(781) 286 8176 FAX (781) 286- 8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA '02151 Name Date of atlon cod Service ?ouiine Address at k? Retail [3 Re?inspection I 3 [.7fo 57? Leiel Residential Kitchen Previous Inspection 9 ep one Mobile Date: Owner 13" QI HACCP YIN Temporary Pre-operation Q3 Caterer E) Suspect Illness Person In Charge (PIC) MECCA Md Time Bed Breakfast 322%: Complaint . . In: ?5"?me vW/a 57231 H. warm oat: eras Fem" Other Each violation" check?d requires an explanation on the narrative page(s) and a citation of speci?c provisionls) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009 IE) 590-009 (F) action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT El 1. PIC Assigned Knowledgeable Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. Receiving/Condition 6. Tags/Records/Accuracy Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation/ Segregation] Protection 9. Food Contact Surfaces Cleaning and Sanitizing 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 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 26. Water. Plumbing and Waste 27. Physical Facility . 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures El 17. Reheating 18. Cooling El 19. Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories To FoodbOrne Illnesses Interventions and Risk Factors (Red Items 1-22): Of?cial Order for Correction: Based on an ins?edion 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. If aggrieved by this order. you have a right to a hearing. Your request must be in writing Number of Violated Provisions Related 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. as Other DATE OF REJNSPECTION: [n Wad?Awe PIC's Signet . M/m Print. 6R A Page?r of 4 Pages Establishment Name: Address: $12,455 SDAML 5- Date: [0/25/17 Page: Item Code Critical Item No. Reference - Red Item DESCRIPTION OF VIOLATION a' PLAN OF PRINT Date Veri?ed 60/; [21?1453 Im'?h? um,? r4 Am. I555 9mm aka/u 4m mum?s?? Mug Pigg? Aw! 2-4517 5:63 Emir 3 ?h?F'r Qn-t to?p?? 013}; I .320? Quads. 0'th 201'?? Discussion With Person In Charge: Fro- Pith? I I: fmdcoddnar doc City of Revere (731) 286- 8176 . . FAX (781) 266- 8369 FOOD ESTABLISHMENT INSPECTION REPORT or HEALITH 249R Broadway "tT'i'I? .Izns ?If-$31161 Revere,1,MA_02151. . . Name 7- Date Tug of Owationis] -- - TIE 'on Doric/m wow 1? sic/T oer 39/sz m: Food Service Routine Address I, a? f' 12 Risk IZI- Retail EJ Reinspeciion "9 Ui?r?m?ii' Level Residential Kitchen Previous Inspection Telephone ?13- 1.19.2 311% El Mobile Date: Owner .15 - Fr I I HACCP YIN 1] f\ P5 11CatererII Suspect Illness Person in Charge (PIC) WC, ?'Ian'K: Time up. Bad 8 Breakfast General Compiaini . 1 In: . HACCP Inspector H. 11111111 Out' ,1on Permit No. Each violation checked requires an expianation on the narrative pagets) and a citation of speci?c provision(s) violated. Violations Related to Foodborne illness Interventions and Flisk Factors (Red Items) Violations marked may pose an imminent health hazard and require immediate corrective action as determined by tho Board ofI Health. FOOD MANAGEMENT PIC I Knowledgeable Duties EMPLOYEE HEALTH 2 Reporting of Diseases by Fo'od Employee and PIC 3. Personnel FOOD FROM APPROVED souacevu 4. Food and Water from Approved Source 5. I 6. Tags/Records/Acouracy Of Ingredient Statements "Nan- -compiiance with: Anti. Tobacco. see. one IE) 590. ooet'r') Ci 12. Prevention of Contaminatlon 'frdrIn' Hands 13. IHandwash . I I PROTECTION FROM CHEMICALS. El 14. Approved Food or. Color Cl 15. Toxic Chemicals .. 1jI TIMEITEMPERATURE CONTROLS ?(Potentially Hazardous Foods) El 16. Cooking Temperatmes I 17. Reheating. . -.7 Conformance Approved Procedures/HACCP Plans 18' Edwin-g . I .. I I. FROM CONTAMINATION - El El 8. Separ?ationiI Segregatidn] Fretaction 20" T'mi?. Health Emit"!- El 9. FOOCI Contact SDFTECBS Clepnmg and Sanitizing]: REQUIREMENTS FCIR SIJSCEPTIBLE PIUPULATIIONIS (HSPI Food and Food Preparation for HSIP El 10. Proper Adequate Handweshing CONSUMER ADVISORY I, .. 11' 600d Hygienic Practices [3 22.? Posting ofConsumerAdVIsorIes I Violations Related to .Good Retail Practices {Blue Number of Violated ProvIsIohs Related Items) CriticalI' violatiOns marked must be corrected To Foodborn'e llInesseernterventIons - 3 Immedlately 6r Within 10 days ?as determined by the Board and Risk Factors: (Rediltems 1-. of Health. Non- critical violations muSt be corrected 0' ac ed 0 a 5 immediately or within 90 days as determined by the Board Of?cial Order for orr' lion Baa in paction lth. today, the iterns' oh'etiite'd i?dicate violations of 105 CMR 0 ea . 590. Food Cede. This r'eport. when signed below by a Board of Health moron-or or its agent constitutes an order of the Board of Health. Failure to correct violations cited' In this report may 'I'e's'ult In suspension or revd'cation of the food establishment and cessation of food establishment operations. it aggrieved 'tiy this order you 23. Management and Personnel (Fe-anemooe) 24.. Food and Food Protection (rcaiiseo coo 25. and Piu?ibirig' and. Waste 27:2Physicai.Facility have a right to a hearing. Your request must be' In writing 28. Poisonous or Toxic'Materials (Fe-meadow) 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: S'gnmm?W?l mum/i. - Icy/t ditto PmSignature: .- 1fo I Print: 2, {11! Page Pages Establishment Name: a Address: KabobDate: 5/27/44?? Page: Item Code No. Reference - Critical Item - Red Item DESCRI PTION OF I PLAN OF CORRECTION ma?a? Date Veri?ed Fr in'?f fl] f" 14' Fr"; a? i?gln?rfrg' g. . 15r- "Laure-l Ah?Xr?i I . r-i er?n- 1\ [I'm?Ii} *f 11': I .. I Discussion With Person In Charge: I If?. hat/"Li IE4 fmdcoddnar do: Lalliy or nevere (781) 286-8175 BOARD OF HEALTH . FAX (781) 286-8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT Revere: MA 02151 Name Bat of atlon of the ion ?eet/moat x??mf ?716?; Food Service Routine Address . Ri?k Retail Rewinspeciion I: Firm :6 Level Residential Kitchen Previous inspection Telephone 787 '889 6:29 A Mobile Data: Temporary [3 Pro-operation Owner ?95 HACCP YIN Caterer El Suspect Illness i Ch TI [3 Bed &Breakfast General Complaint son a g? Arum iningl?lss HACCP Inspector H. wulJ' Out: .0330 Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of speci?c provisionisi violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors lRed Items) AMi-Chomng Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590-009 (E) El 590-009 IF) El action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 12. Prevention Of Contamination from Hands 1. PICA si Knowled eable Dutie 5 9 I I 5 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) 2. Reporting of Diseases by Food Employee and PIC [j 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. Receiving/Condition El 6. Tags/Records/Accuracy Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 19- Hot and Cold Holding [1 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP 16. Cooking Temperatures 17. Reheating 18. Cooling 8. Separation] Segregation] Protection 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing . . . CONSUMER ADVISORY 11' Hygienic Practices El 22. Posting of Consumer Advisories Violations Related to Good Retail Practices IBlue Number of Violated Provisions Related Items) Critical IC) 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 0f Hea'th' 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 resutt In suspension or revocation of 23. Management and Personnel 24. Food and Food Protection 25' Eqmpment and Ute-nails 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 28. Poisonous or Toxic Materials and submitted to the Board of Health at the above address 29, Special Requirements (590009) within 10 days Of receipt Of this order. 30. Other DATE OF RE-INSPECTION: H. don Inspector's SignatureW 5? I PrintSignature: A Print: [4656? Page_ of_ Page: gstablishment Name: t7 (am If Date: 7?kb Page: I of I Address: If 3t Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION - Bate No. Reference - Red Item Veri?ed -. Wm? gm?w .?Thr?f Seth-m ma?a -J (3:47er dud-t L410 Discussion With Person In Charge: MM I: fmdcodelnar doc City of Revere .. I781) 286-8176 - FAX (731) 286-8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA 02151 Name Date of ation of Ins ion gathers/1t Sudan.) ?ll] Food Service Routine Address Risk Retail Re-inspection I ?5 (Tram?rL SE Level Residential Kitchen Previous Inspection ep one ?ifl/JS?Q -KQDQ Mobile Data: . Owner ACCP YIN Temporary Pre-operatlon Zap-I Caterer Suspect Illness Person In Charge (PIC) cm ?1 I Cal: MIL an El Bed Breakfast 332%? Complaint Inspector M, lV-tS Permit No. Other Each violation checked requires an explanation on the violated. Violations Related to Foodborne Illness Interventions and Risk Factors (Red Itemsl Violations marl-zed 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] Knowledgeable] Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded narrative pageIs) and a citation of speci?c provisionIs) Non-compliance with: Anti-Choking Tobacco 590009 (E) 590.009 (F) El 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives 15. Toxic Chemicals FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. Receiving/Condition 6. Tags/Records/Accuracy Of Ingredient Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION CI 19- Hot and COM ?Olding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Food Preparation for HSP TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures 17. Heheating 18. Cooling 8. Separation] Segregation] Protection 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing CONSUMER ADVISORY 11' Good HygIenIc Practices 22. Posting Of Consumer Advisories Violations Related to Good Retail Practices lBlue 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 - - . - . . . . . Of?cial Order for Correction: Based on an ins ctIon Immedlately or Within 90 days as determined by the Board today, the items checked Indicate violations 01.1%: CMR 0f 93?? 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 23. Management and Personnel 24. Food and Food Protection . 25- Equ'Pmem ?lens? (PG-411590905) the food establishment permit and cessation of food 25- Water. Plumbing and Waste establishment operations. If aggneved by this order. you 27. Physical Facility 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 ($0.009) Within 10 days Of receipt Of this order. 0 Other DATE OF RE-INSPECTIDN: 5.