r: (?fty at ?lehfurh BOARD OF HEALTH City Hall ?.Room 311 85 George Hassett Drive - Medford, Massachusetts 02155 3111111211111)!ng Telephone (781) 393-2560 FAX: (781) 393-2562 TDD: (781) 393-2516 Food Establishment Inspection Report - FDA Insp Date: 11/9/2017 Business ID: MA000015 Inspection: Business: Andrews Middle School Permit 3000 Mystic Valley Parkway Phone: Health Director: RS1383 Kimberly Fowler Medford. MA 02155 Reason: 01. Routine Results: No Follow-up Time In Time Out Date - In Out Insp Travel Total Mileage_ Kites 11/09/17 11:51 0208 0200 0108 0 Total: 0:08 0_:00 . 038 0 Inspection Summary Official Order for Correction: Based on an inspection today, the items checked Indicate violations of 105 CMR 590.000/ 2013 Federal Food Code. This report, when signed below by the Inspector constitutes an order by the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and/or fines. If aggrieved by this order, you have the right to a hearing. The request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. PIC Linda Bottari ServSafe Exp. Allergy Exp. .. Choke Exp. Foodborne Illness Complaint Investigated (All) Involving More Than Two Persons FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS Compliance status: IN in compliance OUT not in compliance NIO not observed MA not applicable Marked in appropriate box for COS and/or R. COS corrected on-site during inspection repeat violation Risk factors are improper practices or procedureskzlenti?ed as the most prevalent contributing factors of foodborne illness or njury. Public Health Interventions are control measures to prevent foodborne illnesses or injury. I IN OUT NIO COS REPEAT [Supervision 1. PIC Present. Knowledge and Duties G) 0 El Cl 2. Certified Food Protection Manager G) El lEmployee Health I Responding to Contamination Events I IN OUT NIO 008 REPEAT 3A. Employee Health: PIC Knowledge, Responsibilities Reporting (9 0 El El 38. Employee Reporting Proper Use of Restriction Exclusion G) El El (9 El 5. Clean-up of Vomiting and Diarrheal Events taste?1151: Ins?tor I Acknovwedged Receipt Page 1 of 6 Food Establishment Inspection Report - FDA Good Hygienic Practices IN OUT NIA cos REPEAT 6A. Proper eating. tasting. drinking. or tobacco use (9 0 El El GB. Preventing contamination when tasting G) El 7. No discharge from eyes. nose. and mouth (9 0 Control of Hands as a Vehicle of Contamination IN OUT NIO COS REPEAT 8A. Hands clean properly washed (9 El SB. Where to wash. hand antiseptics (9 0 El El 9. No bare hand contact with RTE food or a pre-approved alternative procedure (9 0 El El properly allowed 10A. Adequate handwashing sinks properly supplied and accessible (9 El 108. Handwashing sinks accesible with proper signage. handwashing aids El [Esme?veer Sources IN our NIO NIA cos REPEAT 11A. Milk. eggs. juice. and processed food (9 l] 113. Fish and Shellfish 0 i] El 110, Game animals and wild mushrooms (9 Ci 12A. Food received at proper temperature (9 0 El El 128, Shipping and receiving frozen food (9 13. Food in good condition. honestly presented. safe. 8( unadulterated G) 138. Food package integrity (9 Ci 14A. Required records available: shellstock tags. parasite destruction 0 G) El 143. Missing shellstock tags. destruction 0 6) El El 140. Parasite destruction- storing rawfpartially cooked fish 0 (9 El E1 Protection from Contamination IN OUT NIA COS REPEAT 15A. Food separated protected G) 0 CI El 158. Cleaning equip/utensils/food containers (9 El 16A. Food-contact surfaces: cleaned sanitized immersion 171? and above 9 0 El El 168. Food contact surfaces cleaned and sanitized NMT 194? F. NLT 180? G) 0 El El 160. Mechanical warewashing equipment sanitization food contact surfaces. (9 0 El equip.. utensils Proper disposition of returned. previously served reconditions. unsafe food 6) Time/T emperature Control forSafety Food (TCS Food) lN OUT COS REPEAT 18A. Proper cooking time temperatures (9 El 188. Whole meat cooking and sewing. storing 18C. Microwave cooking of raw animal foods El 00 El El @000 19. Proper reheating procedures for hot holding swat Inspector Acknowledged Receipt Page 2 of 6 Food Establishment Inspection Report - FDA Time/Temperature Control-for Safety Food (TCS Food) 20. Proper cooling time 8: temperatures 21. Proper hot holding temperatures 22. Proper