection .245" Level Residential Kitchen Previous Inspection Telephone Mobile Data: Temporary El Pro-operation Owner 6?79 (Did/{rm 797/?f/ HACCP a Caterer suspect Illness - 11 Bed 8. Breakfast General Corn laint Person in Charge (?Chico/gar? male]: 70 HACCP loopector Mar/4 [470.31 :6 Out: Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provision(s) violated. Non-compliance with: Vio ations Related to Foodborne II ness Interve ions and Risk Fac (Red Items) Anti-Choking 590.0095) I: Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009 IF) action as determined by the Board of Health. Allergen Awareness 590.009 FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands Cl 1. PIC ASSIgnediKnowledgeableiDuttes El 13? Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives Cl 15. Toxic Chemicals El 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with infections RestrictediExcluded FOOD FROM APPROVED SOURCE CI 4' Food and Water from Approved Source TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) Cl 5. ReceivingiCondition 16. Cooking Temperatures El 6. TagsIRecordslAccuracy of Ingredient Statements 17- Reheating 7. Conformance with Approved Proceduresli-lACCP Plans 13' c. 2'77 0 PROTECTION FROM CONTAMINATION 19- and H0'dlng 20- Time A5 a Film? 00'1"? CI 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Food Preparation for HSP CI 10. ProperAdequate Handwashing 11. Good Hygienic Practices CONSUMER El 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical (C) violations marked must be corrected To Foodborne Illnesses interventions Immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1.22,; of Health. Non-critical (N) violations must be corrected Official for Correction: Ba ed on an ins ectio immediately or within 90 days as determined by the Board today, the items checked Indicate violations of 105 CMR 590.00iliFederal 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. It aggrieved by this order. you on. 23. Management and Personnel 24. Food and Food Protection (Po-attssonoa) 25. Equipmentand Utensils (Fc-Atlssonos) 26. Water, Plumbing and Waste (FC-5M590.006) 27- Physical Facility (FC-Gll590-007l have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30, Other . DATE OF RE-INSPECTION: . at- ?155,. Primate/kg? 77?1?fga'r?2 c; 3 FORM 734A AM suudit co CHARLESTOWN MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF 61 d/m Establishment Name: ?if 5" 55* Date: Page: 2of 2? Item 50"? Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date Red Item PLEASE PRINT CLEARLY Veri?ed ?34 (1.49 7543 ?64/5 5 jib/2&7 (if An/cmg 12 c2119! c: 5/ 6/ Tz??x?n 0/ a: a' A was Add" (Add 7:45. 17:56:! +5 (Afr/E/ r27 pffy?cWr? A?rm 7zgx$5?$7 ALE pf LAP 72? A: 72/ camcw-r? max? I?m-six 7614?? (In Mr 1415' a: (rm/fr" {1/550 Wm? i'r'rs/ am?" 61/7/7ch Cr d/?g 779 6. 75700:" 75/6 516% Ara/cr? z?z?szz' 070 74/ a 74771:? 5/ Discussion With Person in Charge: corrective Actlon Requlred: No El?Yes El Voluntary Compliance u/Reinspeclion Scheduled El Embargo El Volunlary Disposal Employee Restriction I Exclusion Emergency Suspension Emergency Closure Other. Form 734 AM. Sulkin Cm. Charleslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF PAa/m?a?/ Massachusetts Department of Public Health Division Of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date to ration 0 MC hqik?lf/k: Sfj?i??/ A 9 Food Service outine Address Risk Retail Re-lnSpecliot-i Level 8 Residential Kitchen Previous Inspection Telephone Mobile Data: Temporary Pro-operation Owner 7271?) (J 6/56/2275 Eif?f HACCP YIN 23:38:; 11 a ran as enera omp ain Person in Charge fl?. a Fire r'iZLdS HACCP inspector 4/11. Out 7.5" Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provisionis) violated. Non-compliance with: Violations Related to Foodhorne Illn es in rventi 5 Factors (Red Items} Anti-Choking 590.0095) Violations marked may pose an imminent health hazard and require Immediate corrective TOWN 590 009 (n 8 action as determined by the Board of Health. 590-009 FOOD PROTECTION MANAGEMENT 1. PIC Assigned i Knowledgeable i Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and FIG 3. Personnel with infections RestrictediExcluded FOOD FROM APPROVED 4. Food and Water from Approved Source [312. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals TIMENEMPERATURE CONTROLS {Potentially Hazardous Foods) [3 5. Receivingi00ndition 6. TagsiRecordsiAccuracy of Ingredient Statements 7. Conlonnance with Approved ProceduresiHACCP Plans FROM CONTAMINATION [1 ti. CI 9. Food Contact Surfaces Cleaning and Sanitizing 2?df?d72 El 10. Proper Adequate Handwasiilng El 11. Good Hygienic Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board at Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils ire-Algernon) 26. Water, Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials trc-riiseonoai 29. Special Requirements (590.009) 30. Other 16. Cooking Temperatures C117. Reheating 18. Cooling CI 19 Hot and Cold Holding ?7 - /0 El 20. Time As a Public Health Control REQUIRIIENTS FOR HIGHLY POPULATIDNS (use) 21. Food and Food Preparation for HSP CONSUMER ADVISORY 22. Posting oi Consumer Advisories Number of Violated Provisions Related To Foodborne illnesses interventions and Risk Factors (Red Items 1-22): Official Order for Correction: Based on an inspection today. the items checked indicate violations of 105 CMR 590.000lFederal 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 aggrieved by this order. you have right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within days of receipt of this order. DATE or ?57) 9 inspector? 3 Signature: Pm" Mark marries/1L PiC's Signature. J?le?x m" Fitter or; r. Crierti THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF {Ac/M74m7 Establishment Name: ?EA/Jiffy 34:11053/ Date: Su?/5170? t? Page: 2' of item Code Item DESCRIPTION OF VIOLATIONIPLAN 0F CORRECTION Date No. Reference - Rod Item PLEASE Pm," CLEARLY Verified 26? 7796 [oft/1 on {in freezer' deaf :5 daze/'4? all ?le ?g a bur?la?f Maj Ill? and 52mm; dd MI MIMI "The dimer 111+ch 7?29 Jae ass; :0 fit ct?-rf? 4117/ hi9, (Ll/ 7'79: Mm: 1.2111217 will DfPl/c?nf' Ac: IZLF LS (2&6 I3 i/Z?ql?ic? 27 7316: C. back Morl/ Min/P I955 4 [a/q?d flimsy} 7?46 ?54? (F ?7?59 of/ Aprra/ I: .I/(?#6019 +169 mail [mowed 37/} V4: #5 who {affirm dawns-sad 0/ rrjz? 1937/7: i? Khan 7629/77 7*le $53529} fv?f?n?mdfm Ma; ?Ma/e @492? 0% Au Iowa/24 795a {mm of)? Mined-I an f: ,7 f3?? {Ix?77,26 ?4742/ 63/4? 243%me come :27 37749 7444,26 54 M??ff? 7946? J??zw?i/ 7-77.51 Za/fr?z ?ood? ?ac?rg/ri (if/6? May/?99m? 5?7?9 haw/"7? Discussion With Person in Charge: Corrective Action Required: El No D/Yes El Voluntary Compliance CI Employee Restriction I Exclusion (Re-inspection Scheduled Emergency Suspension El Embargo El Emergency Closure Voluntary Disposal Other: Form 734 AM. Sulkln 00.. Charloslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF (rm/mere Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name is oration Hit/?Afr middl? 5-4.2106/ {r cod Service outine Address 7 Risk Retail Rio-inspection 7 6/7/71. 6? IV [275/ Level Residential Kitchen Previous Inspection Telephone Mobile Date: Temporary Pro-Operation Owner Tia/?7 Ig/o/ HACCP YIN gaff; guspetg?m?; -. . ree as enera om aln Person In Charge (PIC) @201 0t (46.?th ill-:13; .95, HACCP Inspector [0445? I Out: Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations R_e _ated to Foodborne Illness interventions and Risk Factors (Red Items) Anti-Choking 590.0095} Violations marked may pose an imminent health hazard and require immediate corrective 590-009 action as determined by the Board of Health. 590-009(5) FOOD PROTECTION MANAGEMENT 1. FIG Assigned i Knowledgeable! Duties EMPLOVEE HEALTH (3 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RestrictediExclucIed FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source El 5. RaceivinglCondition El 6. TagsiRecordsIAccuracy oi Ingredient Statements 7. Conformance with Approved Proceduresii-iACCP Plans PROTECHON FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing call 10. ProperAdequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board of Health. (3 23. Managementand Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water, Plumbing and Waste Inspections) Physical Facility IFc-euseocor) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other 12. Prevention of Contamination from Hands El 13. Handwash