- if? It Inspedor?jmw Print: I w-Ll I.) PTC's Print: 133 ((1:64 I iiEstablishment Name: Date: 5/30/17 Page: .i-bf I ddress: l5 5&er Sf "em Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date a M- agma? Mann ?mod Rw$f?km? {nah-f Sm}. run-K 71v Mini/:1 Discussion With Person In Charge: .1 - - 5/ billy or Revere (781) 286-8176 FAX (781) 286-8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA 02151 Name Date ofD ration a of Ins ion Add Ri/lf) 2.5% Eangervice ID?Rou?tineecf . e?rnsp Ion 8:8 GgP/j?f?f 1Q Letel Residential Kitchen Previous Inspection ep one Mobile Date: Temporary El Pro-operation Owner (3 i? UK HACCP YIN Caterer person In Charge! (plc, Time . Bed Breakfast General Complaint In: (fj? HACCP Inspectorj; my A 5.7 17 Out: Permit No. El Other Each violatiori checked requires an explanation on the narrative page(s) and a citation of speci?c provision(s) violated. Violations Related to Foodborne Illness Intel'venti ns 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 Knowledgeable Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source El 5. Receiving/Condition 6. Tags/Records/Accuracy of Ingredient Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation/ Segregation] Protection 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practices 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 26. Water, Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials Non-compliance with: Anti-Choking Tobacco 590009 (E) 590.009 (Fl 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) El 16. Cooking Temperatures 17. Reheating 18. Cooling El 19. Hot and Cold Holding El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 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): Of?cial 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. 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 29. Special Requirements (590,009) within 10 days of receipt of this order. 30, Other DATE OF id?: In: my items ?mac mu PIC-s Signature: Print: [:26 f? {f Page of_(Pagu I . F?zfm. u. Establ' entName- {21 0 GAUO ?mm 490 Date: Page: I of I DESCRIPTION OF VIOLATION I PLAN OF CORRECTION PLEA-5E PERT CLEARLY Item Code Critical Item No. Reference Red Item Date Verified ?pinme -- 6;me and; 1H. 1531141,! LL40 3'4 45mm.? Clem Errol; ?fa?'m pfl.}a_ ?Pnr Half} mam: 190? Discussion With Person In Charge: ?2?.ng ?4ij Ill-I I'mdcodelnzr City Of Revere (781) 286- 8176 FAX (781) 288- 8389 FOOD ESTABLISHMENT INSPECTION REPORT OF HEALTH 249R Broadway . Revere Meozrsi Name Cw . Dat ofO ation Woe ear/?uff - 8.0588! 5? gar/IS} Food Service ?Routine .I?iddress II Ri'sk Retail . .I Re?inspection I . I) L. TEN Level Residential Kitchen Telephone Ix 9' I49 I) Mobile Data: n, Temporary Cl Pro-Operation ?We" Raf ?Accp Caterer . . Person in Charge (PIC) . Time BedSIBreakfast [:lGeneraICompIaint . ,0 I: HACCP Inspector Out: ?4-4 Pefmlt - EIOther Each violation checked requires. an explanation on the narrative begets) and a citation of. speci?c provision(s) violated. Violations Related to Foddborne Illness Interventions and Risk Fgctors [Had 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 EMPLOYEE I: 2. Reporting of Diseases by Food Employee and PIC 3. Pers onnciwithI Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved =Source 5. . 6 Tags/Hecords/AcCuraCy of lngredlent Statements 7. Conformance With Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation)? Segregation] Proi?oilon 9 Food Contact Surfaces Cleaning and El 10. Proper Adequate 11. Good Hygienic Practices . i Violations?elated to Geod Retail?Practices tremat-Critical '{Ci violationsImarked must be corrected immediately day's??is'idet?'rmined by the Board of Health. Non?CriticaI (N) violations must be corrected immediately. or within EJQI as determrned by the Board of Health. 23. Managementand Personnel 24. Food and Food Protection {Fe-aireeomi) . _25. Equipm8nt and? (FQ 26. were Plumbing and Waste (Fe?5x590006) 27. Physical; Facilityn: 28. Poisonous or Toxic Materials (Fe-memooe) 29. Special Requirements (590.008) ?Non- compliance with. AntIChokIng I r'Il?ObaccoI I can. 009 5'88. 888 tr) 12. Prevention of Contamination from Hands 13. Handwash FaciIi'tIes PROTECTION FROM CHEMICALS 14. Approued Food or Color Additives 15. Toxic Chemicals It"! . CONTROLS (Potentially Hazardous Foods] 16. Cooking Temperatures [j 17. Reheating 18. Cooling I: 19. Hot and Cold Holding I I .. . -, Ni?! 1 I 20. "lime As a Public Health ContrOl REQUIREMENTS FOR HIGHLY PDPULATIONS IHSP) 21. Food and Food _Pr8parationI tor HSPII CONSUMER ADVISORY El 212.PosiingI Of'Consumer AdVIsques Number of VIoIated ProyISIons ReIated To FooIdborneI Illnesses Interiientions and Risk Factors (Re-d- Items 1-22) Of?cial Order to__r correction. Based on an Inspection today, the items checked indicate {violations of 105 CMR 590 .UDOIfederaI F?Iiod Code. This report when signed below by. a- Board of Health member}_ or its agent constitutes an order of the Boanl of Heaith. Failure to correct violations cited this report maiiresmt i'ri .Is'usIIber'Islon orieyooation of the feed establishment permn a'nizl ees'sation of food establishment gperaitons. If aggrieired by this order you have a right to a hearing. Your reqqest must be' In writing and submitted to the. Board of. Health _at the above address within 10 days of meeipt Of this order. 3.98 Other DATE OF e'I InspectOr?s Signature: If? Viki/126.. PrintPIC's Signature: I x. I-,rr Print 19"; .9344 ?lief?"i Pig? f? . (If: Establishment Name: 1 9.7, -f Address: 7 [g JANA. Item Code ,r ii Date: jig? Page: of - Critical Item No. Reference - Red Item DESCRIPTION OF VIOLATION I PLAN CORRECTION PERT El?nData Veri?ed f2? ..-I I r. {IE-val Hex-Eff - an+- 5 I. on Greer?I k) fair] Ia:- ?ir/ d. bu t-In xx a. ,f If} razraf.."" f' :11 r? . 12.14:; I'll. :1 .- r' r1?; =tr?"I 9.. Cit-7Q" I r" {Pan Inc?! i {rt/153:3-.r Tm; .- I .?in'l'if mom c? a. fry 5! 723/. ?1 1 fair,? {?71 j?lu . 7,1 v.43 it hasDiscussion With Person In Chargefur?! In! It {We/nu doc bIIy OT nevere (781) 286-8176 BOARD OF HEALTH - FAX (781) 286-8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT ReVe?ev MA 02151 Name Dat of ation of Ins ion 9716 It 9 Food Service Routine Address Risk Retail Re?inspection 65%; Level Residential Kitchen Previous Inspection eP one .. Mobile Date: Owner .7 8f (0 9? ACCP YIN Temporary Pro-operation . Caterer El Suspect Illness person in Char me Time Bed Breakfast General Complaint 9 i I "r was El HACCP Inspector H. Wt.? Outng?n Permit No. l:l Other Each violation checked requires an explanation on the narrative wards) and a citation of speci?c provisionls) Nan-compliance with: Violations Related to Foodhorne Illness Interventions and Risk Factors IRed Items) Ami-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590-009 IE) 590-009 IFI El action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1. PIC Assigned Knowledgeable Duties 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 16. Cooking Temperatures 17. Reheating El 18. Cooling El 5. Receiving/Condition El 6. Tags/Records/Accuracy of Ingredient Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 19- HOI and COM ?Olding El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSPJ El 21. Food and Food Preparation for HSP 8. Separation] Segregation] Protection 9. 'Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing CONSUMER ADVISORY El 11' Good Hygienic Practices 22. Posting of Consumer Advisories Violations Related to Good Reta_iI_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 Order for Correction: Based on an inspection or W'thm 90 days as determined by the Board 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 resutt in suspension or revocation of 23. Management and Personnel 24. Food and Food Protection 25? Equipment and 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 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 FIE-INSPECTION: New A MUS Signature: Pn'nt: my Page of Page: Establishment Name: ?do! an Date: 7/25 Page: I of I Address: Gar?t ?4 A: Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Data No. Reference Red Item PRINT CLEARLY Veri?ed a ?m ?ll-L Q2 Plane 1 - v; Egg (2 ?54m?: PM: 103:? {/Mr J- cur-ace: - gauze: 49.93.?; Flor - mm? (that: #49 (?ng (mi) W?f??f vag ?la/aura? 4159 Okay Discussion With Person In Charge: Wmc?mug' Ill-t I: foodcoddnar do: x? NEE-ifs? - 13> blty or Revere =9 rim-7?73?: tr t. .1 . (781) 286-8176 BOARD OF HEALTH ?"suag?, FAX (781) 286-8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT Revere: MA 02151 Name .- . Dat of etion of Ins ion (We Sim M-Jila Food Service Routine Add . ta'l t' ?:55 t' it. 71L 44" Rgsidential Kitchen Prevliugsl?izegrtion 9 ep one . 9 Mobile Date: CM ?78 ACCP YIN Temporary Pro?operation ner CPS Caterer Suspect Illness - Bed 8. Breakfast General Complaint Person in Charge (PIC) Clue-1 I Colc Em; "45- HACCP Inspector I t? Out: Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of speci?c provisionis) violated. Non-compliance with: Violatigns Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti~Chokin9 Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009 (E) Cl 590-009 IFI El action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT El 1. PIC Assigned/Knowledgeable Duties EMPLOYEE HEALTH [3 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. Receiving/Condition 6. Tags/Records/Accuracy Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation] Segregation] Protection 9. 'Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practices [Blue Itemsl 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 (Po-assume) 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 trim: El 12. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous FoodSI 16. Cooking Temperatures 17. Reheating 18. Cooling 19. Hot and Cold Holding 20. Trme As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSPI 21. Food and Food Preparation for HSP CONSUMER ADVISORY 22. Posting of Consumer Advisories 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 590.000/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. 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 FIE-INSPECTION: Number of Vioiated Provisions Related Mich: I Mr LI 4' Page; of Pages 0 Inspect 5' at Print: Signature: Print: I Esfablishment Name: E/em Date: 5130/1? Page: I of ?gIdress: [70 Git-54H AA Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION - Date No. Reference - Red Item Verified PRINT MY Wm?hni 03ml Hana.? M17549 ?urldop - 1??:ch (no+ cued ?1 ?at Ftp) 6017) .buwI- burg Audit: :r (-2.751; 3'3 16hr -- aw Jeni bual?lqo Q'aar'f Lama a-F . fl JP 579-9311) (6+5 Discussion With Person In Charge: 71/ U14 I: foodoodelm doc billy or Keven-.- 1 (781) 286-8176 . FAX (781) 288-8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA 02151 Name Date ofD ration of ns Ion 5&th (Ollie/'1 IE Food Service Routine Address Risk El Retail Rue?inspection Park Level Residential Kitchen Previous inspection u? . 9" 86% I EI Eatlgre-o at' Owner HACCP YIN 2P5 Caterer SUspect Illness Person in Charge (PIC) I. 4? Timed}. 