cold holding temperatures 23. Proper Date Marking 238. TCS Foods Disposition 24A. Time as a public health control: procedures 248. Time as a public health control: temperatures 8. discarding food 240. Time as a public health control: highly susceptible population (HSP) Consumer Advisory 25. Consumer advisory provided for raw or undercooked foods IHighly Susceptible Populations (HSP) i 26A. Pasteurized foods used: prohibited foods not offered 268. Reservice of foods [Chemical i 27. Food additives: approved and properly used 28A. Toxic substances identified. stored and used 288. Poisonous materials. sanitizers. additives. medicines restriction. separation. storage 28C. Conditions of Use: law Conformance with Approved Procedures 29A. Compliance with variance. specialized process. HACCP plan 298. Treating juice- HACCP, reduced oxygen packaging wlout variance. conformance with approved procedures 290. When HACCP plan is required GOOD RETAIL PRACTICES OUT No COS REPEAT OUT OUT OUT COS REPEAT (9 El El NIA COS REPEAT (9 El G) El El NIA COS REPEAT (NIA COS REPEAT Good Retail Practices are preventative measures to control the addition of pathogens, chemicals. and physical objects into foods. IN in compliance OUT not in compliance COS - corrected on -site during inspection REPEAT repeat violation Safe Food and Water 30. Pasteurized eggs used where required 31A. Water ice from approved source 318. Sampling. alternative water supply 310. Sampling report 32. Variance obtained for specialized processing methods {7/1 Like?) anF/Qri?i Inspector I Acknowledge?dRece-ipt IN 00069 OUT NIA COS REPEAT 0000 EIEICICI USED Page 3 of 6 Food Establishment Inspection Report - FDA I$d7e7nos?alure Control I IN OUT Nlo cos REPEAT 33A. Proper cooling methods used; adequate equipment for temperature control G) 0 El 1] 333. Frozen food 6) 34. Plant food properly cooked for not holding (D El 35. Approved thawing methods used 0 El 36A. Thermometers provided and accurate G) 0 El E1 368. Thermometers function properly 0 0 El CI IFood Identification I IN OUT cos REPEAT 37A. Food properly labeled; original container (9 Cl 373. Food labels. labeling of ingredients 6 IPrevention of Food Contamination I IN OUT COS REPEAT 38A Insects. rodents. 8: animals not present 0 El 388. Handling prohibition. controlling pests. prohibiting animals 39A. Contamination prevented during food storage (9 El 398. Food display: ice used as an exterior coolant prohibited as an ingredient (D 0 El El 390. Consumer self-service operations- utensils and monitoring 6) 0 El El 40A. Personal cleanliness~ prohibition jewelry (9 0 El 4GB. Maintenance of fingernails El 41. Wiping cloths; properly used and stored (9 El 42A. Washing Produce - following chemical manufacturers label 6) 0 El 428. Washing produce (9 420. Washing produce- chemicals 0 Proper Use or Utensils IN OUT cos REPEAT 43. In-use utensils: properly stored El 44. Utensils. equipment linens; properly stored. dried. and handled G) El 45A. Single-use! single service articles properly stored and used. required (5) 0 CI 453. Single-use/service articles use limitation. kitchenware and tableware preventing (D 0 El El contanuna?on 46. Gloves used properly (9 0 El El Utensils. Equipment and Vending IN OUT COS REPEAT 47A. Food non-food contact surfaces cleanable El 478. Food contact surfaces [utensils cleanability. molluscan shellfish tanks. consumer self? 6) sen/Ice 470. Properly designed characteristics: food and non-food contact surfaces. molluscan (D 0 El El shellfish tanks inspect?or Acknowledged R.eceEt_f Page 4 of 6 Food Establishment Inspection Report FDA Utensils. Equipment and Vending IN OUT cos REPEAT 43A, Warewashing facilities: installed. maintained. used; test strips (9 El 483. Operational warewashing machines (9 0 El El 49. Non-food contact surfaces clean (9 0 El 2 OUT NIA COS REPEAT El [Physical Facilities El 50. Hot 8: cold water available; adequate pressure 51A. Plumbing installed; proper backflow devices 51 B. Prohibiting a cross-connection. inepectlon and servicing system 510. Approved system and cleanable fixtures. service sink 52A. Sewage and waste water properly disposed 528. Grease traps easily accessible for cleaning 520. Removing mobile food establishment waste 53A. Toilet facilities; properly