Facilities FROM CHEMICALS 14. Approved Food or Color Additives Cl 15. Toxic Chemicals HMEHEMPERATURE CONTROLS (Potentially Hazardous Foods) El 16. Cooking Temperatures U17. Roheating El18. Cooling 35-5 .12 7316 El 19. Hot and Cold Holding 3; 2' 5 ,5 1r 0 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEFTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): Official Order for Correction: Based on an inspection today. the items checked indicate violations of 105 CMR 590.00tiiFederal 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 aggrieved by this order, you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE ?cior?s Signature! 5M5 Print: I/b mature: I Print: 3 A M. SULKIN co. CHARLESTOWN. MA ate/'hfk ?33 Page?LOLLPagcs 4/ OF HEALTH Establishment Name: be #211" Cr {1053/ Date: fl f/ Page: 2/ of 7- ltem Code DESCRIPTION OF VIOLATION I PLAN OF page No. Reference - Red Item mew cLEAt-m Veri?ed Mar @311 ?les; (251/ 255%! 794-29! 49% s??r'?zfl? 4/1? 5 362m JAE 7495355] Syn/rm d/ff WM, l?d' Sig/2740:. 5% Mo Egg-a 949 Urm'erm?g great! re (has: Cg?? did 1?5 :1qu .Jn?irnj lug/j twaLtfiI r?nrfLa anti: n?m ?(Jig \le 10' fit/ten _..h15 deem d?z/ 9:654an! jib-Oi CH9 dV?fi Discussion With Person In Charge: Corrective Action Required: CI No CI Yes El Voluntary Compliance CI Fla-inspection Scheduled Embargo CI Voluntary Disposal El Employee Restriction I Exclusion Emergency Suspension Emergency Closure ODD Other FORM 734a (REV. 7/2000) HOBBS a: WARREN. aosron This Form Approved by the Department of Public Health THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF d/Ie/mc-Ai/v/ Massachusetts of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name . Date eration I 5 action 1? f0?! $61) 043/ gaff/l Food Service Routine Address 7 .. . ,2 Risk Retail Rte-Inspection . L43 1? or?! The?! 5? Level Residential Kitchen Previous Inspection Telephone El Mobile Date: Temporary El Pre-operation Owner 7501/11 chd,m/2Val HACCP YIN Caterer Suspect illness person In Char PIC Time Bed Breakfast General Complaint 9 I Ida?; 'Ma rel/{AM ,m ,1 HACCP Inspector ?6 [71? 5 J. C. Out: Permit No. CI Other Each violation checked requires an explanation on violated. Violations Related to Foodborne Illness interventions and Risk Factors (Red Items) Violations marked may pose an imminent health hazard and require immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned I Knowledgeable I Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RastrictedlEchuded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. 6. TagsiRecordsIAccuracy the narrative page(s) and a citation of specific provision(s) Non-compliance with: Anti-choking 590.009 (E) Tobacco Allergen Awareness I: 590.009 (F) El 12. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives CI 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) El 16. Cooking Temperatures El 17. Reheating CI 7. Conformance with Approved ProceduresIHACCP Plans 18- [319. Hot and Cold Holding 3'3 .723 PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel (Fc-zxseocozn 24. Food and Food Protection 25. Equipment and Utensils (ac-duesoms) 26. Water, Plumbing and Waste (Fc-snseocoe) 27. Physical Facility (chuseoccr) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other CI 20. Time As a Public Health Control 37? /43? 37? REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP CONSUMER ADVISORY 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne illnesses Interventions and Risk Factors (Red Items 1-22): Official Order for Correction: Based on an Inspection today, the items checked indicate violations of 105 CMR 590.00IJIFederai 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. It aggrieved by this order. you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OFJE-WSPECTION: CW inspector?s Signature: l'rint: (trite/I?d: "rm? (lo Ti- duvet fi?wr/?h?c) I?ngoLui?LI?ngcs FORM 734A AM SULKIN CD. CHARLESTOWN MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF axe/mew Estalalishment Name: EA r/(cf ijJ?lfl/E? 45:1, Date: 4' {57/3 Page: 1 Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item .- PLEASE PRINT CLEARLY Veri?ed 9 "1 1:4. lg: (?ery? Jr: f: 291? dzL?mj' Juana: e? 7?74 :3 4: EKdel??f'?r? I'll 5'le (thy {fc??w 45/052573 Alf/'7? 