5? Bed Breakfast 3 (13:12:: Complaint In: mm" H. We"! Out: 1011? Perm? Other Each violation checked requires an explanation on the narrative pagets) and a citation of speci?c provisionts) violated. Violations Related to Foodborne Illness Interventions an?ijsk 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 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. Receiving/Condition El 6. Tags/Records/Accuracy Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION - El 8. Separation/ Segregation/ Protection 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue ltemsl 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 of Health. 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water. Plumbing and Waste (chxseocos) 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Nan-compliance with: Anti-Choking Tobacco 590.009 (E) El 590.009 (Fl 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) 16. Cooking Temperatures 17. Reheating El 18. Cooling 19. Hot and Cold Holding El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSPI 21. Food and Food Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories Number of Violated Provisions Related To 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. If aggn?eved 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-LNSPECTION: Inspector's Signature: I?d-19 Print: Michael Page i of_l_ Pages Signature: (/1964? ?estas (61% Establishment Name: [741/ 565 no I Address: 5/ P/Iila Date: ,0 fag/,7 Page: of Item Code - Critical Item No. Reference Red Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date Veri?ed ln?h? Ole?n on but: 60y; no wan: U1 Discussion With Person In Charge: . '1}.qu 2" Wim x? ?24 foodcodeluar do: City of Revere (781) 286-8176 FAX (731L 295- 3339 FOOD ESTABLISHMENT INSPECTION REPORT BOARD 9F HEALTH 249R Br adway Revere MA 02151 atlons: Name Date . Tugg. of Inleon h! IIS IE Food. Service Routine Address, -i Risk Retail.- . Ro?inspeCtion 1 5 Level Residential Kitchen Previous Inspection Telephone I . (K ?1:9 '9 Mobile Date: Owner . HACCP YIN Tempmary P'Mpe'atm" itr .. El Caterer CI Suspect Illness Persian In Charge (PIC) :1 Time 0 7 Bed Breakfast 323%: Complaint . J. Inspector 1,1 out' 1015 0 Permit No. 1U Other Earth violation checked reqmres an explanation on the narrative page(s) and a citation of speci?c provisionis) 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 EMPLOYEE HEALTH 1 . 1 . 2. Reporting of? Diseases by Food Employee and PIC 3. Personnel with Infections FOOD FROM APPROVED: SOURCEI 4. Food and Water from. Approved Source El 5. ReceIVIng/Condition 1 61Tags/Records/Accuracy of Ingredient Statements El 7. Confermance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Sepa?ration/ SegregatioanrotectIon 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing . [311. Good Hygienic Practices violations Re_lated to GoodRetail'P'ractices [Bldg Items) Critical violations-marked?mbet be corrected immefdiatelybr Within 10 'da'y'sias determined by the Board of Health. Non critical (N) v-IOIat-ions? must be odrrected immediately or within 90 days-as determined by the Board of Health. . . . 23. Management and Personnel (Fe-2x590. 000) _24 Food and Food Protection: (Fcexsoo. 004) 253 Equipment and Utensils 26 Water. Plumbing and Waste 005) 274199119981 Facility .. (Powwow) 28. Poisonous arr-Texic Materials 29. Special Requirements (590.009) 30. Other 5: HS?inuponiFurm?-fl?ar: Non- compliance with: _Anti?hoking . Tobacco 590009191 590.cclei 12. Pretiention cijontamination from Hands 13. Facilities . PROTECTION FROM CHEMICALS I 14. Approved Food or Color. Additives 15 Toxic Chemicals 1 CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures 17. Reheatin'g El 18. C00 irig . . 19. Hot and Cold Holdi.ng-? 20. Time As; Public REQUIREMENTS FOR HIGHLY POPULATIONS (HSP) 21. Food?an?d Food'Preparation foriiHSP CONSUMER ADVISORY 22. Posting of ConsumerAdvisories Number of Viol?ated Provisions Related To Interventions and Risk O?iciai Order for correction: Based on an inspection today. the items checked indicate violations of 105 CMR 590 UODifederal Food Code when signed below by a Board of Health mer'iiber or its agent constitutes an order of the Board of Health. Failiire to correct violations cited" In this report may rest)? in sii's'penston dr revocatlon of the food establishment pe'rrnitand 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 Haelth at the above address within days of receipt of this order. DATE OF RE-INSPECTION: Inspector?s Signature: 1? 1 In"! .1 MIMI-1 Print: tin/11.141 1.11.4111 Signature: . 11 . - rill Print: ?:11 1 I. I Page of_L Page: tad/r I. :79 k/ Establishmen} Name: fifG'I/ I Date: 52/1?95/55 Page: Address: 37} 1953'}: Item Code - Critical Item of No_ Reference R- Red Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION PRINT CLEARLY Data Veri?ed Kin 14-: 227/ p5 {pa?73 iv: R1347 {Jun [?1056 c: 2741? Discussion With Person In Chargefoodcoddnu blty 0T nevere (731) 286-8176 BOARD OF HEALTH -. . FAX (781) 286?8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT MA 02151 Name Dat of Omationls] of Inspe_ction bi?, Mew! 9715/19 ET Food Service Routine Address I 1 Risk El Retail El Re?inspection I 5" Level Residential Kitchen Previoue Inspection eep 0"9 ?a :2 :13 Mobile Date: Ow 7 236 8? ACCP YIN Temporary Pie-operation ner Caterer Suapect Illness Person In Char PIC Time 36d Breakfast General Complaint 9 Arum!? In: ?0 l] HACCP Inspector Out: hit-.329 Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of speci?c provisionts) violated. Non-compliance with: Violations Related to Foodhorne Illness Interventions and Risk Factors (Red Items) Anti-Choking Tommi! Violations marked may pose an imminent health hazard and require immediate corrective 590-009 El 590-009 (Fl El action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1. PIC Assigned/Knowledgeable/Duties El 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 2. Reporting of Diseases by Food Employee and PIC El 14- Approved Food or ColorAdditives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. Receiving/Condition El 6. Tags/Records/Aocuracy of Ingredient Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION Cl 19. Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS 21. Food and Food Preparation for HSP El 16. Cooking Temperatures 17. Rehearing El 18. Cooling 8. Separation] Segregation] Protection El 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing CONSUMER ADVISORY El 11' 600d Hygienic Practices 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 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 a. ?3353? 590.000Ifederal Food Code. This report. when signed below by a Board of Health member or Its agent constitutes an 23' Managemem and Personne' order of. the Board of Health. Failure to correct violations 24? and Protection cited in this report may result in suspension or revocation of 25' EqLIIpment and Utensils the food establishment permit and cessation of food 25- Water . Plumbing and Waste establishment operations. If 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 and submitted to the Board of Health at the above address 29. Special Requirements (@009) within 10 days of receipt of this Older. Other DATE OF RE-INSPECTION: Inspector's Signatqu?b Print: 1 the.? PIC's Signature: ?mpa/ Print: K5935 14 a? Page?l of Page: Establishment Name: Date: 9/25?? Page: I of I iddress: .57 flu Item Code Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date a No. Reference Red Item Varl?ed ?1 gags PRINT CLEARLY Qm?u no Comes Discussinn With Persan In Charge: S?s: 7? . A W311: l?d It [Modems do: bit)! or Revere (781) 286?8176 . FAX (781) 286-8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA 02151 Name Date of 0 ation of ins ion ?an 31100! 5 I24 [i9 Food Service ?gment- Address . Risk [3 Retail El Re?in'spection I 5/ PM Level )3 Residential Kitchen Previous Inspection eep one Mobile Date: CI Temporary E) Pro?operation Owner IZPJ HACCP YIN Caterer E) Suspect Illness Person in Charge (PIC) Cheer CE: I: 4 Time?ouw Bed Breakfast El 3:29;! Complaint In: Inspector . W?r? Out: ?6 .50 Permit No. El Other Each violation checked requires an explanation on the narrative page(s) and a citation of speci?c provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590-009 IE) CI 590.009 IFI CI 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 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) 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. Receiving/Condition 16' Cooking Temperatures El 17. Reheating El 18. Cooling 6. Tags/Records/Accuracy of Ingredient Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation] Segregation] Protection 9. Food Contact Surfaces Cleaning and Sanitizing 19. Hot and Cold HOlding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSP) 10. Proper Adequate Handwashing CONSUMER ADVISORY El 11' (300d Hygienic Practices 22. Posting of Consumer Advisories 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. 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 590.000/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. 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 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water, Plumbing and Waste 27. Physical Facility (Fcoxsocoon 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF Inspector?s irn [?lls Print: Wt") PIC's Signuru% Print: - 7 Page or_l_ Pages Es?tablishment Name: ?n 52in, Date: 5/21/ Page: I of I Adgress- pm: Au.- Cm?: 0- Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Data Reference R- Red Item Ved?od Rm?ni. I R?eo SAL Lalxl- "Food PAM Discussion With Person In Charge: (.42 Wig-Lu JILL: l'mdcoddnu blty or Revere (781) 286-8176 . . .4?st (781) 286-8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA 02151 batch) Sol-lac! Address (0 8' - Sf. Telephone "lat-'96? tatt? Owner PS Person in Charge (PIC) (AI?(amort? lnspector [Aid/I5 Date Time of Op?atlohlsl of Ins ion {Cl/g1 Food Service ?cutlne Risli El Retail Re-inspection Level Residential Kitchen Previous Inspection Mobile DDate: Temporary Preoperation HACCP VIN Caterer Suspect Illness Time 5 El Bed Breakfast General Complaint in: El HACCP Out: qr-l? Permit No. Other Each violation checked requires an explanation on the narrative pagets] and a citation of speci?c provisionts) 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 El 1. PIC Assigned Knowledgeable Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. Receiving/Condition El 6. Tags/Records/Accuracy Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation] Segregation] Protection 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practices [Blue ltemsl 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. 0 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water. Plumbing and Waste Nan-compliance with: Anti-Choking Tobacco . 