constructed, supplied. cleaned 538. Toilet tissue availability 54. Garbage refuse properly disposed; facilities maintained 55A. Physical facilities installed. maintained. clean 553. Private homes and living or sleeping quarters. use prohibition 0000000000000 0 56. Adequate ventilation lighting; designated areas used ONLY REGULATIONS Rules and Regulations adopted for use in Massachusetts only. [Facilities IN our cos REPEAT 57A. Catering 0 El 578. When plans are reviewed. prerequisite for operations- valid permit 0 0 El 570. Contents of plans and specifications. preoperational inspections 0 0 El El 58. Mobile Food Operations 0 59. Temporary Food Establishments 60. Residential Kitchens 0 0 El Procedures IN OUT COS REPEAT 61. Anti?choking Procedures 0 0 El 62. Tobacco Products: Notice and Sale 0 0 CI El 63. Food Allergy Awareness Requirements (9 0 El El Narrative Freezer compressor is leaking enough to have significant ice build up. Provide maintenace to walk in freezer. (is- . ?err?ci?-?lm: lnspectoF Acknowledged Receipt Page 5 of 6 Food Establishment Inspection Report - FDA Fail Notes Summary Fail Code Fail Text Insects, rodents. animals not present 6-202.13 Insect Control Devices. Design and Installation 'Addl Notes: [Mice are being baited inside of the kitchen. Contact pest control and obtain traps for inside of a food establishment. 6-501.111 *Controlling Pests Addl Notes: [Pest droppings observed beneath 3 bay sink. Fifi in notes with steel wooi. property ctean up and remove droppings. 9/152 Qw? 'inspector? chnow?ledQEd Receipt Page 6 of 6 QEitp 0t ?tehturh BOARD OF HEALTH City Hall Room 311 I'v- We? Kid?st?ixi'?. 85 Geor Hassett Drive - Medford, ?assachusetts 02155 539113531053} Telephone (781) 393?2560 FAX: (781) 393-2562 TDD: (781) 393?2516 Food Establishment Inspection Report Insp Date: 5/7/2018 Business ID: MA000015 Inspection: M3000264 Business: Andrews Middle School Permit 3000 Mystic Valley Parkway Phone: Health Director: 037400 Melanie Dineen Medford. MA 02155 Reason: 01. Routine Results: Next Routine 180 Time In Time Out Date In Out Insp Travel _TotaI Mileage?-Naes 7 _w 05/07/13 12:30 PM 12:43 PM 0:19; . 9m 0:13 0 Total: 0:13 0:00 0:13 0 .I [Inspection Summary Official Order for Correction: Based on an inspection today. the items checked indicate violations of 105 CMR 590.000/ 2013 Federal Food Code. This report. when signed below by the Inspector constitutes an order by the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and/or fines. If aggrieved by this order, you have the right to a hearing. The request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. PIC Name Linda Bottari Chokesaver Risk Category 2 Certified Food Protection Manager CFPM Exp Date Certified Allergy Trained Name 7 Allergy Exp Date Permit Posted In 0 Out 0 Inspection Report Available In 0 Out 0 Foodborne Illness Complaint Investigated (All) Involving More Than Two Persons Inspection Report Provided by: e-mail Hardcopy [j FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS Compliance status: IN in compliance OUT not in compliance N10 not observed MA not applicable Marked in appropriate box for COS and/or R. COS corrected on-site during inspection repeat violation Risk factors are improper practices or procedures Identi?ed as the most prevalent contributing factors of foodborne illness or injury. Public Health Interventions are control measures to prevent foodborne illnesses or Injury. Supervision IN OUT NIO NIA COS REPEAT 1. PIC Present. Knowledge and Duties El 2. Certified Food Protection Manager G) 0 El V: Inspector Acknowledged Receipt Page 1 of 7 Food Establishment Inspection Report Employee Health Responding to Contamination Events 1 IN OUT MD MA COS REPEAT 3A. Employee Health: PIC Knowledge. Responsibilities Reporting (9 El 38. Employee Reporting to PIC (9 El 4. Proper Use of Restriction Exclusion G) El 5. Clean-up of Vomiting and Diarrheal Events (9 0 El El Good Hygienic Practices IN OUT NIO NIA COS REPEAT 6A. Proper eating, tasting. drinking. or tobacco use (9 68. Preventing contamination when tasting 7. No discharge from eyes. nose. and mouth (9 0 El E1 Control of Hands as aVehicIe of Contamination IN OUT NIO COS REPEAT 8A. Hands clean 8. properly washed (9 BB. Where to wash. hand antiseptics G) 0 El El 9. No bare hand contact