6/75/13 021/! 771a new cog/er: 421m? 205+ hat/e r5 Place? a? f?rrmomef??r 1119. dz (up cad? xm/x: 162/50 vG/ILhe?rH mr/k coo/r6 are wake] Jo :16 ?3an r25? Mr: r'g med-#01171 7?2: 7537? Mil/4. 7L?M3~f?f7?Vf? meme/A: r" were first a 2/ ?dj?gjn 74-: oz) [pew y?f? (Cg/zz?? L/r sci/C made smw?y? Jib? ?ea/If 652-15! .59- af?f?ZLf? fr; 755:?! cm?: 7W 0-5 firm!? annr?y?r fracrh?{zra ll?l ?/I?SP/rty ea/ 19/40.: MIL cyq'f?es on a fart/4 mm}: 77:55 Uracj 3 mrrpecmercf 2,!an Cam f?ihfrT 1 7?7?761? ?f?c d. and and qv?? 1'6: coma?M5 1:19 a 7? if (brat?df?f Discussion Witli Person In Charge: Corrective Action Required! No 3/ Yes Voluntary Compliance El Employee Restriction I Exclusion (Re-inspection Scheduled El Emergency Suspension El Embargo Emergency Closure El Voluntary Disposal Other: Form 734 8 AM. Sulkin (20.. Charlestown. MA THE COMMONWEALTH OF MASSACHUSETTS U/Ze/rm?/ 2/ TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date no of Oerallon a 5 action l47lf/QJ/Ca SC [1537/ lk?v/l' IrRoodiIService D?Rouiine Address . Risk eta 7 7:51.01 ?3 ?24, Level Residential Kitchen Previous Inspection eep one Mobile Date: CI Temporary Pro-operation own" ?rm/1 0/7 (7/5 Jim's?3rd HACCP gaff]; ki . 1" rea as enera omp aln Person in Charge [$97 Mom [gm/9K Ed CIHACCP Inspector I Out: Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Violations Related to Foodborne Illness interventions and Risk Factors (Red Items) Violations marked may pose an imminent health hazard and require immediate corrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned Knowledgeable i Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections RestrictediExcluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. El 6. TagsiRecordsiAccuracy of Ingredient Statements 7. Conformance with Approved ProcedureslHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing CI 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations REJLEIJBO to Good Retail Practices (Blue items} Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (Ni violations must be corrected immediately or within 90 days as determined by the Board . 23. Management and Personnel 24. Food and Food Protection 25. Equipmentand Utensils 26. Water. Plumbing and Waste (Fosllseopuel 27. Physical Facility (Fc-eilssopori 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Non-compliance with: Anti-Choking 590.009iei 1: Tobacco 590.009 (F) Allergen Awareness 12. Prevention of Contamination from Hands D13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives El 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) CI 16. Cooking Temperatures El 17. Reheating D18. Cooling [119. Hot and Cold Holding 37" 7? El 20. Time As a Public Health Control ?10 3? CONSUMER ADVISORY El 22. Posting of Consumer Advisories REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Food Preparation for HSP Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red items 1-22): Official Order for Correction: Based on an inspection today. the Items checked indicate violations of 105 CMR 590.000iFederal 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 aggrieved by this orderI you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF FEE-INSPECTION: inspector'sSignuturc: Mark ?rms/f0 Print: a1 fir/WI; I?ll nos FORM AM SULKIN CO CHARLESTOWN MA THE COMMONWEALTH OF MASSACHUSETTS 3 TOWN OR CITY OF 5/75/an 147m? Establishment Name: Dirk?!" {MI/cf Sag/927% Date: 22/1?? 3/ Page: Zof 1" Item code - Critical Item DESCRIPTION OF VIOLA110N I PLAN OF CORRECTION ?3?9 No. Reference - Red Item PLEASE "um Verified 9 3' g. 2/5/75: firm/r xJ?f/h ,WS/?f?c :72! 