590.009 (El 590.0os (F) [j 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 FoodsI El 16. Cooking Temperatures 17. Reheating El 18. Cooling 19. Hot and Cold Helding El 20. Time As a'Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSP) El 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): Of?cial 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 27. Physical Facility 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: nmr??uli?nc I Inspector 5 Signature: Prmt: IC [42? I I4 Signature: PageL of_rPage Print: Mil Establishment Name: Annual/7 SCI) 00 Date: [0 l2b/I'7 Page: of Address: 6 2 56 Item Code 0- Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item Veri?ed PLEASE PRINT CLEARLY Raine}; ln?pm?hcr?im Ew'lLupah ?n ?It/(5rd walk-1:0 ?ver?(r- Old-nice? +5 ?34 r?nslalarm-I Discussion With Person In Charge: . l; fundcm?'llr City of Revere (781) 286-8176 BOARD eF HEALTH FAX (781) 283. 8369 I: 249R Broadway ESTABLISHMENT INSPECTION REPORT - Revere MARI-5.1. Name Date -Of0 ations Oilns? ion 1 i In? It 1590/ 5 IfFood Service - I. - [E?odtine Address . Ri'sk Retail. . - Elle-inspection 5r?? (l 71?? (Mew A Level Realdential Kitchen Previous Inspection Telephone l- 313- Mobile .-. Date: mg. "Temporary Pre'so'p'EratIOn owner A. I95 . w? Caterer . person in Char Time Bed 8. Breakfast General Complaint 9 Mo?v?v?ic? In: HACCP Inspector (A 0 US Out: Permit No. Other Ea?ch violation checked requires ah explanation on the narrative pageis) and a citation of speci?c provision(s) violated. Non- -compllan'ce with: Violations Related to FOOdborne Illness Interventions and Flisk Factors lRed Items) AMP C-hoking Tribe?? Violations marked may pose. an imminent health hazard and req uire immediate cerrectives 590- 009:15) CI 59041? IFI El action as determined by the Board Of Health. FOOD PROTECTION MANAGEMENT- 1. PIC Assigned Knowledgeable [Duties EMPLOYEE HEALTH .r . 2. Reporting of Diseases bylFood Employee and PIC El 3. Personnel with InfectiorisRestricted/Excluded FOOD FROM APPROVED 4, Food and Water from Approved Source CI 5. ReceIVIng/Condition I. 6. Tags/Records/Accuracy Of Ingredient Statements 7. Conformance With/Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATIQN 8. Separation} Promotion 9. Food Contact Surfaces Cleaning and Sanitizing 1.0. Emper Adequate Ha'ndwashin'g 11. Good Hygienic Practices I Violations Related to Good Retail. Practices {Blush Items) Critical ICI VICE-lotions. marked must be corl'ected immediately or Withih .10: days? as?determmed by the Board of Health. Non- must be correlated immediately or within 90 days as determined by the Board of Health. . . . 23. Managemem ?snaziee'r's'onnei 24. Foodfa'n'd.? Food Pipte?etlon {Foams-some} ?do: 12. Prevention of' Contamination f'rOan Hands 13. Handwash PROTECTION FROIVI CHEMICALS El .14. Approved Food or Color Additives 15. To'xic Chemicals - . CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures 17.:Reheating El 18. Copling 19. Hot and: Cold Holding. 20. Time As a Public Health. FOR POPULATIONS 21. Food and Food CONSUMER ADVISORY 22. Posting of Consumer AdVIsorIes Number of Violated To Foodborn'e? and Risk Factors (Ra'd- Items'1 22): Of?cial Order for correctiOn: Based on an today, the items check?d'in'dicate violations of 105 CMR 590. unaffederal Food Code. This report when signed below .by a Board of Health rhe'mb?r or its agent constittites an order of the Board of Health. FailI'Ire tO correct vidla?tipns cited In this report may result In suspension or revocation of 25? Eqmpment and Ut'ens?s 4Jl$0005l the food establishment permit anp cessation of food 25' Water. Plumbing and Waste (FC5II590 005) establishment operations if aggrieved by this order .you Facility .s . ooh have a right toe nearing, Your request must be' In vm'ting 28. Peisonous or ToxicMate?riais and T'the Beard of Haaiih at the above address 29. Special Requirements (590.009) within 10 days of receipt Of this Order. 30. Other DATE OF Inspector 5 Signature Wit ?Lt ILLIAAEL Print: /?1r?1 I Li If, PIC'sSignnturIcg. 4? Print: .C/l PageiofiPagu Establishment Name: 1: inc of Address55/55:? Date: is: Page: Date Item Code Critical Item No. Reference - Red Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION ENTCLEARLY Veri?ed A {mpg - a! Elie I I C3 ?7 Discussion Person In Charge: - .. I (Jim-J fmxkoddlur blIy OT nevere (781) 286-8176 FAX (781) 286-8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA 02151 Name Dat Type of Operationlsl Type of Inspection [Lincoln Q'Izli?g Food Service Routine Address G- 1! are; Retail [1 Re-inspection I 3? 5 Laval Residential Kitchen Previous Inspection 9 9P one .. age: Mobile Data: Owner 78" a e, HACCP YIN El Temporary Pro-operation (.105 Caterer El Suspect Illness Person in Char PIC Tim Bed 8: Breakfast General complaint 9 I M, In: 2?3? HACCP Inspector 1.1 Out: 5? Permit No. El Other Each violatio?n checked requires an explanation on the narrative pagets) and a citation of speci?c provision(s) Violamd. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009 590-0091Fl El action as determined by the Board of Health. 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods] FOOD PROTECTION MANAGEMENT 1. PIC Assigned Knowledgeable Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source El 5. Receiving/Condition 6. Tags/Records/Accuracy of Ingredient Statements El 16. Cooking Temperatures El 17. Reheating 7. Conformance with Approved Procedures/HACCP Plans El 18' Cooling PROTECTION FROM CONTAMINATION El 8. Separation] Segregation/ Protection 9. Food Contact Surfaces Cleaning and Sanitizing 19. Hot and Cold Holding El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSPI 21. Food and Food Preparation for HSP 10. Proper Adequate Handwashing . . . CONSUMER ADVISORY 11' Hygienic Practices [3 22. Posting of Consumer Advisories 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. 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 590.000lfederai 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 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 Help: Inspector's Signatures/WM Print: MICIIQH 00?? P105 Signature: C??kwpp/ Print: Page_?_ of; Page: Establishment Name: cal/r Date: Page: of - Aficiress: (95? Mm?! 5?3 {Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No- Reference - Red Item Veri?ed ?mhpl? Armada? f? No (?aV-uJ "Jl Discussion With Person In Charge: ?24 (Inc (M urty OT rtevere (781) 286-8176 FAX (781) 286-8369 FOOD ESTABLISHMENT INSPECTION REPORT DtIt ame Arman we?! 6773/? Address 8' Martha 86. Elskl Telephone eve Owner [cps HACCP. YIN or: me - - erson Il'l arge Chit; I C, If Ana-ant; mr'eq: 4p . Inspector pl Out: BOARD OF HEALTH 249R Broadway Revere, MA 02151 of ationtsi '?ype of Inspection ?e Food Service gremlins Retail El Re?inspection Residential Kitchen Mobile Temporary Caterer . BedEBreakfast Permit No. Previous inspection Date: Pro-operation El Suspect Illness General Complaint HACCP El Other Each violation checked requires an explanation on the narrative pageis} and a citation o_f- speci?c 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 cerrective action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned Knowledgeable Duties EMPLOYEE HEALTH 2. Reporting of Diseases by' Fo'od Employee and PIC 3. Personnel With infections Restricted/Excluded FOOD FROM APPROVED SOURCE El 4. Food and Water from ApprOVed Source 5. Receiving/Condition 6. Tags/Records/Accuracy of Ingredient Statements 7. Conformance with Approved Procedures/HACCP'PIans PROTECTION FROM CONTAMINATION 8.- Separation/ Segregation] Protection 9. 'Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing I. [111. ?Good Hygienic Practices Violations Related to Good Retail Practices iBlue 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 26. Water. Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other ?do: Non- -compiiance with: Anti-Choking. Tobacco_ 588.009 (E) 590.088 (F) El El 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS .14. Approved Food or Color Additives 15-. Toxic Chemicals. CONTROLS (Potentially Hazardous Foodsi 16._Cooking Temperatures 17. Reheating 18. Cooling 19. Hot and Cold HOlding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. 'Food and Feed Preparation for HSP CONSUMER ADVISORY El 22. Posting of Consumer Advisories ?To Foodborne Illnesses Interventions Number of'Violated Provisions Related I 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 590.000lfederal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Beard 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 RE- INSPECTION. wort: Im'm?" PIC's Signs 11m; Clay/Cite? Page Page. _Es?tablis?ment Name: [mania 3543/ Date: 5/29/17 Page: of Address: ?711mm 3* Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item Veri?ed Wm Baf?n-L: @un - ?rst! Shams]. -mpl?c?_ a? ?"9pr smh. Luz/- ?Foa?' PM My ~15 KH-rn Cairn-1 - healeu 7510? ?rrcl 4' 4144.3 rug; ?1ijme 43L J?bm-c ijbhi Chaney: WithP uscussmn arsonInCharge 1L ?2.4 I: [Mandel-w do: City or Revere (781) 23643176 BOARD OF HEALTH . FAX (781) 286-8369 249R Broadway F030 ESTABLISHMENT INSPECTION REPORT Revere. MA 02151 Name Date of ration of Ins ion cod Service outine Address 77 Risk Retail Reinspection 3 $5 EU Eli/L 5 Level Ci Residential Kitchen Previoua Inspection eep 0'19 Mobile Date: Owner 1 8? (98:0 Ea my ACCP VIN Temporary Pre?operation RPS El Caterer Suspect Illness Person in Char a me Time Bed Breakfast General Complaint 9 35?"1 In. 9:30 HACCP 4314-4 057:9 Out: to: I50 Permit No. El Other Each violation r?checltetl requires an explanation on the narrative page(s) and a citation of speci?c provisionis) violated. Non- -compiiance with: Violations Related to Foodborne Illness Interventions and Risk E__actors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009 IEI Cl 590-009 iFi action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands . . . El 1 PIC Aasrgned Know edgeable/ utIes El 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS El 2. Reportmg of DIseases by Food Employee and PIC El 14- Approved Food or Color Additives El 15. Toxic Chemicals 0U EDD: Source CONTROLS (Potentially HazardOUS Foods) El 5. Receiving/Condition 6. Tags/Records/Accuracy of Ingredient Statements 3. Personnel with Infections Restricted/Excluded 16. Cooking Temperatures 17. Reheating El 18. Cooling 19. Hot and Cold Helding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY POPULATIONS (HSP) 21. Food and Food Preparation for HSP 7. Conformance with ApprOVed Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation] Segregation/ Protection El 9. 'Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing . . . CONSUMER ADVISORY 11' (300d HyglenIc PractIces 22. Posting of Consumer Advisories 1 Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) critical (C) violations marked must be corrected To Foodborne "Inesses Interventions 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 Of?cial Order for Correctien' ?Based on an inspection ?Tmedliate'y 0r Within 90 days as datermined by the 305?? today the items checked indicate vioiations of 105 CMR 0 ea . 