with RTE food or a pure-approved alternative procedure (9 0 El properly allowed 10A. Adequate handwashing sinks properly supplied and accessible (9 0 El El (9 108. Handwashing sinks accesible with proper signage. handwashing aids Approved Sources IN OUT COS REPEAT 11A. Milk. eggs. juice. and processed food (9 El 118. Fish and shellfish (9 El 110. Game animals and wild mushrooms 0 (9 Cl 12A. Food received at proper temperature 0 0 El El 128. Shipping and receiving frozen food 6) 0 Cl 13. Food in good condition, honestly presented. safe. unadulterated (9 El 138. Food package integrity (9 [1 14A. Required records available: shellstock tags. parasite destruction 0 (9 El El 148. Missing shellstock tags. destruction 0 El 140. Parasite destruction? storing raw/partially cooked fish 0 (9 El CI Question from Contamination IN our cos REPEAT 15A. Food separated 8: protected (9 0 El 156. Cleaning equip/utensilslfood containers 6) El 16A. Food-contact surfaces: cleaned sanitized immersion 171? and above 9 0 El El 168. Food contact surfaces cleaned and sanitized NMT 194? F. NLT 180? (9 0 El El 160. Mechanical warewashing equipment sanitization food contact surfaces. G) equip. utensils (9 El Proper disposition of returned. previously served reconditions. unsafe food InspectoF Acknoleged Receipt Page 2 of 7 Food Establishment Inspection Report Ema/Temperature Control for Safety Food (TCS Food) 18A. Proper cooking time temperatures 188. Whole meat cooking and sewing, storing 180. Microwave cooking of raw animal foods 19. Proper reheating procedures for hot holding 20. Proper cooling time temperatures 21. Proper hot holding temperatures 22. Proper cold holding temperatures 23. Proper Date Marking 2538 T08 Foods Disposition 24A. Time as a public health control: procedures 248. Time as a public health control: temperatures discarding food 24C. Time as a public health control: highly susceptible population (HSP) I Consumer Advisory i 25. Consumer advisory provided for raw or undercooked foods Highly gu-sc-eptible Populations (HSP) i 26A. Pasteurized foods used; prohibited foods not offered 268. Reservice of foods [Chemical mi 27. Food additives: approved and properly used 28A. Toxic substances identified, stored and used 288. Poisonous materials, sanitizers. additives. medicines restriction. separation. storage 280. Conditions of Use: law Conformance with Approved Procedures 29A. Compliance with variance. specialized process. HACCP plan 298. Treating juice- HACCP. reduced oxygen packaging wlout variance. conformance with approved procedures 290. When HACCP plan is required LI OUT NIO COS REPEAT 000000000000 0 0 OUT 0 00000000000 MK96900000000 MIA (COS REPEAT El El COS REPEAT El COS REPEAT Cl El El El El COS REPEAT GOOD RETAIL PRACTICES Good Retail Practices are preventative measures to control the addition of pathogens. chemicals, and physical objects into foods. IN In compliance OUT not in compliance COS - corrected on -site during inspection REPEAT repeat violation lSafe Food and Water 30. Pasteurized eggs used where required 66% Inspector Acknowledged Receipt IN OUT NIO NIA COS REPEAT Page 3 of 7 Food Establishment Inspection Report Safe Food and Water I 31A. Water 8. ice from approved source 31 8. Sampling, alternative water supply 31C. Sampling report 32. Variance obtained for specialized processing methods Food Temperature Control 33A. Proper cooling methods used; adequate equipment for temperature control 333. Frozen food 34. Plant food properly cooked for hot holding 35. ApprOVed thawing methods used 36A. Thermometers provided and accurate 368. Thermometers function properly IN 0 00 006696) OUT COS REPEAT 0 OUT Food Identification 37A. Food properly labeled: original container 378. Food labels, labeling of ingredients IPrevention of Food Contamination 38A. insects. rodents. animals not present 388 Handling prohibition. controlling pests. prohibiting animals 39A. Contamination prevented during food storage 398. Food display; ice used as an exterior coolant prohibited as an ingredient 39C. Consumer self-service operations- utensils and monitoring 40A. Personal cleaniiness- prohibition jewelry 4GB. Maintenance of fingernails 41. Wiping cloths; properly used and stored 42A. Washing Produce - following chemical manufacturers label 