794.? M, 14.19435, ?re xii/em? a; gig/life ?roxz ?an/5 an Me 5% Km a [cw/Jed ?mar (Ana/717g; legycz?s >97; Vf??a?ifu Discussion With Person in Charge: Corrective Action Required: 0 No a Yes Voluntary Compliance Employee Restriction I Exclusion El Re-inspection Scheduled El Emergency Suspension El Embargo 0 Emergency Closure Voluntary Disposal Other. Form 734 8 AM. Sulkin 50.. Charlestown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name - . Oat ration S?z/l (325/ 51?5597,? '7 Food Service ij?outioe Address - 3k Retail RB-li?iSpBCiiOi?r 7 ($31.34; flab? Elf? Level Residential Kitchen Previous Inspection Telephone Mobile Data: Temporary Pro-Operation Owner 212:0? Clea/ms gr] HACCP YIN Caterer Suspect Illness Perso in Che pic 1 . Time Bed 8. Breakfast General Complaint root ?Zora/Ara a In: I :75- HACCP Inspector [1,44 [17 i5f?f2 Out: [21% Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of speci?c provisionis) violated. Non-compliance with: Violation Ia ed to od me It! ess Int tion it Factors (Red Items) Anti-Choking someones) Violations marked may pose an imminent health hazard and require Immediate correctIVe Tobl?oo 59?43'19??) action as determined by the Board of Health. ?mm" a FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands CI 1. PIC Assigned Knowledgeable Duties 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and Pic [3 3. Personnel with Infections RestrictediExctuded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source CONTROLS (Potentially Hazardous Foods} 6. TagsIRecordsIAccuracy of ingredient Statements 17' Reheating 7. Conformance with Approved ProceduresIHACCP Plans [118. Cooling . 0 l5 3. PROTECTION FROM CONTAMINATION H20- Time As 3 PUWC 00""0' 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY BUSCEPTIBLE (HSP) El 21. Food and Food Preparation ior HSP 10. Proper Adequate Handwashing CONSUMER ADVISORY 11' Good Hygienic Practices El 22. Posting of Consumer Advisories til i new d1? dRetailP (B'ua NumberofViolated Provisions Related Items) Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1.22); of Health. Non-critical (N) violations must be corrected Immediately or within 90 days as determined by the Board of Of?cial Order for Correction: Based on an inspection today. the Items checked Indicate violations of 106 CMR 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 25' Equipment and Utensils the food establishment permit and cessation of food 26. Water, Plumbing and Waste (Fe-succeeds) establishment operations. It aggrieved by this order, you 27- Physical Facility have a right to a hearing. Your request must be In writing 28. Poisonous or Toxic Materials (Fe-Tumor!? and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within in days of receipt of this der. 30. Other DATE OF 7 7 23. Management and Personnel (FC-2N590.003) 24. Food and Food Protection (metronome) inspector's Signature: MEr/W/m?d/?/ Print: ?49.3 lie/[0 PlC?s Print: (in in? C) PagoLoLLPagc: FORM 734A AM. SULKIN CD. CHARLESTOWN. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF diam; 7/2/14 Establishment Name: IBT-f?ff 2/7675? Date: Page: '2 of .2- "em Coda - Critical ?em DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item PLEASE PRINT CLEARLY Veri?ed fC-? 2/2 75? U?l'fz ?/ocz [dd/ZS msM?e 754a mhh?n g/f 5111/ c/e??rr/ from [951' [Iva/S :hsree?an 7?55 ?554? 75" Pr,? 01" 72? J?ff? 51/: 7?56- y?gyj?ff?zfpk) (2 6047/ 256%;- 592017 (I (Q) 7756 61%qu glow-MM m7" 0; z: Air?" 230 7A2 A/z??rero Gaff/f 64742!? Am! r14 Ac: romp/ wzc: MP WW W766i: 24/5? 202 :21 25:16 7756. A?J??rn {Wire/1 ?Ir/7?2? (arcadf'n 1/4/er nae-2G 6a? Gems-4? 4409? 433/- ?562441929 217? Vzwe? ?2:572:59 sac?27.5% gaggm 25/ 3 a 26?: Mai/M17 7/934 2?5 maze/17L 16;! 7?79! (few/ea r4? 7432267 7490/ 77,3 m?r?c?n ?aw/5 45/5, 73-day Mfr: Isiah 127 "#76637 11A Iii/(07955? 0/ 7556 10:2? 74/? Tm?- 71:72! 354044 jag-y?, Discuss?ion With Person in Charge: Corrective Action Required: El No Yes Voluntary Compliance 0 Employee Restriction! . Exclusion Rte-Inspection Scheduled El Emergency Suspension El Embargo El Emergency Closure 0 Voluntary Disposal Other. Form 734 AM. Sulkin 00.. Charleslown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Date eration Ins an ion ?ght ELJHDO 5/277- [3 Food Service El outine Address Risk Retail Pie-Inspection Level Residential Kitchen Previous Inspection Telephone a Mobile Dale Temporary Pro-operation Owner 4/ 6161/qu re/ HACCP YIN El Caterer Suspect Illness Person in Cha 9 PIC Time Bed 8. Breakfast General Complaint rg /R\?l0 IN aim/"W HACCP Inspector Maj/57b Out' Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provisionis) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk factors (Red items) Anti-Choking 590.0095) I: Violations marked may pose an imminent