590.00Eiifederai Food Code. This report, when signed below by a Board of Health member or its agent constitutes an 33' order of the Board of Health. Failure to correct violations 25' i Ut il cited in this report may resuit In suspension or revocation of Equ pmen an ans 5 the food establishment permit and cessation of food 25' Water, Plumbing and (?Wm-005) establishment operations. If aggrieved by this order, you 27. Physical Facility have a Iight to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials and submitted to the Boand of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30, Other DATE OF farm: ?ins! 9/4 949K751 PIC's Sign?i?ire:/ MM Print: A RE A Kg?! Page of_1_ Page: (?aw ?c?mL E?tablishment Name: Date: Page: of ?3 97h? Item Code -Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference - Red Item PLEASE mm CLEARLY Veri?ed 3 Bl?! JIAIL Mair M11319 o?wul. fem, Janth-z??z?j b6 angler- Rl?s?f. Discussion With Person In Charge: {jaunt/fr) Ill-l {nodcoddnar doc City of Revere (781) 286- 81 76 oF HEALTH FAX (731} 233-3369 ?1124'sR Broadway . . Foal) ESTABLISHMENT INSPECTION REPORT Revert}. MA 02151: Name Dot . T1-1ot0 atlon - Ix? oflns? on ?71-?11 I -I 4/500! IQ) IE Food Service ERoutine Address - . Ri'sk Retail . Re?inspection - 2c" . . ?1 11'11Level El RESId'entiaI Kitchen Previous Inspection Telephone _1 gI I .3 $3 CI Mobile . Date; r7: . .T Temporary Pre?operatlon Owner i351 HACCP YIN Caterer Suspect Illness - - - Bed Breakfast General Corn Person In ChargejPlC) ?an-ma (TL Ema (0.1 00 IE HACCP Plain Inspector 71/.123/4' I . Out: 101- 2 c" Permit No. CI 01th Each Violation checked requIres an explanation on the narrative page(s) and a citation of speci?c provisi'on(s) violated. - - Non- compliance with: Violations Related to Foodborne 1l1 nessl1nterventions and Risk Factors IFied Itemsi 7199,9999- Violations marked may pose. an imminent health hazard and require immediate corrective 590-009 (E) 590:0091? action as determined b'v the Board of Health. 1 FOOD PROTECTION MANAGEMENT 1 El 12. PreVention' of Contamination from Hands El 1. PIC ASSIgned[Knowledgeable/Dunes 13. HIaIndwash Facilities r? EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 21:11 14. Approved Food or Color Additives 1.11:1 Chernica s111 1 1 . CONTROLS (Potentially Hazardous: Foods) El 2. Reporting oi Diseases by Food Employee and PIC 3. Personnel ?estriotediEonLIded FOOD FROM APPROVED SOURCE: 4. Food and Waterfrom Approved Source El 5. .. El 16. Cooking Temperatures II 6. Tags/Records/Accuracy- of1-I1n19redie1nt Statements 1:1 17.Reheating. 181. Cooling 7,-ICo1nformance WIth Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation] Segregatlon/ Protection 9. Food Contact Surfaces Cieamng and Sanitizing 10. Proper Adequate El 11. Good IHygiIIeniIc Practices Violations Related to Good Retail Practices {Blue Items} Critical ICI violations marked moat be corrected immediatelV orwith?in 10 days as determined by the Board of Health. Non- critical (N) violations 'must be corrected immediately or within 90 days as d'Ietermined by the Board of Health. 23. Management? and Personnel 24. Food arid Food Protection 25. Equlpment and Utensils disco. one} 216.Wa1ter. Plumbing and. Waste [Fe-summon 19. Hot and Cold Holdingi 20. TIme As a Pubiic Health Control REQUIREMENTS FOR HIGHL1Y1 S1USC1EPTIBLE POPULATIONS (HSPI 21 Food and Food Preparation for HSP in: CONSUMER ADVISORY 22. Posting of Consumer Advisories Number of Violated ProvisiIonszliielated To InterVentions and Risk . Of?cial Order for Correcm Based on an inspection today. the Items. checked Indicate violations of 105 CMR 590. ODOIfederal Food Code. This report. when sigIneId below by a Board of Health member er its agent consi'rh'rtes an order of the Board of Health. to correct violations cited in this report may 1'resuit In suspension or 'revocation of the food establishment pennit and cessation of food establishment operations. It aggrieved by this order .you 27; (FC-EJESBD-OOD have a right to a hearing. Your request must be In writlng 2.8- Materials (.Foim'smme) and submitted to the Board of Heaith at the above. address 29. Special Requirements (590.009) within 1110 days of receipt of this Or1d1er. 30. Other DATE OF RE-INSPECTION: 11131113111011 1 Signatum 11?? vi vial/LL 3/44 Print: (1?1 1x1! L5 Sign? (1 . ?in? 134: (32.: I it" 1111? 11'? Fag? Establishment Name: f??m Address: 39 [ipr? ?j Ur"r( L. if Date: 5 [,rgj/ c? Page: of Item No. Code Reference - Critical Item Red Item DESCRIPTION OF PLAN OF CORRECTION magma? um? Date Veri?ed yr -: Discussion With Person In Charge: I- ?fth-4 JIF- i'J-i' 2'53fnodcodelnu doc blIy or (781) 288-8178 gs - FAX (781) 286-8369 INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere. MA 02151 Mame gm! 2 WM 51/:qu Address 395 earl-(PC 8 IT Telephone 1 KI 3?80 ?89341 Owner RPS HACCP YIN Person in Charge (PIC) Af- nm? il'trne 1L4 . me, LL: gilt: ation 5 Food Service Retail Residential Kitchen El Mobile El Temporary Caterer Bed Breakfast Permit No. of Ins tion I?goutlne Re?inspection Previous Inspection Date: Pro-operation Suspect Illness General Complaint HACCP [3 Other Each violation checked requires an explanation on the narrative page(s) and a citation of speci?c provisionts) violated. Violations Related to Foodborne Illness Interventions and Risk Factors (Red ltemsl 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 Knowledgeable Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. Receiving/Condition El 6. Tags/Records/Accuraoy Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation/ Segregation/ Protection 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices {Blue Items) Critical (Cl 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 of Health. 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 Non-compliance with: Anti-Choking Tobacco 590.009 IE) 590.009 (Fl 12. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods] 16. Cooking Temperatures El 17. Reheatlng 18. Cooling El 19. Hot and Cold Holding El 20. Tlme As a Public Health Control 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 Illnesses Interventions and Risk Factors (Red Items 1-22): O?ic? 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. 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-INSPECTION: Inspector?s Signature:qu II I Print wot; PIC's Signature: Print Page_l_ of__I_ Page: 36W Establishment Name: QM gm 353% Dam: 9/24/18 Page; I of I Addregs: 325 all-ere lten{ Code -Critica Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Data No. Reference - Red Item Veri?ed EE PRINT CLEARLY HQ mold-1m; 6H- 7'1mCa o-p ragged/70;- Discussion With Person In Charge: A ?a m" foodcoddnu do: City of Revere (781) 286-8176 . FAX (781) 288-8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA 02151 . Name .. . atlo of Ins-Eton Paw! 24"? $512?, I4 igFood Service Routine 1 Address - - Retail Rte-inspection 39$ aw? 6* Level. Residential Kitchen Previous Inspection Telephone El Mobile Date: . El Temporary Pre?operetion Owner RPS HACCP YIN Caterer? . Suspect Illness -. Person in Charge (PIC) C4 I r. I . Time as El Bed &Br-kfast BS7223: Complaint - In: In"- . Inspector #1.de Out: Permit No. Other Each violation checked requires an explanation on the. narrative .pageis) and a citation of speci?c 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-l KnOwledgeable Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE . El 4. Food and Water from Appr?oVed'SoUrce 5. Receiving/Condition 6. Tags/Records/Accuracy Statements Nan-compliance with: Anti-Choking Tobacco . i .. 590.009 (E) 590.0091Fl El El 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals I CONTROLS (Potentially Hazardous Foods) El 16. Cooking Temperatures El 17. Reheating 7. Conformance with Approved Procedures/HACCP Plans El 18' Cooling PROTECTION FROM CONTAMINATION El 19- Hot and'Cold Holding 8. Separation! Segregation] Protection El 20- Time AS a PUbliC Health CODthl REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS 9. dCont ct Surf ces Cl'eanin 'and Sanitizin . 00 a a - 21. Food and Food Preparation for HSP 10. Proper Adequate Handwashing CONSUMER ADVISORY El 11' 600d Hygienic Practices 22. Posting of Consumer Advisories Violations Related to Good Betail Practices {Blue Number of Violated ProvisionsRelated 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 ot Health. Non-critical (NI violations must be corrected immediately or within 90 daysas determined by the Board of Health. Of?cial Order for Correction. Based on an inspection today, the items checked indicate violations of 105 CMR 590. GOO/federal Food Code. This report, when signed below . a Board of Health member or its agent constitutes an 23' Management and Personnel o?r?der of. the Board of Health. Failure to correct violations 24' F009 and Food Protection (?3690004) cited in this report may result In suspension or revocation of 25' Eqqument and Utensils (Fe-?43590005 the food establishment permit and cessation of food 26- Water. Plumbing and Waste (?5115909?) 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 and submitted-to the Board of Health at the above address 29. Special Requirements (590mg) within 10 days of receipt of this order. 30 Other DATE OF HIE-INSPECTION: do: Inspector' i re' Print: MU PIC'sSgnatu 41/ Print: .. Page of _l Pages Name: amp] ?nial 52409:, Date: Page: I of deresse 3:75 ?nial! 57-: i Hem Code C-C?ti?lltem DESCRIPTION OF VIOLATIONIPLAN OF CORRECTION Date No. Reference - Red Item mm Veri?ed Rutg? 1 Ha. ?#13914; on ?ber bag]; 'fb bun-II .2 Ham-L 92p .sm- Lake/v wax i?hp Only" .5 My. .s-mz - puzii- Clings-m I/nu} C?chr blot; wu! Discussion With Person In Charge: - 4/ City or Revere (781) 286-8176 BOARD OF HEALTH FAX (781) 286- 8369 249R Broadway ESTABLISHMENT INSPECTION REPORT ReVe'ev MA 02151 Name . Dot of ation TIE of Insmion .rll 1-;1 Ifz I Food Service Routine Address 3,;1 . wt ,f Risk Retail El Reinspection .f -- y?a? x7. It" Level Residential Kitchen Previous Inspection Telephone .I'Iit/ ?i Ci Mobile DDate: I: I, CI Temporary Pro-operation Owner If JILL: If HACCP YIN Caterer Suspect Illness person in Charge (PIC) {rm-?I .. Time Bed 8! Breakfast Complaint it?" I I .) In: HACCP Inspector r; . if?, Out: Permit No. Other Each violation checked requires an explanation on the narrative pagels) and a citation of speci?c provisionls) 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 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infectidns Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. Receiving/Condition 6. Tags/Records/Accuracy of Ingredient Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation/ Segregation] Protection 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practices 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 26. Water, Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) nether Non-compliance with: Anti-Choking Tobacco 590.009 IE) 590.009 IF) 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) El 16. Cooking Temperatures 17.Reheating 18. Cooling 19. Hot and Cold Holding 20. TIme As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSPI 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 590.0001federal 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 wn'ting and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF REJNSPECTION: Inspectors-is sw?lg?ii?iifhi . Prints-I .j . . ?