423. Washing produce 420. Washing produce~ chemicals Proper Use of Utensils 43, In-use utensils; properly stored 44. Utensils. equipment linens; properly stored, dried. and handled 45A. Single-use! single service articles properly stored and used. required 453. Singie-uselservice articles use limitation. kitchenware and tableware preventing contamination 46. Gloves used properly 0/167 mam. Inspector NIO 000000 2992 @603 COS REPEAT OUT COS REPEAT 0 El 0 El El OUT COS REPEAT OUT COS REPEAT Page 4 of 7 Food Establishment Inspection Report Utensil?s.Equipmentand Vending IN OUT COS REPEAT 47A. Food non-food contact surfaces cleanable G) CI 478. Food contact surfaces futensils cleanability. molluscan shellfish tanks, consumer self? (9 0 El El servrce 4TC. Properly designed characteristics: food and non-food contact surfaces, molluscan G) El shellfish tanks 48A. Warewashing facilities: installed. maintained. 8t used; test strips (9 0 El El 468, Operational warewashing machines (9 13 Cl 49. Non-food contact surfaces clean 6) 0 El El Physical Facilities IN OUT COS REPEAT 50. Hot cold water available; adequate pressure G) 0 El 51A. Plumbing installed; proper backflow devices G) 0 El El 51 B. Prohibiting a cross-connection. inspection and servicing system El 510. Approved system and cleanable fixtures. service sink 6) 0 El El 52A. Sewage and waste water properly disposed (D 0 El El 528. Grease traps easily accessible for cleaning 0 G) El 520. Removing mobile food establishment waste (9 El 53A. Toilet facilities; properly constructed, supplied. cleaned G) 0 El El 538. Toilet tissue availability (9 El 54. Garbage refuse properly disposed; facilities maintained (9 0 El El 55A. Physical facilities installed. maintained. clean G) 558. Private homes and living or sleeping quarters. use prohibition El 56. Adequate ventilation lighting; designated areas used (9 0 El El IMASSACHUSETTS ONLY REGULATIONS Rules and Regulations adopted for use in Massachusetts only. Facilities IN OUT COS REPEAT 57A. Catering 0 0 El El 573. When plans are reviewed. prerequisite for operations- valid permit 0 El 570. Contents of plans and specifications. preoperational inspections 0 58. Mobile Food Operations 0 0 El 59. Temporary Food Establishments El 60. Residential Kitchens 0 0 CI El Procedures IN OUT COS REPEAT 61. Tobacco Products: Notice and Sale G) l] 62. Food Allergy Awareness Requirements 0 0 El El Inspector Acknowledged RecEpt Page 5 of 7 Food Establishment Inspection Report with Manager LA ?y?mm inspector Acknowledged Receipt Page 6 of 7 Food Establishment Inspection Report Fail Notes Summary Fail Code Fail Text 38A. Insects, rodents. animals not present 6-501.111 (A. B. D) *Controlling Pests . Addl Notes: [Last invoice on premesis for pest control was 02/28/18. Provide a pest control log (with details on finding-either on the premesis or available electronically for reference. 1 41. Wipin_g_cloths; properly used and stored 3-304.14 Wiping Cloths. Use Limitation Addl Notes: [Wet single use Wiping cioths on counter wet. in use wiping cloths that are wet must be stored in a bucket of sanitizer solution. 44. Utensils. equipment linens; properly stored. dried. and handled 4-901.11 Equipment and Utensils. Air-Drying Required Addl Notes: [Employees observed to be drying food trays (plates) with paper towels. All dishes must be air dried. 52B. grease traps easily accessible for?cleaning 5-402.12 Grease Trap Addl Notes: [Greast trap records need to be on location. ?7137 (16% Quit/tam _lEpector Acknowledget?eceipt Page 7 of 7 (titty 0f :itiiehturh BOARD OF HEALTH City Hall Room 311 85 George Hassett Drive - Medford, Massachusetts 02155 52311939115133} Telephone (781) 393-2560 FAX: (781) 393-2562 TDD: (781) 393-2516 Food Establishment Inspection Report Date: 11/19/2018 Business ID: MA000015 Inspection: Business: Andrews Middle School Permit 3000 Mystic Valley Parkway Phone: Health Director: 037400 Melanie Dineen Medford, MA 02155 Reason: 01. Routine Results: Next Routine 120 Time In Time Qt? . Date _Out? __In?sp? Trev?el- Total? Tri?e?gs Notes AM 11:43 AM 0:15 0:00 0:15 0 Total: 0:15 0:00 0:15 0 [InspECti?on SEmEa-ry' T. Official Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.00011 2013 Federal Food Code. This report. when signed below by the Inspector