health hazard and require immediate corrective Tubman action as determined by the Board of Health. ??5153" 590-00916) FOOD PROTECTION MANAGEMENT 1. PIC Assigned i Knowledgeable I Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and FIG 3. Personnel with Infections RestrictedlEchuded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source Cl 5. ReceivingIConditlon El 6. TagisecordsiAccuracy of Ingredient Statements 7. Coniomiance with Approved ProceduresIHACCP Plans PROTECTION FROM CONTAMINATION B. El 9. Food Contact Surfaces Cleaning and Sanitizing Cl 10. Proper Adequate Handwashing 11. Good Hygienic Practices Lilo?lotions Related to Good Retail Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water, Plumbing and Waste (Fe-siiseocuei 27. Physical Facility (Rousseau?) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other D12. Prevention of Contamination from Hands D13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or ColorAdditives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) CI 16. Cooking Temperatures D17. Reheating 6 D13. Cooling 154 70 33? CI 19. Hot and Cold Holding 2 are not: 4?0? 365 El 20. Time As a Public Healtii Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) Cl 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne illnesses Interventions and Risk Factors (Red items 1-22): Of?cial Order for Correction: Based on an Inspection today. the items checked indicate violations of 105 CMR 590.000I'Federal 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 aggrieved by this order. you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF HIE-INSPECTION: Inspector?s Signature: Print: fry/(2 /27(251'e #9 Pics Signaturcr Print: FORM 734A A M. SULKIN C0. MA alone ?13940quin THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF 6% ?7 ., Item Code - Critical Item OF VIOLATION I PLAN OF CORRECTION Date Reference Red Item PLEASE PRINT CLEARLY Veri?ed Hep)" r?sor/ 315x343 dc: fe?j are?! an GE Na .9347? 01; am! ?01%an #272 ('10 ?ags we r; ?hd/l 745'?? a 2? 4fP?daq/ 5539f?: ?rth? MM mt.? c/M u" Discussion With Person In Charge: Corrective Action Required: No El Yes Voluntary Compliance El Employee Restrictionlr Exclusion El Ree-inspection Scheduled El Emergency Suspension El Embargo El Emergency Closure Voluntary Disposal El Other. Farm 734 AM. Sutidn 00.. Charlesiown. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF (?e/nzg?rwg/ Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name 9 - Date eo rations Ins ection ?3045"? r0) Q?w/ 5752,75, DI ?ned Service suites Address . St; Retail Re-inSpeclion .135. 0 6?55 78? Level Residential Kitchen Previous Inspection Mobile Data: Temporary Pris-operation Owner 733qu my dds/mfg'd HACCP YIN 3:71:33; guspecmnes? . rea as enera omp aln Person in Charge (PIC) ill-11:11:? '3'0 HACCP inspector psi/? Jqusde/b Out: Permit No. El Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne interventions and Elsi: Factors (Red Items) Anti-Choking seasons) Violations marked may pose an imminent health hazard and require immediate corrective 70133000 590-009IF) action as determined by the Board of Health. ?We" 590309 I: FOOD PROTECTION MANAGEMENT 1. PIC Assigned I Knowledgeable I Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RestrictedIExciuded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. ReceivingICondition Cl 6. TagsIRecordsiAccuracy of ingredient Statements CI 7. Conformance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) CI 16. Cooking Temperatures 17. Reheating 18. Cooling [319. Hot and Cold Holding IV) a 36? 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSPI 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 11' 600d Hygienic Practices El 22. Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Items) Critical (0) violations merited must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board I: 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water, Plumbing and Waste (Fc-siiseocue) 27. Physical Facility (chussocori 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): 5 Official C_i_rder for Correction: Based on an Inspection today, the Items checked indicate violations of 105 CMR 590.000iFederal 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 su5pension or revocation of the food establishment permit and cessation of food establishment operations. If aggrieved by this order. you have a right to a hearing. Your request must be in writing and submitted to the Board of Heaith at the above address within 10 days of receipt of this order. DATE OF RE-INSPECTION: Inspector's I 14 I?I'int I?rrfxe ?at fey/J aliases l'ugcs FORM 734A AM SULKIN CO CHARLESTOWIM Quinn Mosgxm THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF C?c/his?/ef/ Establishment Name: {Eda}, 52-1/7 Date: Page: 2/ of 1 Item Code - Critical ?3'11 DESCRIPTION OF VIOLATION PLAN OF CORRECTION Date No. Reference -Redltem PLEASE PRINT CLEARLY Veri?ed 4, 76? r4029 019 f?g?g x/eA 6?1 5751/ )c?umy (Jeff/K 47,27? I 471/ 1" jig fag? agaqfr 2?0 :1 rep/age?" 744/ xbs?'m?? if}; 523% a 44 Car/Iv fr/es 512?? 4/ 7?4: [zr?f?LAdA or; (212/ an? c/ am/ Agra (Hen-17)} [47 {Pep/ode 7144? r2397" on If J'zie 27/ 775:. Avid, fray,? 7% 294:: 24/? J54 05/2/66?? Discussion With Person in Charge: Corrective Action Required: No a? Yes Embargo El Vol aryCornpliance Re-inSpeotion Scheduled El Voluntary Disposal DODGE Employee Restriction! Exclusion Emergency Suspension Emergency Closure Other: Fora-n 734 AM. Sulldn 00.. Charlestoum, MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Chi/ms? 0"th Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name a Date of 0 iion i 0i} 1?}1 56-11225] '1 3? Food Service Eli i Routine Address . . Risii Retail Pie-Inspection .256 rm Level Residential Kitchen Previous Inspection Mobile Date: Temporary Pro-operation Owner f: 11.11/ 211.3 7557/ HACCP YIN Caterer Suspect Illness Person In Charge {pm} Time El Bed Breakfast General Complaint go HACCP Inspector pew/[4 1mg {5 I om: Permit No. Other Each violatIon checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations marked may pose an Imminent health hazard and require immediate corrective ?him 55?13?19?} Violatiggs Related to Foodborne Illness intgmentlons and B ?k Factors (Red Items) And-crinkle: summers] action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT El 1. PIC Assigned I Knowledgeable i Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections ResidctedIExcluded FOOD FROM APPROVED souncE [j 4. Food and Water from Approved Source 5. ReceivingICondition El 6. TagsIRecordsIAccuracy of Ingredient Statements 7. Confonmnce with Approved ProceduresIHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. ProperAdsquate Handwashing El 11. Good Hygienic Practices Related to 599g Betail Practices (Blue Items) Critical (C) violations marked must be corrected Immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board tthaj?. 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 25. Water. Plumbing and Waste Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Allergen Awareness 5911.009 to} [312. Prevention of Contamination from Hands D13. Facilities PROTECTION FROM CHEMICALS D14. Approved Food or Color Additives U15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures U17. Reheating E118. Cooling . U19. Hot and Cold Holding 77/57 #00 ?o [we El 20. Time As a Public Health Control REQUIREMENB FOR HIGHLY SUSCEFTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP CONSUMER Advisortv El 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne illnesses Interventions and Risk Factors (Red Items 1-22): Of?cial Order for Correction: Based on an inspection today. the Items checked Indicate violations of 105 CMR 590.0tIOIFederal 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 load establishment pennit and cessation of food establishment operations. If aggrieved by this order. you have a rightto a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE Inspector's Signature: I (417% Print ?7qu Maison X?im Print IN THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF [/7510an ?e (?Wye-xx Km; MK- 59ch elegy-M. Establishment Name: Sn Ufa}? ?9.93? Sch/l Date: 1' ail/f 2" Page: 2?0f ltam Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item PLEASE PRINT CLEARLY :12 f6; 6 775 If tic/I?M c9 (f/F in com 371744/7 7'34: t/?f/L x?r?ff?t-r' 7?76"? {0 97 771? 6v - 776 Ha?z/4! 196%? F5 5 5 m/ch'? AWFGIJS ?