/ij . $11.4} 52- PIC's SignatuFef""'i f" Print: i. If .- Page of Page: were H?l Es?ablishment Name: a Id 53509 Add ?ess: Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No- Reference - Red Item PLEASE PRINT CLEARLY Veri?ed Q?pfgu. qa;ka+ 071 101w?:? #3 P1 papa-19? @423; 7511?: CA-cgg?c?cngumf?Amc Cer'hm ?1 Char? +239 o-P wir? Clean ?10wa dm;n? Unclu- ?a?fr/ur/Ovrmg ., Clean (a Mar?rnt Discussion With Person In Charge: Ii fnodnodelnlr mm City of Revere (781) 286- 8176 FAX (77371129979369 FOOD ESTABLISHMENT INSPECTION REPORT BOARI OF HEALTH 249R Broadway Revere,.,MA 02151 Name .273. - Date of -0 atiorI a of Ins?tion tr" 1J- {#1qu Illn?f Food Service Routine Address I 7- 4/7 .- Risk Retail Rat-inspection 7? AC Level Residential Kitchen Previous inspection Telephone Mobile DateTemporary; Pra??operatbn Owner I35 HACCP YIN Caterer [:17 Suspect Illness perm)" i7? Charge (PIC) 77 Time Bed Breakfast General Complaint 7 [473? In: 307. 777 HAOCP Each Violation checked reqaires an explanation on the narrative page(s) and 7a citation specu?c provisionis) 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 the Board?of Health. FOOD PROTECTION MANAGEMENT 7 El 1. PIC Assigned [Knowledgeable Duties EMPLOYEE HEALTH 77 2. Reporting ofDiseases' by Feed Employee and PIC 3. Personnel FOOD FROM APPROVED SOURCE-- El 4. Food and Water fromI'Approved (Source El 5.ReceIVIng/Cond1tlon 7 El 6. Tags/Records/Aocuracy of Ingredlent Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. SeparatIon/Segregatlonf Protection El 9. Food Contact Surfaces Cleanlng an?d Sanitizing L721 Non compliance with: IAnti- eChoking _"I7?o7hacco77~ 7 "590. 009 IE) 590.0091FI El El 12. Prevention of Contaminatlon from Hands 13. Handwash Facilities '1 PROTECTION FROM CHEMICALS 14. Approved Food or Color. Additives 15. Toxic Chemlcals I. 7 CONTROLS 7(7P79tontlally Hazardous 7Foods) 16. Cooking Temperatures 17. Reheating El 18. Cooling 19. Hota 20. '?maAs 9 nd Cold Holding REQUIREMENTS FOR HIGHLY POPULATIONS (HSP) 21. Food and FoodIPreparation for HSP El 10. Proper Adequate HandvIIashing CONSUMER ADVISORY 11 600d Hyglenic Practices 22. Posting of ConsumerAdvi?ories olation7s7? la 3 0 Hot il Prac' ices 3 Number of Violated Provisions.=.Related Items} CrItIcal must be corrected To Foodborne l neSsesl Interventions .1- O?ici_al Order for correction: Based on an inspection of Health today, the items checked. Indicate violations 7.590. ODD/federal Food code: This r'e',port when signed below Board of. Health member or its agent constitutes an anagelrlen If?? ?e ?film-m order of the Board or Health Failure to correct violations 24' Food and Protection cited' In this report may r'?si?IIt In seepension or revocatIon of 25- Equipment and 7.7Utensils 4Il?59? 005} the road establishment pennrt'. and cessation of food 25' Water, Plumbmg and Waste .establishmentoperations. If aggrieved by thIs order you 27-.IPhysicalIFacilitIygg- (Footage-007) have a right to a hearing. Your request must be In writing 28. Poisonousrori'lloxic Materials (Fc'.7xseo.ooe) and submitted to the Board "of Health at the above address 29. Special Requirements (590mg) within 10 days of receipt of this order. 307 Other DATE OF RE-INSPECTION: I'd. do: Inspector 3 Signature; II Irmf Printgull r" .n (F 4" gnaw}! I age__ 0 ages 5-.-. . Establishment Name: hfv??fr 50": 0 3): Date: 3/ 7 if; (it Page: DESCRIPTION OF VIOLATION I PLAN OF CORRECTION of Data Veri?ed Address: Item Code No. Reference - Critical Item - Red Item We? f3: Afr. EE flirfw ?1 '54 1nf? 1- ram r; fair-mu} 511'?- . . rfr' ft? r?f?fq-th i I 7 Disgussion With Person In Chargewe; [Latit? I foodcoddnu doc billy or Revere (781) 286-8176 .. FAX (781) 286?8369 FOOD ESTABLISHMENT INSPECTION REPORT BOARD OF HEALTH 249R Broadway Revere, MA 02151 Name . Dat of 0 ration of Ins ion ?4111 SUMO I '1 I ?2 ii Food Sen/Ice Routine Address Risk Retail Re?inspection Moot ?36 Level Residential Kitchen Previous Inspection Telephone Mobile Date: El Temporary Preoperation Owner HACCP YIN Caterer Suspect Illness Person In Charge (PIC) 49! Timeqlo 39d 3* Breakfast 322%: Complaint in: Inspector N. 1 Out: 1?91 1.0 Perm It Other Each violation checked requires an explanation on the narrative pagets] and a citation of speci?c provision(s) violated. Non-compliance with: Violations Related to Foodborne illness Interventions and Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590-009 IE) 590-009 IF) 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 El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE . El 4. Food and Water from Approved Source El 5. Receiving/Condition El 6. Tags/Records/Accuracy Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation/ Segregation] Protection El 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practices {Blue Items] Critical (Cl 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. (J 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water. Plumbing and Waste (Fceitseome) 27, Physical Facility 28. Poisonous or Toxic Materials (Fe-meadow) 29. Special Requirements (590.009) 30. Other 1:1.an 12. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) El 16. Cooking Temperatures 17. Reheating El 18. Cooling El 19. Hot and Cold Holding El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIDNS IHSP) 21. Food and Food Preparation for HSP CONSUMER ADVISORY 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions 5 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 590.000/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 resutt 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 Signaturcq? I II II a I Print: Hahn? Print: Pagei Pages 51/ Estainshment Name: 1?ch I Address: Item Code - Critical Item wi?hds? Date: i?mW Page: I of! No. Reference - Red Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Pm?nn. PLEE PRINT CLEARLY Date Veri?ed 60mg. 35?? (50.13.15,: Imus) Ce (Tm: T116 nr?gl_ ohm: or Fm?rr #5 - Themes-hf 14mm @171 gal? #1 now. but #5me 32:100.:- Dls}. mazhuCL - (41435 '11:?th no+ wa/Zm, - ?Hf-cr- {Yang Rust? shelve: In .he/I' Ema/1 In (J mhr? Em th?rre' Mann; 067'!" duji jam-14449 $35.15?; QM @112. +61 amt .. 711,,Mo?l?r c' j'0. 5t t" 1?5" Discussion With Person In Charge: 06+ II. 1? Ill-l fmdcoddnardo: bIIy or nevere . . (781) 285-8176 BOARD OF HEALTH (781) 286- 8369 249R Broadway ESTABLISHMENT REPORT ReVe" e. MA 02151 Dat H) ation 5 Tim ofl ame RPUCM ?75 IA SWOO I el 1 I 9 lg Foid Service CI Rriutinnr:s ?m Add - El Retail set 1 ress lo, Moo, St ?Ed Residential Kitchen reviiu: Telephone Mobile Date: Temporary Pro-operation {2.05 HACCP YIN Caterer I3 Suspect illness Person in Charge IPIC) llama?: Emeqzss Bed 3? Breakfast 322%? Complaint Inspector H- Well-Y Out. ~33 Permit No. Other violated. Violations Rel ted to lliness Interventions and Risk Factors IRed 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 El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. Receiving/Condition 6. Tags/Records/Accuracy of ingredient Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation/ Segregation] Protection 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 of Health. 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water. Plumbing and Waste 27. Physical Facility (Fc?exwoon 28. Poisonous or Toxic Materials (Fe-mseome) 29. Special Requirements (590.009) 0. Other 5. Hi do: Each violation checked requires an explanation on the narrative pageis) and a citation of speci?c provisionis) Non-compliance with: Anti-Choking Tobacco 590.009 El 590.009 (F) El 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods] El 16. Cooking Temperatures 17. Reheating El 18. Cooling El 19. Hot and Cold Holding El 20. "lime As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 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): Of?cial Drde_r_ for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.00tilfederal 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 ri ht 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 ?emspEcrloN: m? Mic/act bout-i Inspector' Signatu 2% P105 set-array Pm? Page_L of._r Pages ?O/If/lg Establishment Name: Ha lo I Date: Page: of I Address: ?em Code - Critical Item DESCRIPTION OF VIOLATION PLAN OF CORRECTION Date 0. Reference - Red Item Veri?ed 1 mm CLEARLY l2: - [arm/100 I?'f'im; (Buff?{QM 413m 3' (75hr: ?d?l?d Jul?! War .31?ch in!" (?min Cab! hm: 111;; car-14(- Dismn With Person In Charge: (MCOKLJ 12! :lnc Ulty OT Kevere . (781) 286-8176 BOARD OF HEALTH FAX (781) 286-8369 249R Broadway INSPECTION REPORT Revere: MA 02151 Name of ration of Ins ction mun? Shine, [q Food Service i? Routine Address Risk Retail Hie-inspection Scam] 5* Level Residential Kitchen Previous Inspection 9P one a Mobile Date: Owner 3g (6?99 AGCP YIN Temporary El Pro-operation 2P5 Caterer El Suspect Illness Person In Charge (PIC) Ch?yl f. If ?4me Erne? :qo Ci Bed 3? Breakfast 3:39;! CompIaInt Inspector H.LIJMLS out: Lag-.29 Permit NC. El Other Each violation checked requires an explanation on the narrative page(s) and a citation of speci?c provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items] Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590-009(51 Ci 590-309 Ci action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands . I bl 1 PIC Ass gned/ nowle gea e/Dutles Ci 13. Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS [Potentially Hazardous Foods) El 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. Receiving/Condition 16. Cooking Temperatures 17. Reheating 18. Cooling 6. Tags/Records/Accuracy of Ingredient Statements 7. Conformance with ApprOVed Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 19- Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS 21. Food and Food Preparation for HSP 8. Separation/ Segregation/ Protection El 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing CONSUMER ADVISORY 11' HygIenIc Practlces 22. Posting of Consumer Advisories Violations Related to Good Retail Practices [_Blue Number of Violated Provisions Related Items) Critical (Cl 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 (NI violations must be corrected immediately or within 90 days as determined by the Board O?icml Order for Based on an Inspection today. the items checked indicate violations of 105 CMR Ofg'ealfh' 590.000/federal 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' F??d and F??d Protection 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 (F05lim?005) establishment operations. If 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 and submitted to the Board of Health at the above address 29. Special Requirements (590,009) within 10 days of receipt of this order. 