constitutes an order by the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and/or fines. If aggrieved by this order, you have the right to a hearing. The request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. PIC Name Linda Bottari Chokesaver Risk Category 2 Certified Food Protection Manager CFPM Exp Date Certified Allergy Trained Name Allergy Exp Date Permit Posted In (9 Out 0 Inspection Report Available In 0 Out 0 Foodborne Illness Complaint Investigated (All) Involving More Than Two Persons Inspection Report Provided by: e-mail 1] Hardcopy [j FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS Compliance status: IN in compliance OUT not in compliance NIO not observed not applicable Marked in appropriate box for COS and/or R. COS corrected on?site during inspection repeat violation Risk factors are improper practices or procedures Identi?ed as the most prevalent contributing factors of focdborne Illness or njury. Public Health Interventions are control measures to prevent foodhorne illnesses or Injury. IN OUT COS REPEAT Supervision 1. PIC Present. Knowledge and Duties G) 0 El El 2 Certified Food Protection Manager (9 m} {If} $112501; Inspector Acknowledged Receipt Page 1 of 7 Food Establishment Inspection Report OUT NIO COS REPEAT 0 Ci [3 i] OUT COS REPEAT OUT NIO NIA COS REPEAT El Employee Health I Responding to Contamination Events 3A. Employee Health: PIC Knowledge. Responsibilities Reporting 38. Employee Reporting to PIC 4. Proper Use of Restriction Exclusion 5. Clean-up of Vomiting and Diarrheal Events Good Hygienic Practices 6A. Proper eating. tasting. drinking. or tobacco use 68. Preventing contamination when tasting 7. No discharge from eyes. nose. and mouth Control of Hands as a Vehicle of Contamination 8A. Hands clean properly washed 0 88. Where to wash. hand antiseptics 9. No bare hand contact with RTE food or a pre?approved alternative procedure properly allowed 0 0 El El OUT NIO NIA COS REPEAT 10A. Adequate handwashing sinks properly supplied and accessible 108. Handwashing sinks accesible with proper signage. handwashing aids Approved Sources 11A. Milk. eggs. juice, and processed food 0 0 El 118. Fish and shellfish 110. Game animals and wild mushrooms 0 6) El 12A. Food received at proper temperature 0 G) 0 El E1 128. Shipping and receiving frozen food 0 El 13. Food in good condition, honestly presented. safe. 8. unadulterated CI 138. Food package integrity 0 0 El El 14A. Required records available: shellstock tags. parasite destruction 0 (9 148. Missing shellstock tags. destruction 0 C9 El 140. Parasite destruction- storing rawlpartially cooked fish 0 G) El ?otection from Contamination OUT NIA COS REPEAT 15A. Food separated protected 0 158. Cleaning equip/utensils/food containers 0 0 El El 16A. Food-contact surfaces: cleaned sanitized immersion 171? and above (9 [21 El 168. Food contact surfaces cleaned and sanitized NMT 194? F. NLT 180? E) El El 160. Mechanical warewashing equipment sanitization food contact surfaces. 0 0 El E1 equip. utensils 0 El El Proper disposition of returned. previously served reconditions. 8. unsafe food f2 tar??nu ar?fixb??g?i/L?ep?Ch/ Inspector I Acknowledged Receipt 1' Page 2 of 7 Food Establishment Inspection Report Timefl'emperature Control for Safety Food (TCS Food) - I IN OUT NIO COS REPEAT 18A. Proper cooking time temperatures 0 (9 0 El El 188. Whole meat cooking and serving. storing (9 Cl 180. Microwave cooking of raw animal foods 0 G) El 19. Proper reheating procedures for hot holding G) [3 El 20. Proper cooling time 8; temperatures G) 0 21. Proper hot holding temperatures (9 0 El El 22. Proper cold holding temperatures 0 0 El [3 23. Proper Date Marking 0 (D El 235. TCS Foods Disposition (9 El 24A. Time as a public health control: procedures 0 El 248. Time as a public health control: temperatures discarding food 0 (D El 240. Time as a public health control: highly susceptible population (HSP) (D lConsumer Advisory IN OUT NIO NIA cos REPEAT 25. Consumer advisory provided for raw or undercooked foods 0 Susceptible Populations (HSP) IN OUT NIA cos REPEAT 26A Pasteurized foods used; prohibited foods not offered G) 0 El El 268. Reservice offoods (E) El [chemical IN OUT Nro NIA cos REPEAT 27. Food additives: approved and properly used 6) El 28A, Toxic substances identified. stored and used (9 0 El El 288. Poisonous materials. sanitizers. additives. medicines restriction. separation. G) El storage 280. Conditions of Use: law (9 Conformance with Approved Procedures IN OUT NIO NIA COS REPEAT 29A. Compliance with variance. specialized process. HACCP plan 0 (9 298. Treating juice- HACCP. reduced oxygen packaging wicut variance. 