/76 ?fe/1:24 my?" aor? mm/ 555/ {pm Ame. 79? 5:445 Serwcac Eran/,5 m?n? 46v; r9;- .6: In sax/e magml?/ (?ue/w (cm 2/ 17/56 g/gz? mv/a?m? 5443 fa ?and! 7?357" 5 I I 7. 237p 7?756 rm? debts har??c?f (740? 4' 572m 744: .a'frt?m 4.0/qu wefim 74/74 Affair/n MOW r? 4.7975 :56; ?7953. Action Required: No El Yes 7646 Discussion With Person in Charge: . [g/Jy/ (7 In?! Voiuntary Compliance Exclusion 16/3! (chart; r2634 43? Law 76-4/6 j?rwg'CQ? Re-inspeclion Scheduled El El Embargo El Voluntary Disposal Other. Employee Restriction I Emergency Suspension Emergency CIosure Form 734 5 AM. Sul?n Co.. Chanestowrn. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF (Hades/erc/ Massachusetts Department of Public Heath Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Dat a CI rat Leif/7 ?099? .9100 5-2410 ?9 IE Food Service ??gouiine Retail Reinspection Address 35157?? Risk Telephone um 7m?? :74 C/rd?wr??/d/ Residential Kitchen Previous Inspection Mobile Date: a Haccp w? Temporary Pro-Operation El Caterer Suspect litness . Bed 8. Breakfast El General Com taint Person in Charge (PIC) 2?55)? HACGP Inspector ff/ziS/ki/{e gut/glgo Permit No. El Other Each violation checked requires an explanation on the narrative pageis) and a citation of speci?c provisionis) violated. Non-compliance with: Ulgigtiong Related to Foodborne Interventions and Risingclors (Red items) Anti-choking someone: Violations marked may pose an imminent health hazard and require Immediate corrective '1on 590-009IFI action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned I Knowledgeable i Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and FIG 3. Personnel with Infections RestrictediExcluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. ReceivingiCondition 6. TagsiRecordsiAccuracy of Ingredient Statements CI 7. Contonnance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Belated to good Practices (Blue Items) Critical (C) violations marked must be corrected Immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected Immediately or within 90 days as determined by the Board 23. Managementand Personnel (Po-anemone) 24. Food and Food Protection (recurrence) 25. Equipmentand Utensils 26. Water, Plumbing and Waste (Fe-silences) 27. Physical Facility (menswear) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009: 30. Other Allergen Awareness ?0.009(6) 5? E112. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS D14. Approved Food or Color Additives Ci 15. Toxic Chemicais TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures U17. Reheating I318. Cooling /ays? MW [119. Hot and Cold 3 3.2 93 El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY POPULATIONS (HSPI El 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne illnesses Interventions and Risk Factors (Red Items 1-22): Of?cial Order for Correction: Based on an inspection today. the Items checked Indicate violations of 105 CMR 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. it aggrieved by this order. you have a night to a hearing. Your request must be In Writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DEE 0F RE-INSPECTION: Pm": mid? Sire/b Signa'm?? 197 {3 Mair/??, Signature: Vi Pu git??0 L'AI?agcs FORM 73? Au atrium an ll:- Printrquh IN ?3)ng THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: ?2077) Eon) .Qlyw/ Date: g/?/py Page: 2.. of 2? Item DESCRIPTION OF VIOLATIONIPLAN 0F CORRECTION 03" No. Reference R-Radliom PLEASE pm CLEARLY Veri?ed aw 746,95 foam 4k a? ?gn?/dgt/i Egypt-7929? fcw'r?f 2w? .5 1447?; at? 5237/7 my fwff?f? me Marco?s 8.44? z? ggfj/?g? ?ggi (did a? ?ea/?59? 444,511 (in? S?M/die . 7795:. #1731607 can/4:7 as ,s?ztw' n07? ea 74?: Farm/:- Cv Dep?n?zwmz? veg/r (3/46 Acme/e fir ml?? 1:9 7?3? bej/ 71?: D?p??rfmc??f' 34457?? #57; w-a/r 6- 73c $2.5m: as; ff??l? (1.5 7545?? .15 mm"- :57 f?/lgP/fcz?ce . (<37 771! mm 1* (gay/1 ace A, 7425: 373% 475/792: 2929- 24523: 25w? wee-r? Discussion With Person in Charge: CorrectlveAction Required: 0 No Yes El Voluntary Compliance El Employee Restriction! Exclusion El Re-inspeciion Scheduled Emergency Suspension El Embargo El Emergency Closure 0 Voluntary Disposal El Other. Form 734 8 AM, Sulkin Cm. Chadaslown. MA