0 Other DATE OF RE-INSPECTION: 3- A Inspector?s atu Print: I 1 I Sign me: Print: 483m 10? Page_ Page: Esta} liShment Name: aver-c Ad [a I I 12:93 SCAN 3 Date: 5/3 It 9 Page: of] Code - Critical Item DESCRIPTION OF VIOLATION 1' PLAN OF CORRECTION Data No. Reference - Red item Veri?ed Pm?sl I Grim: Cine-ac, CZ C/cohj ?hip g? glue; mil-.421 :2 bun-14 um um 131.3 .4 club: 13cm M4 bun-14' U9 LAJarA-irr' r/I Discussion With Person In Charge: I: roodcodunu doc Ulty or Revere It .- (781) 286-8176 BOARD OF HEALTH - FAX (781) 286-8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT REVere! MA 02151 Name to of 0 attor- of Ins ion ?4:be Mar/stat e?"n ect' res?s L11 ?Mng?d [9111}! Leim Residential Kitchen Telephone 7 (1310.. K3. Mobile Eats: rati "Amp 52355? I: 3335:} "miss Person In Charge (PIC) M4 El Bed Breakfast 322%: Complaint 4 7/2; Out: Permit No. Other Each violatiorl checIt'Ed requires an explanation on the narrative page(s) and a citation of speci?c 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 El 1. PIC Assigned Knowledgeable Duties EMPLOYEE HEALTH [3 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. Receiving/Condition El 6. Tags/Records/Accuracy of Ingredient Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation] Segregation] Protection 9. Food Contact Surfaces Cleaning and Sanitizing CI 10. Proper Adequate Handwashing . 11. Good Hygienic Practices Violations Related to Good Re?il 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 of Health. 0 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water. Plumbing and Waste 27. Physical Facility (Fcexwmn 28. Poisonous or Toxic Materials (Fe-momma) 29. Special Requirements (590.009) 30. Other ?.ch Non-compliance with: Anti-Choking Tobacco 590.009 (E) 590.009 (F) El 12. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods] El 16. Cooking Temperatures 17. Reheating 18. Cooling 19. Hot and Cold Helding El 20. TIme As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS El 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): O?iciaL Order for Correctm 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 aggn?eved 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 onder. DATE OF 11.11.1713), Visage/25.42 Miami 0 lC?s Signstu re: Page7L of (Pages Pm? n?eetbi idly Establishment Name: Address: MW #74ng a?leg/w/a??; Date: 7 Page: of Item Code No. Reference Critical Item - Red Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION PLEASE PRINT CLEARLY Date Veri?ed Expme?Mm 57561.19} CV) Quasar Walt/u} Discussion With Person In Charge: 1 all?: Ill-l l: [oodcoddnar doc City of Revere (7'81) 286 8176 I FAX I FOOD ESTABLISHMENT. REPORT eF HEALITH 249R Broadway Name .73) Date Type of Operatioan] Type of inspection ft In ,L/arr 11 An: Jam-c}, 3/7 ?7 .Foo-?d Service Routine Address . - Risk Retail - .Reinspe?ion . INTO A741 Lt? Level ResidentialKitchen Previous Inspection Telephone 9%9/ ??jd [3 Mobile Data: . :i El Temperary D-Preope'r'ation Owner QFPJ HACCP YIN El Caterer . IZISuspect Illness Pers?dn in Char . Tir'ne .. Bed Breakfast General Complaint . . 9 I ?earn In: HACCP Inspector 11 I I5 Out: ?01 LID Permit No. Other Ea'Ch violation she-cited. requires an explanation on the narrative page(s) and a citation :of_ speci?c provision(s) Violamd. _N_on- -compiiance with: Violations Related [toeFoodborne Illness Interventions and Risk Factors (Red Items) {Anti?CIwkihtI Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590-00913 590:009 IF) I: action as determined by the Board Of Health. PROTECTION MANAGEMENT El 1. PIC Assigned KhdeI?edg'eabIe I Duties EMPLOYEE HEALTH . II 2. Reporting of- Diseases by Food Employee and PIC El 3. Personnel with InfectIons RestrIctod/Exciuded FOOD FROM APPROVED SOURCE . . 4. Food and Water from ApprOved?Source 5. El 6 of Ingredient Statements 7 Conformance with Approved IPr-ocedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation/ Segregatlon)? ProtectIon El 9. Food Contact Surfaces Cleaning and SanItIzmg 10. Proper Adequate HandWashing 11. Good Hygienic PraIctiTIeIs Violations Related to Good Retail Practices [Blue Items] Critical'i'CI?vielations merited must be corrected immediately or within ?i?'days as d'?termined by the Board of Health. Non'? critical (N) violations must be corrected immediately or within 99 as determined by the Board of Health. I .. diff- I 23. Management and Personnel {Fe-3590. I113) 24. Food and Food Protection (FC-SJIISBD. coo) 12. Prevention of ContamInatIon ?fro?m Hands 13. HandwasIh 1' PROTECTION FROM CHEMICALS .14. Approved Food or Color AdditifyesI 15. Toxic Citemiwcals TIMEHEMPERATORE CONTROLS (Potentially Hazardous Foods) CI 16 Cooking Temperatures I 17. Reheating -- El 18fCOoiing 3 .19. Hort-and?Cold 3. El 20. As a PubIIiIc Control I REQUIREMENTS FOR HIGHLY SLISCEPTIBLE POPULATIONS (HSP) 21. Food and;:FoIod Preparation for- HSP CONSUMER ADVISORY - 22. Posting of ConsumerAdVIsorIes Number of Violated To and Risk Factors (Redi'teriis . Of?cial Order for Correctiohz'iBased on an Inspection today, the of '105 CMR I590. D??ifederal Fodd' Code. This r'epo'rt. when signed below by a Board of Health member or its agent constiilites an order of the Heard Of Heelth.? Failure to correct viciations cited in this report may In suspension or revocation of 25:.IEunIiprnent and 43599005) the food establishment pennitI and lobssation of food 26,. Waller Plumbing and Waste (FE-Sit?eom?i establishment operations. If aggnevecl by this order you :Facilityn .. I have a right Ito a [rearing Your request must be In writing 28. Pplsonous'or Toxic Matenals 0013) :and submitled to. the Board Of Health at the above address 29. Special Requirements (590909) within 10 days oT receipt of this order. Other DATE OF RE-INSPECTION: 4. n?oc mm? Slammer). PrintP105 Signature: ((14 I Print: II Page_I__ Pages . Jr" . A If Establishment Name: ,3 (if? r; it, Date: W. Page: I of Address: 7' [a gum Wu; Item Code - Critical ?It?em DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date Verlfiod No. Reference - Red Item WY f? rid-L, walk: Q/ng' 1.40 sz'flqal . I C, {?1?ch EMK ?loci ?f?a ell/4.13 mmf?lru banal/<1, Discussion With Person In ChargeLg, if?! I - - L. ?Media??i. ?weevixe?r'; .- f, . . Ir. ['er do: City or Revere (781) 286-8176 BOARD OF HEALTH '(781) 286-8369 249R Broadway Fooeesraeusamemr INSPECTION REPORT Revere, MA 02151 Name Dat ofO ration of Ins ion Rammy Marsh Ataehmy Q72 '1 Food Service Routine Add Rl ?k Retail Re?inspection fess '10 Leia] Residential Kitchen Previous Inspection Telephone Mobile Date: Temporary Pre?operation Owner HACCP YIN Caterer Suspect Illness 4 . Bed Breakfast General laint Person in Charge (PIC) WW 3:31:01?) HACCP Inspector H. Nuts Out: ??55 Permit No. Other Each violation checked requires an explanation on the narrative page-(s) and a citation of speci?c provisionis) violated. Non-compliance with: Violations Related to Foodborne illness Interventions and Rislr Factors (Red Itemsi Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590-009 IE) I: 590-009 IFI 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 Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. Receiving/Condition 6. Tags/Records/Accuracy Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation] Segregation] Protection El 9. Food Contact Surfaces Cleaning and Sanitizing CI 10. ProperAdequate 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 of Health. 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils (Fe-gramme) 26. Water. Plumbing and Waste 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) 16. Cooking Temperatures 17. Reheating 18. Cooling El 19. Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSPI 21. Food and Food Preparation for HSP CONSUMER ADVISORY 22. Posting of Consumer Advisories Number of Violated Provisions Related To 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. if 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 and submitted to the Board of Health at the above address 29. Special Requirements (590,009) within 10 days of receipt of this order. 0. Other W: S: urinE-H,dac Inspector?s Signature-m? ii I Print: Muh?yt/ Mic? Signature: Printzo 4 I Page of 1 Pages Establishment Name: ?mn?ey Mahdi. Date: 9 [2?7 /1 9 Page: I of I Address: {90 AM Item Code - Critical "Jm DESCRIPTION OF VIOLATION PLAN OF Date No. Reference - Red Item Veri?ed CLEARLY Rm'hmjr-r ?i 7&3 Violabhru at of (am-bun Discussion With Person In Charge: g_ I: do: Ulty Revere (731) 286-8175 BOARD OF HEALTH . FAX (781) 286-8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT Reverer MA 02151 Name Dat of 0 etion of ins ion 71"!de MW ?tlh?c-?f/ .3 l? l:Il ?Food Service ?tment:- Add Ri Retail ?re-inspection ress Am Q7. n' b.6717 Letel El Residential Kitchen Previous Inapection Telephone ?73, 48"??an Mobile Elate: Temporary Pre-Operartion Owner HACCP YIN El Caterer El Suspect Illness . Person in Charge (PIC) Anni-41 .- luv/1! minim-mg Bad 8? Breakfast a 3:253: Complarnt Inspector M4 (,0qu 0m: tar-IQ Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of speci?c provision(s) violated. Violations Related to Foodborne illness Interventions and Risk Factors (Red Items} Violations merited 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 El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. Receiving/Condition 6. Tags/Records/Accuracy of Ingredient Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation] Segregation/ Protection 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices lBlua 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. 0 23. Management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water. Plumbing and Waste (Fe-enmeboe) 27. Physical Facility 28. Poisonous or Toxic Materials (Fe-meadooe) Non-compliance with: Anti-Choking Tobacco 590.009 IE) 590.005 IF) 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) [1 16. Cooking Temperatures 17. Reheating El 18. Cooling 19. Hot and Cold Holding El 20. Tlme As a Public Health Control CONSUMER ADVISORY El 22. Posting of Consumer Advisories REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSPI 21. Food and Food Preparation for HSP Number of Violated Provisions Related I, To Foodborne Illnesses Interventions and Risk Factors (Red Items 1?22): Q?icial Order for Correction: Based on.an inspection today, the items checked indicate violations of 105 CMR 590.0001federal 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 conect 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 29. Special Requirements (590,009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: dint-or: Inspeq at? 1.111.: Punt: Mr. PIC's Signature Print: Page- . f? Establishment Name: Af'l Date: #31/11 Address: {yo MIMI (Ll?ft? Page: of] Item Code - Critical Mm DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date Verified No- Reference Red Item 5.53 mm CLEARLY Rm?u Deaf buu'll up 0?3 \Je??