0 G) El conformance with approved procedures 290. When HACCP plan is required 0 GOOD RETAIL PRACTICES Good Retail Practices are preventative measures to control the addition of pathogens. chemicals. and physical objects into foods. IN In compliance OUT not in compliance COS corrected on -site during inspection REPEAT repeat violation ?re Food and Water IN OUT NIA cos REPEAT 30. Pasteurized eggs used where required 0 El creep/Lesa Inspector Acknowledged Receipt Page 3 of 7 Safe Food and Water 31A. Water ice from approved source 31 B. Sampling. alternative water supply 31C. Sampling report 32. Variance obtained for specialized processing methods Food Temperature Control 33A. Proper cooling methods used; adequate equipment for temperature control 338. Frozen food 34. Plant food properly cooked for hot holding 35. Approved thawing methods used 36A. Thermometers provided and accurate 368. Thermometers function properly FoocLEstablisjrnent ection Report IN 0 OO OUT NIA COS REPEAT 0 OUT [Food Identification 37A. Food properly labeled; original container 378. Food labels. labeling of ingredients [Prevention of Food Contamination 38A. Insects. rodents. 8. animals not present 388. Handling prohibition, controlling pests. prohibiting animals 39A. Contamination prevented during food storage 398. Food display; ice used as an exterior coolant prohibited as an ingredient 39C. Consumer self-service operations- utensils and monitoring 40A. Personal cleanliness- prohibition jewelry 408. Maintenance of fingernails 41. Wiping cloths; properly used and stored 42A. Washing Produce following chemical manufacturers label 428. Washing produce 420. Washing produce- chemicals Proper Use of Utensils 43. ln-use utensils; properly stored 44. Utensils; equipment linens; properly stored. dried. and handled 45A. Single-use! single service articles properly stored and used. required 458. Single-use/service articles use limitation. kitchenware and tableware preventing contamination 46. Gloves used properly -11- lnspector I Acknowledged Receipt 0 MO EQQE COS REPEAT OUT COS REPEAT 0 El El 0 El El OUT COS REPEAT OUT COS REPEAT Page 4 of 7 Food Establishment Inspection Report Utensils. Equipment and Vending IN OUT cos REPEAT 47A. Foocl non-food contact surfaces cleanable El 478.. Food contact surfaces lutensils cleanability. molluscan shellfish tanks. consumer self? (9 serwce 47C. Properly designed characteristics: food and non-food contact surfaces. molluscan G) E1 shellfish tanks 48A Warewashing facilities: installed. maintained. used; test strips 0 G) El 488. Operational machines (9 0 El E1 49. Non-food contact surfaces clean G) 0 El [1 Physical Facilities IN OUT cos REPEAT 50. Hot 8: cold water available; adequate pressure G) 0 El El 51A. Plumbing installed; proper backflow devices (9 0 Cl El 51 B. Prohibiting a cross-connection. inspection and servicing system 6) 0 510. Approved system and cleanable fixtures. service sink 6) 0 El E1 52A. Sewage and waste water properly disposed G) 0 El l] 528 Grease traps easily accessible for cleaning 0 0 El 520. Removing mobile food establishment waste (9 El 53A. Toilet facilities; properly constructed. supplied. 8. cleaned (9 El 538. Toilet tissue availability (9 0 Cl El 54. Garbage refuse properly disposed; facilities maintained (9 El 55A. Physical facilities installed. maintained. clean (9 El 558. Private homes and living or sleeping quarters. use prohibition G) l] 56. Adequate ventilation lighting; designated areas used (E) El ONLY REGULATIONS Rules and Regulations adopted for use in Massachusetts only. lFacilities IN OUT cos REPEAT 57A. Catering 0 0 El El 578. When plans are reviewed. prerequisite for operations- valid permit 0 El 570. Contents of plans and Specifications. preoperational inspections 0 0 El El 58. Mobile Food Operations 0 0 El El 59. Temporary Food Establishments 0 El El 60. Residential Kitchens 0 0 El El Procedures IN OUT COS REPEAT 61. Tobacco Products: Notice and Sale 0 62. Food Allergy Awareness Requirements G) ace/?ex ?mgaasea lnspet? Acknowledged Receipt 1 Page 5 of 7 Food Establishment Inspection Report [Discussion Manage: :?75 5111'? #75; Inspector A?kmieaged ReceipF' Page 6 of 7 Food Establishment Inspection Report Fail Notes Summary Fail Code Fail Text 8A. Hands clean properly washed 2-301.12 *Cleaning Procedure Addl Notes: [Employee observed to wash single hand at sink while other hand was inside of hot mitt. No paper towel use for drying. No soap used. Employees must use proper hand washing procedures each and every time their hands are washed. 16A. Food?contact surfaces: cleaned sanitized immersion 171? and above 4?501.111 *Manual Warewashing .. Hot Water Sanitization Temperatures Addl water santitizer set up- Hot water at 130- not suf?cient temperature)l 4-501.114 1&2) Chemical Sanitization - Temperature. pH, Concentration and Hardness Addl Notes: [Sanitizer was not set up upon arrival. Sanitizer sink was setup with BOH and corrected on site. 4-702.11 *Frequency of Sanitization of Utensils and Food?Contact Surfaces of Equipment Addl Notes: {No sanitizer in use upon arrival for food contact equipment. Provide santizer for all food contact equipment and surfaces. 22. Proper cold holding temperatures *Cold PHFs Maintained at or Below 410F- also pertains to untreated eggs Addl Notes: [sandwiches at cold services at 45. Cool sandwiches to 41 in walk in before service. 23. Proper Date Marking Date marking: RTE. TCS Addl Notes: [items such as turkey not labeled with a use by date. Items such as apple dessert not named with a name. Provide proper date marking for all TCS, RTE foods} 38A. Insects. rodents. animals not present 6-501.111 (A. B. D) *Controlling Pests Addl Notes: does not have knowledge of pest control. Maintain up to date knowledge of pest control situation. 48A. Warewashing facilities: installed. maintained, used; test strips 4204.115 Warewashing Machines. Temperature Measuring Devices Addl Notes: {dish machine heater is not working. not in use at this time. 4-501.110 Mechanical warewashing equipment. wash solution temperature 528. Grease traps easily accessible for cleaning 5402.12 Grease Trap Addl Notes: grease t?tp pumping record present. Maintain grease trap pumping records. Inspector Acknowledged Receipt? Page 7 of 7 (titty of BOARD OF HEALTH City Hall Room 311 85 George Hassett Drive Medford, Massachusetts 02155 Telephone (781) 393-2560 FAX: (781) 393?2562 TDD: (781) 393?2516 Public Health Prevent. Promote. Protect. Food Establishment Inspection Report Date: 5/20/2019 Business ID: MA000015 Inspection: Business: Andrews Middle School Permit 3000 Mystic Valley Parkway Phone: Medford, MA 02155 Time In lj'ime Out Date In Oit_. Travel _T_9tal ?05l20/19 11:50 1:35 0:00 1:35 Total: 1 :35 0:00 1 :35 Health Director: MPH002 Sophie Antoine Reason: 01. Routine Results: Next Routine 180 ?Milea?ge 0 ?tgi inspection Summary 1 Official Order for Correction: Based on an inspection today, the items marked indicated violations of 105 CMR 590.000 and applicable sections of the 2013 FDA Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and cessation of food establishment operations. If you are subject to a notice of suspension, revocation, or non-renewal pursuant to 105 CMR 590.000 you may request a hearing before the board of health in accordance with 105 CMR PIC Name Linda Bottari Certified Food Protection Manager Risk Category 2 CFPM Exp Date Certified Allergy Trained Name Allergy Exp Date Linda Bottari . ChokeSaver Exp Datelti?i2?9_ Certified ChokeSaver Name Permit Posted In (9 Out 0 Inspection Report Available In 0 Out 0 Foodborne Illness Complaint Investigated (All) Involving More Than Two Persons [1 Inspection Report Provided by: Hardcopy FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS e-mail Compliance status: IN in compliance OUT not in compliance not observed MA not applicable Marked in appropriate box for COS and/or R. COS corrected on-site during inspection repeat violation Risk factors are improper practices or procedures identified as the most prevalent contributing factors of foodborne illness or niury. Public Health Interventions are control measures to prevent foodborne illnesses or Injury. - 43r?