/?Ccfha?J/Wa? Discussion With Person In Charge: "24 I: fmdcodelmr doc blty or Revere (781) 286 8176 a- .pr (781) 286- 8369 FOOD ESTABLISHMENT INSPECTION REPORT Dat of 0 atlun fl 5 I RDEISEMCB Roztin:w_ 0n 7 e-Ins Ion fess 70 KM ?Lrl:rel Residential Kitchen Previous BOARD OF HEALTH 249R Broadway Revere, MA 02.151 Telephone a El Mobile Date: 78 589 8 a 9? Temporary Pre-operation Owner P5 HACCP YIN CI Caterer 3 Suspect Illness in Ch Tim Bed Breakfast General Complaint son argel I KW ?of a In: eq?, 50 HACCP mam" Out: "1'00 Fem" '3 01"? Each checked requires an explanation on the narrative page(s) and a citation of speci?c 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 2; Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. Receiving/Condition El 6. Tags/Records/Accuracy of Ingredient Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. Separation/Segregation] Protection El 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate HandWashing 11. Good Hygienic Practices Violations Related to Good Retail Practices {Blue ltemsl 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 (Fc-zxsecme) 24. Food and Food Protection 25. Equipment and Utensils 26. Water. Plumbing and Waste (chxsecooe; 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other moor: Non- -compliance with: Anti-Choking Tobacco 590.009 (E) 590.009 (F) 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures 17. Reheating 18. Cooling 19. Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSPI 21. Food and Food Preparation for CONSUMER ADVISORY 22. Posting of Consumer Advisories 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 590.0001feder'al 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 RE-INSPECTIUN: Number of Violated Provisions Related Im- WW Emu ?Mt-Wire?: Y1 ??l?a/Zz PIC's Signatu . Pm? foam my PageAr ot_& Pages . Address: 10/ 694444 677 Page. of Establishment Name: Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference Red Item Veri?er; PLEASE PRINT CLEARLY C/(aq gig-d5 Car/:3 bl? In Fez-4t [tr-km Discussion With Person In? Charge: qudy?J: E. 4 7 4. Ill-l I: l'mdcodclnar doc City Of Revere (781) 285-8175 BOARD OF HEALTH .. FAX ((311 285- 8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT Revere MA 92151 I .. . Name Date T?Eof Omatioms} of the ion ?L'firfr?w' 7- ES Jr ?ue/IE Food-Service Mg?outihe-I Address .- RI 1: Retail., Reinspection . ,0 7 f?t Leiel Residential Kitchen Prewous Inspection I (r Eate- . - emporary Pro-operation Owner [5&3 ?Accp YIN TCaterer I Person in Charge (PIC) 11,41,311Bed Breakfast E- 3:31: ComplaInt Inspector)k A. I 114 I I. Out' Permit NO. Other Each violation checked an explanation on the narrative page-(s) and a citation of- speci?c provisionIs) violated. Non-compliance with: yiolations Belated to Foodborne Illness Interventions and Risk Factors {Red Items) Anti-Chatting Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590509 590 009 (FI action as determined by the Board of Heatth. FOOD PROTECTION MANAGEMENT 1. PIC A39ighed Knowledgeable Duties EMPLOYEE HEALTH 2. Reporting Of Diseases by Feed Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE-- El 4. Food and Water from Approved Source El 5. Recermg/Condltion I CI 6. Tags/Racords/Aecur-acyiof Ingredient Statements 7. ConfOrmance vIvitIh ApprOved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION 8. SeparatiOri/ Segregation] PrO?tOOtion El 9. Contact Surfaces Cleaning and Sanitizing El 10. PrOpIer Adequate Handwashing 11. Good Hygienic PraIcIticesI Vialations Related to? Good BetallPragtices [Blue Itemsi-Critical [Ci violations marked must be corrected imme?diately? by the Board Of Health. Non- critical (N) 'vioiatiOns' must be cOrrected immediately or within 90 days as determined by the Board Of Health. 23. Management and Personnel 24. Food and Food Protection (FceIIsaoom) and Utensils 26. Water. Plumbing and Waste IFc?oirwcooe) 27=3Physicalr?aciljty 2.8. Poisonous or-ToxicMaterials (Pearce-.003) 29. Special Requirements (590.009) 30. Other E?mrmpoctanl?- dd. do: 12. from Hands 13. Handwash gFa?c?ilitiesI PROTECTION FROM CHEMICALS 14. Approved Feed or COIior Additives 15. Toxic Chemicals . CONTROLS [Potentially Hazardous Foods) 16. Cooking Temperatures 17. Reheating . IsiceoIrng 19. Hot and-Gold Holding - - 20. Tune As a Puinc Health Control - I REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSPI I21. Food and Food Preparation-I for HSP CONSUMER ADVISORY I 22. Posting Of Number Of Violated ProvIsIons Related To Foodborne Illnesses Interventions and Risk Factors (Redh Items 1 22) Of?cial Order for Caused?on: Based on an Inspection today, the items checked indicate Violations of 105 CMR 590. DDUIfederaI Fbod Code. This report when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. to correct viciations cited in this report may result In suspension or revocation of the feed estabIIShment permit and cessation of food establishment opaIations. If aggrieved by this order. you have a right to a hearing. Your request must be' In writing and submitted to. the Brian} of Health at the above address within 10 days Of receipt Of this order. DATE OF RE-INSPECTION: Inspector?s SignatureylmII I intact; ?Fuji . CLIF- I Print: 11. I I Signature; - Print: I I ,1 1.111: 1.5-1 11/: A Page_ of__ Page: Establishment Name: {U/Tirxi?? Address: -f ?y . I ?72 DatePage: of Item No. Code Reference Critical Item - Red Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION WV Date Verified (A) [Kg/Cm TH r. i?i Vale? ?ank/n,? 1 . 1 Car/3 air I 449/4 ij?j?k?m 1i?) (a?f'flr'f? 7' Discussion With Person In Charge: ?24 do: Ulty OT Kevere .. (781) 236 3176 BOARD OF HEALTH . FAX (781) 286- 8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT Revere! MA 02151 Name . Dat of O?ationls) of Iris inn Mite/M '6 Ajay?, #725 ?14? Food Service Routine Address Risk El Retail EReinspection [or] St Level C) Residential Kitchen Previous Inspection Telephone 1 Y) $186- {94% Mobile Date: Owner ACCP YIN E) Temporary E) Pro-operation [8 PJ Caterer El Suspect Illness 9 I Amara/IL. In: ?125? HACCP Inspector Mg Out: 399? Permit No. [1 Other Each violation checked requires an explanation on the narrative pageis) and a citation of Speci?c provision(s) violated. Non-compliance with: Violations Related to Foorlborne Illness Interventions anrl Risk Factors (Red Items) Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590-009 (E) 590-009 El action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1. PIC Assigned/Knowledgeable/Duties EMPLOYEE HEALTH El 13. Handwash Facilities PROTECTION FROM CHEMICALS El 14. Approved Food or Color Additives 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) El 2. Reporting of Diseases by Food Employee and PIC E) 3. PeIsonnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source E) 5_ Receiving/Condition El 16. Cooking Temperatures 17. Reheating E) 18. Cooling 6. Tags/Hecords/Accuracy of Ingredient Statements 7. Conformance with Approved Proce?dures/HACCP Plans PROTECTION FROM CONTAMINATION 19- and HO'ding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) E) 21. Food and Food Preparation for HSP El 8. Separation] Segregation/ Protection E) 9. 'Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate 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 (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 0f Hea'th' 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 (Foeyseocoe) 24. Food and Food Protection {Fcaiiseooco 25' Equ'pmem an.? ?tens? (FC'4li590-005l the food establishment permit and cessation of food 26' Plumbmg and Waste establishment operations. If aggrieved by this order. you 27. Physical Facility - (Fcoxsmoo?l) 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 (seduce) within 10 days of receipt of this order. 30, Other DATE OF RE-INSPECTION: Lida: Inspector' Slgnature: i! i ?us Print: DUAL PIC's Signature Print: ?maa m4?, Page?l of__ Pages I Code Reference Critical llem - Red Item Establishment Name: in}; .6 Man-j Adgiress: It)? Now/at! Sf lem Date: 4/15/11? DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Page: of Data Page mm CLEARLY Veri?ed Pumice I Leanna ?eld; an it?: of Jul: macaw: 4 Mm wm'hr .411 dingo du)? gum}! as" 4AA 5 Jillth (W44 "f ?Wme?mt Discussion With Person In Charge: .. . blty 0T Revere (781) 286-8176 BOARD OF HEALTH - FAX (781) 286-8369 249R Broadway FOOD ESTABLISHMENT INSPECTION REPORT ReVerev MA 02151 Name - Dat ati 539 3724 F:od Serviceon Ro?tine? on Add Ri Reta'l ect' Tess l0?7 Lesvel Residential Kitchen Telephone Mobile Date: Tem are Pr rat? owner RPS ?Amp w? [j Catgrer auggjuufenss Person In Charge (FIG) I a, a ,5 lanmeq El Bed Breakfast 322%?? Complaint Inspector We!? Out: .011? Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of speci?c provisionls) violated. Violations Related to Foodborne I?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 Knowledgeable Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. Receiving/Condition El 6. Tags/Records/Accuracy of Ingredient Statements 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. Separation] Segregation] Protection El 9. Food Contact Surfaces Cleaning and Sanitizing CI 10. Proper Adequate Handwashing 11. Good Hygienic Practices 1Ii'iolations Related to Good Retail Practices items) Critical (CI violations marked must be corrected immediately or within 10 days as determined bythe 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 (Fe-essence) 26. Water. Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials Non-compliance with: Anti-Choking Tobacco 590.009 IE) El 590.009 (F) 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures 17. Reheating El 18. Cooling 19. Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSPI 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 590.0001federal 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 29. Special Requirements (590,009) within 10 days of receipt of this order. an, Other DATE OF team: A ignntu . Print: I [1 Page_ Page: 11', . I. .. . Establishment Name: w/uxm 534 Date: 5/24 [19? Page: of i Address: Newha.? 5% Item Code - Critical Item DESCRIPTION OF VIOLATION I PLAN OF CORRECTION Date No. Reference Red Item Veri?ed Rufus}. Lug-l bun'li on 7'0? a1? (0?53! ?ve/I) chair machihcs Corr-(dad an Sr-h ?2 no r354 {Corr?C-Ck? on Suit) 3 Dmi- (En-fro! Lag 3+3 Ml?w 67A/ma no Elle-far! Jaw: mum; .smu. 9/19 :4 #11423, 72.1? a. 0 {Sada-ow) ?b?gal khan) pra?ud? ??xaraeaz Disgussion With Person in Charge: MAM Ajay/s: IE4 [xv-Wanda: