THE COMMONWEALTH TOWN OR CITY OE .. fiIi?i?i-ariieffi- 2i OF MASSACHUSETTS Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name . Date Type ofOQerationls) ooflns action . . Food Service I Address 2) lg e-F Ris?k I Retail DRe-inspection 3/ r" 7?7 ?4 Level I, E) Residential Kitchen Previous Inspection Telephone be) [3 Mobile Elite: Temporary Pro-operation Owner HACCP YIN Caterer DSuspect Illness per Time Bed Breakfast General Complaint e7) In: 22..) DHAOOP Inspector :a :ei" -. .I-g {7-4 Out j?p Permit No. DOther Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-contpiiance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.009 (E) Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590-0091? action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned i Knowledgeable I Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. ReceivingiCondition 6. TagsIRecords/Accuracy of Ingredient Statements El 7. Conformance with Approved Procedures/HACCP Plans PROTECTION FROM CONTAMINATION El 8. 9. Food Contact Surfaces Cleaning and Sanitizing El 10. ProperAdequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel 24. Food and Food Protection Allergen Awareness 590.009 (8) 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives D15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) CI 16. Cooking Temperatures 17. Reheating D18. Cooling [119. 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 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): Official Order for Correction: Based on an inspection today, the Items checked Indicate violations of 105 CMR 590.000IFederal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations . cited in this report may result in suspension or revocation of 25? Equipment and Utensils the food establishment permit and cessation of food 26. Water, Plumbing and Waste establishment operations. If aggrieved by this order, you 27- Facrlity have a right to a hearing. Your reqUest must be In writing 28. Poisonous or Toxic Materials (FC-7II590-008I and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other [nepcctor ?tiSI Imtult. I, (.1: ii Punt)" I. . L), 4. r-("It I ft l?rILL__0f_Pages I FORM I AM SULKNCO. I. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF 2- .. ?Ix Establishment Name: lm??lA/v?rf? -3: l. 2 [(43329 1' d. . .5 2? Date: 2? r? Page: of Item ?3 -Crltioal_ DESCRIPTION OF VIOLATION I PLAN OF CORRECTION 03?? No. Reference R-Redlmm CLEARLY . Verified 1/ . I, ,le?jl?j} (L . . 2.2.21) ,2 2 ,2 f- 2.2.0 2. L- - .2 2' 52,2 .z 22253? .2- ?j 1 .. j: 14:241. I) 2? {25% 3 ?u?x?xove. a? LA Discussmn With Person In Charge. Corrective Action RequiredIff?f 2 2 Compliance El Employee Restriction! 27.2,: 2,21- Exclusion 2' Re-inspection Scheduled El Emergency Suspension El Embargo El Emergency Closure L'l Voluntary Disposal Other. I THE COMM -.NW OF MASSACHUSETTS .I TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name I .- I. to '1 . Type of Operationisi -e oflnsectiOn 7.391. (M3 1.4.13? Food Service .- -?!Rouiine Address . r? Risk Retail .Re?lnspection I 3 net)?- ?jfz? 1? Level Residential Kitchen Previousinspecthn Telephone 3 Mobile Ester . Temporary Pre?operation Owner HACCP YIN Caterer BSuspeot Illness . ,a - . Bed Breakfast General Com laint Person in ChareelPlC) In I) ?31529? DHAOOP Inspector It?. ill/?46 .34ij 3.. I..- dim! Permit No'. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provision(s) violated: . Violations Related to Foodborne illness Intervention Non-compliance with: Violations marked may pose an Imminent health hazard action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned I Knowledgeable I Duties EMPLOYEE HEALTH . El- 2. Reporting of Diseases by Food Employee and FIG 3. Personnel with Infections RestrictedIExcluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. ReceivingICondition 6. TagsIRecordsIAccuracy of Ingredient Statements 7. Conformance with Approved ProceduresIHACCP Plans PROTECTION OONTAMINATION 8. 9 Food Contact Surfaces Cleaning and Sanitizing 10. ProperAdequate 1.1. ?ood Hygienic-Practices Violations Related to Good Retail Practices (Blue items} Critical (Ci violations marked must be corrected immediately or within 10 days as determined by the Board and Risk FactorsiRed Items 1.22): of Health. Non- critical (N) violations muet be corrected set 23. Management and Personnel (FC 23(590. 003) 24. Feed and Food Protection 004} 25. Equipment and Utensils (FC 005) 26-. Water, Plumbing'iand Waste 27. Physical Facility (menswear) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) Other and Risk Factors (Red Items) Anti-Choking 590. 009 and require immediate corrective Tobacco 599-009 {Fl Allergen Awareness 590.909 (G) - 12. Prevention of Contamination from Hands 13. HandWash Facilities PROTECTION FROM CHEMICALS 14 Approved Food or Color AddItIves 15'. Toxic Chemicals . TIMEITEMPERATIJRE CONTROLS (Potentially Hazardous Foods) El 16. Cecidng Temperatures El 17. Reheating co'oI?in'g D19. Hot and Cold Holding El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP CONSUMER ADVISORY - 22. Posting of Consumer Advisones Number ofIVIolated provisions Related To Foodborne Illnesses Interventions Official Order for CorrectiOn: Based on an Inspection immediately or within 90 days as determined by the Board today. the items checked indicate violations of 105 CMR 590. DU?IFederal 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 vialatlons 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- INSPECTIONL I Tnsp?inr's Signaturekbjej in A 9943 .l I Prip??g; ?ff/In? fig? a. rapist}, 1W {salami {ana?wip? 9 I ?f Eng?- 9 THE COMMONWEALTH OF MASSACHUSETTS . TOWN OR CITY OF I 0? l?twuw. . Establishment Name: Li >91. up Date: 5 if ?y {?Ujl?a?i i 1.: .55555?)! Gaga/"El; lg? 34.5 '3 I 3? frb/ar?ln?! I 3.37 6; LMNt-di Jam 9" c.3449 vii; - quk P2.) Iii/k. q?m? ?fir? (1.2-1 1?5" Eli?47' 5; - I . . g?d' . . d- . .f Iii/{j g?i?w 5,3?3. AJ L/?a Sim-?a *f ?it?m. 3 Cg .7 f/a?Q254:) 7 f? ?ea?x4527:- .rfrhu? Discussion With Person in Charge: ?Ha? Corrective Action Required'3"qu 4?li?m ??Ekp .. ?i {inclifoluntary Compliance El Employee Restriction! 7/ fit: ?77? Cr L1: . Exclusion . V, . . . El Rte-inspection Scheduled El Emergency-- Suspension El Embargo El Eriiergency ClosLi're' El iVquritaryDi?pral Other: I I I TOWN OR CITY OF COMMONWEALTH OF MASSACHUSETTS "Iran. c? I.. L-?jwz- 3 5. Massachusetts Department of Public Health Division of. Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name . 3 . (NI A 3/ Date fofO oration 5 3w I.) {Khaki?? ?it-Mosul? I [/15 -- Food Service "Routine Address I 0/ Risk Retail Re-inspecllon . .4 xix-r? Ch - Level Residential Kitchen Previous Inspection Telephone 3 Mobile Data: Temporary Pro-operation Owner HACCP YIN Caterer ESuspect Illness Person in Char a p30 Time Bed SI Breakfast General Complaint 9 I I (it) Fs I) 331%,: EIHACCP Inspector I UM ,3 23". m. g? Out/ 72' Permit No. CI Other Each violation checked requires an eXpianation on the narrative page(s) and a citation of specific provisionts) violated. Non- compliance with. Violations Related to Foodborne Interventions and Risk Factors {Red Items) Anti-Choking 590.009 (E) Violations marked may pose an Imminent health hazard and require Immediate corrective T0ba?0? action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned I Knowledgeable I Duties EMPLOYEE HEALTH 2 Reporting 0f Diseases by Food Employee and PIC 3. Personnel with Infections ReStrictediEchuded I FOOD FROM APPROVED SOURCE 4. Food and Water from Approved source 5. ReceivingiCondition - 6. TagsiRecordSlAccuraCy of Ingredient Statements '13 7. Conformance with Approved ProcedureslHACCP Plans II. PROTECTION FROM I 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. ProperAdequate Handwashing . 11. Good Hygienic Practices Related to Good Retail Practices [Blue Items) Critical violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical violations must be corrected Immediately or within 90 days as determined by the Board 23. Management and Personnel (FC 003) 324. Food and Food Protection (FC 3ii590 004) 25. Equipment and UtenSils (Fc-4u590.005) 26. Water; Plumbing and Waste 27. Physical Facility" 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Allergen AWaraness 5913309 (I3) 12. Prevention of Contamination from Hands 13. Ha?ndwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color AddItIves 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) Cl 16. Cooking Temperatures D17. Reheating 13. Coating 1:119.- I-Iot and?CoId Holding 20. Time As a Public Health Central REQUIREMENTS FOR HICHLII (HSP) El 21. Food and Food Preparation for HSP CONSUMER ADVISORY 22. Posting of ConsumerAdvisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items Official Order for Correction. Based on an inspection today, the items checked indicate viblations of 105 CMR 590. 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 In r?sSignntureLIg i?r? IV aIW?'?dd? Print: ?z Jig/1? ?4130} {fix/4'4 V7) ?lcasggnaturfz (I) - PW I PIiguLIIfj?gca 51wa WM and}! .3 ?3 (i?mrf (:71 Hog/?I THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name: ?1.35:4 Date3/14me <1 Page: 'of item .HCodes-I Critical Item RE Red Item -i f? a? :n?T "Ta-?41: -43 "Li-,3 c; 7: Hm: din-1; A: (Ci/r: .S :73 (gift-4' if Mr,? {mt-o r? Claim-x. (77? A an Km m. ?aws? fee-?e cafe?whiliiusa W1. 0 - i Discussion With Person in Charge: . ., Corrective Action Required-PAM. El Yes 3" 2 i ?Lr'z' if? 134Compliance El Employee Restriction! f5} M1351 a-i-Pk. - . Re?inspec?'on Scheduled :1 Emergency Suspension El Embargo El Emergency Closure El Voluntary Disposal Other. I If i - . - THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF 5 I ag?iom Massachusetts Department of. Public Health Division of Food and Drugs Date )1 T?ge of Operationisi age 91 inspecgon Food Service Routine FOOD ESTABLISHMENT INSPECTION REPORT Retail - El Rio?inspection. blame Previous Inspection to . a" sirrgfifigeo Address :7 g) ,1 Risk? 1 i" fr Level Residential Kitchen Telephone Mobile Data: Temporary Pro?operation Owner HACCP YIN Caterer Suspect illness . Bed Breakfast . General Complaint Person in Charge (FIG) i311 {Li/f 5 1L Time . x. -. . were La-Lf?w :0 in: H.151. . EIHACCP Inspector II: (I Hil?fixlf-r??; Out: I PBm?t N0. Ulh?r Each violation checked requires an'_explanatlo_n on the narrative page(s) and a citation of Specific provisionis) violated. Non-compliance with; Violations Related to Foodborne Illness interventions and Risk Factors (Red item's) Anti-Choking 590.009 (E) a .iu'iolations marked may pose an imminent health hazard and require immediate corrective T?h?wo Ell] action as determined by the Board of Health. PROTECTIDN MANAGEMENT 1. FIG Assigned Knowledgeable i Duties EMPLOYEE HEALTH I: 2. Reporting of Diseases by Food Employee and PIC [j 3. Personnel with Infections RestrictediExcluded I soon PROM APPRoveo sconce, - El? 4. Food and Water from Approved Source El 5. E. TagsiRecordsiAccuracy of ingredient Statements T. Conformance with Approved Proceduresii-IACCP Plans anorecnon FROM couTAMinanou El El. El 9. -. Food Contact surfaces Cleaning and Sanitizing I:_l 10. Proper Adequate Handwashing . El '11: Good Hygienic Practices Violations Reinted to Good Retail Practices (Blue "31115) 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 . . '23. Management and Personnel (Fe-enssoms} 24. Food and Food Protection 25.: Equipment and Utensils (Fe-4iisso.oos) 26. ir'liater'E Plumbing and Waste (scorissoaosi 27. Physical Facility 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other . Allergen Awareness 590.009 (G) 12. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives El 15. Toxic Chemicals . 1:3 CONTROLS (Potentially Hazaiddijs Foods) 16. Cooking Temperatures. E117. Reheating 18. Cooling I319. Hat and Cold Holding El 20. Time As a Public Health?Control REQUIREMENTS SUBCEPTIBLE POPULATIONS (HSP) 21. Food and Food Preparation for HSP - - grind?t?; 1r. CONSUMER Advisonv . . 22. Posting of Consumer Advisories Number of Violated Provisions Rotated To Foodborne Illnesses Interventions and Risk Factors (Red Items1-22ir Official lEirder for Correction: Basedon an inspection today. the items checked indicate violations of 105 CMR 590.0titliFederal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited In this report may result in suspension or revocation of the food establishment permit and cessation of food establishment operations. It" aggrieved by this order, you have a right to a hearing. Your request must be In writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE oF HIE-INSPECTION: r? - .. . 1 --1 morphism? {#firimvi 9.1.215,- ?o Pa- r) Cert: yer?- inseam?? {?21ch IL e. THE OF MASSACHUSETTS f. CITY OF - Establishment - Bate 2/535 sP?iQ?; 101' A Item-:- Cade- sac?ical DESCRIPTION mom-non; PLAN :oF CORRECTION ?Reference. Ff Red Item: CLEARLY .- 1/3234: Idea 22. - 2?05 - M?mn 5 2212212 or: 2222 2225 wry/2:! x2048? 2651' - 4%??2??222q 292272.22? . 21:22:; 5 F22 JA 1 44'. Discussion Person in Charge: 2 - I I - Corrective-Action Ra??imd' i?u?o :1 Yes 2:234, 25f .414 {-B7Molunmw Compliance El Employee Restn?c?ciomr 2' ?r 2 Excl?sion 5 .. Reeiqspecti'ori Schedmed a Emergency Susp?n'sibn? 01.; Embargo Elg Eme'rg'ehcy' Clbs?re . - - ?Ll?m -. u? Vol?ntary Disposal u? omef.? 5 Penn 734 And. Sulkin Cha?estown, MA TOWN OR CITY .- 312.: ?Lam THE COMMONWEALTH OF MASSACHUSETTS Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name f" I Date Hui-rm .7- - Address in. . ml; 5 Risk it .4 - (I If K3: Level Telephone . 'y Owner HACCP YIN . .I . Time Personm Charge (PIC) U, ?15} vigiqy?yi L.) In Inspector i .I. .Mxi? Dun. ?1'1 Type of Operationisi F?cod Service El Retail El Residential Kitchen CI Mobile Temporary El Caterer Bed&Breakfast Permit No. of Ins )ec ion ifi-Rcutlne Re-inspection Previous inspection Date: [3 Pre-operation Suspect Illness General Complaint HACCP El Other Each vioiatiori checked requires an explanation on the narrative page(s) and a citation of Specific provision(s) Violated. Non- -compiiance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking Violations marked may pose an imminent health hazard and require immediate corrective 590-009 (F) action as determined by the Board of Health. Allergen AWareness 590-009 a FOOD PROTECTION MANAGEMENT El 1. PIC Assigned i Knowledgeable I 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. ReceivingICondition 6. TagisecordslAccuracy ofingredient Statements 7. Conformance with Approved PrcceduresIHACCP Plans PROTECTION FROM CONTAMINATION lj 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. ProperAdequate Handwashing Ci 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. 24. 25. Management and Personnel Food and Food Protection Equipment and Utensils 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives U15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) Ci 16. Cooking Temperatures Ci 17. Reheating El 18. Cooling 19. Hot and Cold Holding 20. Time 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 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 599.000IFederal Food Code. This report, when signed below we 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 26- Water, Plumbing and Waste establishment operations. If aggrieved by this order, you 27- PhySIcaI (PC-Sli590'007l have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (Penman-008) and submitted to the Board of Health at the above address 29. Special Requirements . (590.009) within 10 days of receipt of this order. 30. Other - DATE OF RE-INSPECTION: . - I'll. i . Inspuci?l'? Signature: .1 Print: I: I 1. rJ ..I .I?j?p ft 1'[Print i 5-..: ill? it? Page_ of ("Pages I- - rl'l' l' FORM sutmd co. MA 3.1.: THE COMMONWEALTH OF MASSACHUSETTS Kn?. XML) 1 TQWN OR CITY OF ~53 L5 -. . .?il . I: --) Establishment Name: LLr-?Lar ~57 5} Date: 5' 5? Page: of Item C?de c?c'mca' ?em DESCRIPTION OF VIOLATION I PLAN OF 93?? No. Reference -Red Item 5 . PLEASE PRINTCLEARLY -- Veri?ed f: di?ah7 W, it: i; 11?? I ..-. 03Ilium - If:H-Ipil . I {50 i? I Discussmn With Person In Charge. ,7 Corrective Action Requireclg/kujg. No a Yes 1? I 4'0 LL/t'f: . c" 9 1 4. lav-Voluntary Compliance El Employee Restriction;r . .551 5" . J: A "34?53 - ?5-5 1 I Exclusion Re-inSpection Scheduled Emergency Suspension El Embargo El Emergency Closure Voluntary Disposal El Other. THE COMMONWEALTH or MASSACHUSETTS TOWN OR CITY or?? ?73 Massachusetts Department of UPubiic Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name DE ?0.0 of eration us of ins .ecno ,t a AW: mm 72'Ix1 Food Service i=Rouiine 15?: .., Address Risk Cl Retail Rte-inspection c235" 91m Level 3 Residential Kitchen Previous Inspection Telephone . Mobile Eats: Temporary Pre~operation Owner HACCP YIN Caterer I - - . 11ml: Bed Breakfast General Com laint Person In Charge (PIC) (dirt:- 42,? HACCP . iITspectorI'_ D111: Out' PermitNo. Other Each violation checked requires an explanation on the narrative page(s) and a Citation of Specific provisionis) violated. Non-compliance with: Violations Related to Foodhorne Illness Interventions and Risk Factors (Red items) Anti-choking 590.009 (E) Violations marked may pose an imminent health hazard and require immediate corrective 590-009 (F) action as determined by the Board of Health. merge" Awa'eness 5903.09 FOOD PROTECTION MANAGEMENT . 12. PreventiOn of Contamination from Hands? El 1. PIC Assigned I Knowledgeable! Duties El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 15. Toxic Chemicals TIMEITEMPERATU RE CONTROLS (Potentially Hazardous EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and 3. Person nei with infections FOOD FROM APPROVED SOURCE - Food and Water from Approved Source El 16. COOking Temperatures El 5. ReneiyingiCondition 6. TagsiRecordsiAccuracy [117? Reh?aii'?g D18. Cooling T. Conformance with Approved ProcedureslHACCP Plans - 1:119. Hot and Cold Holding PROTECTION FROM CONTAMINATION- 20. Time As a Public Health Control' REQUIREMENTS FOR HIGHLY POPULATIONS (HSP) 9.- Food Contact Surfaces Cleaning and Sanitizing El 21' Food and F00 Preparation for HSP . . 10. ProperAdequate HandwaShing El 8. CONSUMER ADVISORY TD 11- 50"" HygienIc PractIces El 22. Posting of Consumer Adilisories Violations Related to Good Retail Practices (Blue Number ofViolated Provisions Related Items) Critical (C) vidlatio'ns 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. Nonucritical (Ni uiolatioI'IS most be corrected . immediately or within 90 days as determined by the Beard of ea Official Order for Correction: Based on an inspection today, the Items checked indicate violations of 105 CMR 590.0n?iFederai Food Code. This report, when signed below . - . a Board of Health member or its 3 ant constitutes an 23' Management and Personnel order of the Board of Health. Failure tElo correct violations .24' Form and ?nd Protection cited in this report may result in suspension or revocation of 25' Equipment ?Id Utensils $095909?) the food establishment permit and cessation of food 25- Water, and Waste establishment operations. If aggrieved by this order, you 27- Physical Facility (FC-Bil590-007i have a right to a hearing. Your request must be in writing 28. POISOHOUS or Toxic Materials - and Submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30, Other DATE OF FEE-INSPECTION: 7 Inapept?r sSignature: MN 04;! we; 7L6 Pig?s Bigiwture: (fr?I Pageiofghges' TOWN MA v? b- I I THJE .- f, OR CITY OF S?yg?Establishment Name: 64-35% Aim-r - Date: 5/4 3 Page- 'Df92.3 . x?U $2.4 (.42.. mi? v.21. xf. QHLEA a4. iodf??awnELK/mairm :3de {ff-q 4- 30334, Vim-it 9., f; ?ffr?f - 4:51- 3 ?3 7 #675 'r {if?rm @551?- (Ln/ti"? 3?415-: at} ,m-a (Lo/y air/Pap?. 14245?1, . - I: 17-? L/?r?w?x @5220 g/y'u'c: y; - Embargo Emergency CIosUre . .. Conective Action Required: El No - .J?El??ies DISCUSSION With Person In Charge. 9?4 ?agr?-L, $123.4 [fl?ya. . . - . . gn?i?'bluntaw Comptiance_ El Employee Restriction ,rjy- .15" 71Exclusion . (3/1 . . El Re?inspectioh Sbheduled El ~.Emerge?ncy Suspension El It - El Voluntary Dispos?al Other. . II I COMMONWEALTH OF MASSACHUSETTS Minx . TOWN OR CITY OF 377?? Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name .. A Date as of Deration of Ins on ion I bit) Service rRoutine Address . . I: he. Risk Retail Resinspection ?3 ?1 fun.? :4 Level Residential Kitchen Previous Inspection Telephone . f; Mobile - Temporary Pro-Operation Owner HACCP YIN [j Caterer Suspect Illness Person in Charge (PIC) (I. 4.55-- 1,91 Tim?/I $13) Bed 3? Breakfast 322%: Complaint In . Inspector It: Lift/1 ya.- if {(914 Out 2.30 EIOther FOOD rnoM nerncho souncE Each violation checked requires an Explanation on the narrative page(s) and a citation of specific provisionts) violated. Non-compliance with: Violations Related to Foodborne Illness Interentions and Risk Factors (Red Items} Anti-choking 590.009 (E) Violations marked may pose an imminent health hazard and require Immediate corrective Tobacco action as determined by the Board of Health. Allergen Awa'q?ess 590-003(9) FOOD MANAGEMENT 1. PIC Assigned i Knowledgeable I Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with infections RestrictedIExcluded El 12. Prevention of Contamination from Hands 13. Handwash Faciliti?s PROTECTION FROM CHEMICALS - 14. Approved Food or Color Additives El 15. Toxic Chemicals Gonrnots {Potentially Hazardous Foods} CI 1.6.- Cooking Temperatures El 17. Reheating? El 18. Cooling 19. Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FCIR HIGHLY SUSCEPTIBLE (HSP) El 21. Food and Food Preparation for HSP 4. Food and Water from Approved Source 5. ReceivingiCondItion 6. TagsIRecordsIAccuracy. of IngredIent Statements El 7. Conformance with Approved ProceduresIHACCP Plans PROTECTION FROM CONTAMINATION 3. 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing consumennovlsonv CI 11. Good Hygienic Practices yiolatlons Related to Good Retail-Practices {Blue Items} Critical violations marked must be corrected immediately or within 11] days as determined by the Board of Health. Non orl ltlcai {Ni violations must be corrected immediately or within 98 days as determined by the Board 23. Management and Personnel 003) 24. Food and Food Protection (Fe?sneer). 004) 25. Equipment and usage; (FC-4II590. 005) 26. water, Plumbing and Waste 27?. Physical Facility 28. 'Poison'ous or Toxic Materials 29. Special Requirements (590.009) 30. Other 22. Posting of ConSuhIerAdvisOrles Number ofViolated Provisions Related To Foodborne Illnesses Interventions and RiSk FactOrs (Red Items Official Order for Correction: Based on an inspection today, the items checked indicate violations oi185 CMR 590. U??iFederal Food Code. This report when signed below by a Eloard 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 ?SSigmilillrEL?JjI/? Sw/l/?j?gwf- Signature: :Ir big-139 ff Pugc_r_of_ FIJI .II. Cir/Wag) mien/j - THE COMMONWEALTH OF MASSACHUSETTS OR CITY OF 5/ 9' Establishment Name: 59. f; Date: [Cf/:57) 3 ?Itemiz. .LCode Cw .C?tigallte Date Reference .R- Red Item I . . Venfecl . .1 . . eta/#14? f: . .I I: 2:41.233:- 1945LOH.) ?ack. Hey; 3 Saw: :45 ..43. 5?72 were .0 "1 J, - I I 3.3% Lani 5:33.35 mega; z? a; . if: an?. 4/ ,Li- 7/ - a _xcvg?f dear ,x war-Leer - 5/ 2 Discussion With Person in Charge: Corrective Action Reguipedi?'?; Womplianee El Employee Restriction! fill-F: :rf/ If! fjxrii?r {fitcifdjliRe-Inspectlon Scheduled El Emergenc Sus ensmn k/J/ [ft A El Embargo El Emergency Closure El ,Volunta'ry Disposal El Other. v-Ili THEEJIJMMONWEALT OF MASSACHUSETTS TOWN on CITY or 33sz Massachusetts Departing-it of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT NameI Ir? .. I Dat- on on i omen" . {5139' iiji?J i H.551: 53' r: r. -Routine Address :2 r4. .i?l . .. - r: 1 Risk . Re-lnspection 'Level Residential Kitchen Pr??vious Inspection Telephone - Mobile Date:_ - Temporary Pre-operatlon . "Amp w? El Caterer ., DSuspect-lilness Person Char a FIG .2 r" a; Time . Bed Breakfast General Complaint 9 i I: I or .3 'In: . 3.52/33 EIHAOCP _Inspacto?h 11;? {?ag-o I ,2 to. I-it?u .7135 0?th I Permit No. . DOiher Each violation checked requires an explanation on the narrative pageisi and a citation of specific provisionis) violated. Non- compliance with: Violations Reigt_ed to Foodborne Illness interventions and Risk [Red items} Anti-clicking sec. econ-:1 [j Violations marked may pose an imminent health hazard and require Immediate corrective T093000 5903mm action as determined by the Board of Health . 590309 (?31 FOOD rsorecnon. assessor-1m 12. Prevention of Contamination from Hands . 1. FIG AssignediKnowledgeablal?utiee - D13- Handwlash Facilities - EMPLOYEE HEALTH . - . . 2, Re onin oiiJiseasesb Food Em to es and PIC PROTECTION FROM CHEMICALS . I- II . 14 Approved Food orCoiorAddltives 3. Personnel with infections RestrictediEIIciuded . 15.: Toitic Chemicals w. . FOOD PROM aprnoveo SOURCE - ii . CONTROLS (Potentially Hazardous Foods) 4. Food and water from Approved. Source 5. Receivingicondltion 6. TapsiRecordslAccuracy of ingredient Statements 7. Conformance with Approved ProceduresiHACCP. Plans PROTEOTION FROM CONTAMINATION B. Cooking Temperatures_,_ Reh?ating . 18. Cooling -. 19. Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FOR suscarrieLE POPULATIONS (HSP) . . agree-meta. . 9.- Food Contact Surfaces Cleaning and Sanitizing . 21. Food and Food Preparation for 10. Proper Adequate Handwashing . - cousurnsaaovisonv -r ID 11 Hygienic Practices - 22. Posting of Consumer Advisories. Vidlatlons Belated to Good Retail Erectices (Blue Number of ?0'3th Provisions Related Items) Critical violations marked must be corrected To Foodborne Illnesses int?rventions immediatialv or within days as determined by the Board - and Risk Factors (Rod items 1.22): of Health Non critical {Ni violations must be corrected Of?cial Order for Correction. Based on on his pection immediately or within 9i] days as determined by the Board today, the item?s checked indicate violations of 105 CMR bl! 5912i. ??Dii-?ederal Food Code. This report when signed below by a Board of Health member or its agent constitutes an 23' ganggergegtt (Fe-anew). order of the Board of Health. Failure to correct Violations on an no ro an on (Fe-aiisan. 4) cited in this. report may,r result in suspensiOn or revocation of 25?; Equipment and Utensils (FC-4ii5901 005? the food establishment permit and cessation of. food 25.5, Wotan Plumbing and Waste (F9 51l599-005i- establishment operations. if aggrieved by this order, you 27- Physical Faculti- (F5 007} . have a right to a hearing. Your rednest must be in writing 28', Poisonomor Toxic Materials . and submitted to the Board of Health at the above address .29" Special Requirements (599.009) within 10 days of receipt of this order. 30. Other . DATE OF inspector?s Signature. {Aka/{315 {13" ?News?" (think/K 0?0?j_ "'99 ff, Wigwam: glow/I? II If 'PngeLut?D. E?ugea err-wade- of. Lei wryix no; :5;er COMMONWEALTH OF. MASSACHUSETTS - (ff I. Establishment Name: "(539 .M TQWNIOR CITY OF I gjtqulbf?bnui-Ften; Corie. -DESCRIPTIDN CORRECTION Ma Reference . 64?! if? . -- - giant; Sack-,4! 2d {301 . {Erika I .- - '29)sz gal/?? 15? '5 ?v?a?(47-5 Jamaal??7h? (fr/L. 13-Discussion With Person in Charge: r, 63 . ., .12 Corrective Action Requqqed: game ?Yes if! )?fZ . {rt-?Voluntary Compliance Employee ReStn?ctionl- I 1 - ?2 -- 'Exciusion . - a I a; El Re?mspecton Sche'dulai El Emergencyr Suapqui'on 5 El - Emergiaricy?insure i Volunt?ry-Dispbsal . El omen; Farm 734 AM: Squin CDL. Gha?atciyn. THE COMMONWEALTH OF MASSACHUSETTS a TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name Hm. i ,1 Date mum n?r- 1' ?7 Service -EI'Routine Address .. no Ri?k Retail EIRe-inspection . .Level Resudentiai Kitchen Prevrous Inspectlon Telephone ?5 Mobile Data: Temporary [3 Pro-Operation Owner HACCP YIN Caterer Suspect Illness Person in Charge (PIC) i if") 3' 4 [76,11 ,1?an Time Bed& Breakfast Complaint . . . r. Inspector In: {all} Out: ,1 175;; 3; Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.009 (E) (j Violations marked may pose an imminent health hazard'and require immediate corrective Tobacco 5530-0090:) action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT El 1. PIC Assigned I Knowledgeable I Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC 3. Personnel with Infections RestrictediExcluded FOOD FROM APPROVED SOURCE El 4. Food and Water from Approved Source 5. ReceivingICondition 6. Tags/RecordsiAccuracy OfIngredient Statements CI 7. Conformance with Approved ProceduresIHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items) Critical (0) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected Immediately or within 90 days as determined by the Board 23. Managementand Personnel 24. Food and Food Protection 25. Equipment and Utensils 26. Water, Plumbing and Waste 27. Physical Facility 28. Poisonous or Toxic Materials (Fe-Tiissocoa) Allergen Awareness 590.009 (G) 12. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives 1315. Toxic Chemicals TIMEITEMPERATU RE CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures E117. Reheating 18. Cooling U19. 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 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 of105 CMR 590.000IFederai Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing. Your request must be In writing and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: F. . I: "Trent?sreamif. l'l theaters}: A mi ax? Plies/Ema? T) (:53 I Info"?! .31.- FORM 734A AM SULKIN CO. CHARLESTOWN. MA THE COMMONWEALTH OF MASSACHUSETTS . I '7 TOWN ORCITYOF w? Wig-W 3.1. - - ?7 Establishment Name: kit? If?" 931/ Date: 2/39.; x? Page: of (- Item 3053 CriticVIOLATION PLAN OF CORRECTION . ?at? No. Reference R-Red Item - I- - . .. . Verl?#3215?" .riT' uni?f: - r1191: .- 5/31"; .1 .35" 1' pixies?L_,r 14/? 3?1 t7 1 [il'CLwill JlII. ftt? --1 J'y? 7 .. 7/ if"? 2" (If: '11) f, 1 . I ?1;sz fF 1 (J e. I Discussion With Person in ChargeCorrective Action Required: El No flu: Yes ?1 491?.? -. r? 12:1 1121:1145, - . LEI-=Aloluntary Compliance El Employee Res?m'ction/ 1:77 1 4.92/5.? 1 -551} Exclusion El Re-Inspectlon Scheduled El Emergency Suspension El Embargo Emergency Closure Voluntary Disposal El Other: I I THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY Massachusetts Department of Public Health Division of Food and Drugs . FOOD ESTABLISHMENT INSPECTION REPORT Name 9% .- I is . soft) aratlons .J'lirii' 432m A L- J1 EN ?@191er 95/3 .43 Fo?cd Service Routine Address Risk Retail Re-inIspection 3C) {1531's if .a1 Q. Level 5' ResidentialKitchenl Telephone . Mobile Date: Temporary [i Pre- operation Owner HACCP YIN Caterer Suspect illness Bed Breakfast General Complaint Person in Charge (PIC) ED 5:53va 7:57?) "Imi/ ?3 HACCP Inspector IL I lg; if?? 3 I. lib?? I. 443? Out. [hf Permit NO. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provisionis) violated. Non- compliance with: Violations Related to Foodborne Illness interventions and Risk Factors (Red Items) Anti-?choking 590.009 (E) Violations marked may pose an imminent health hazard and require immediate corrective. - T0ba??0 El action as determined by the Board of Health. - FOOD PROTECTION MANAGEMENT 1.- PIC Assigned I Knowledgeable! Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Einployee and PIC El 3. Personnel With Infections RestrictedlExciuded FOOD FROM APPROVED SOURCE . El 4. Food and Water from Approved Source CI 5. IReceivingIConditlon 6 TagsiReoordsIAccuracy Statements T. Conformance with Approved ProcedureslHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing 10. 'ProperIAdequate Handwashing El 11. coed Hygienic Practices . Violations Related to Good Retail Practices (Blue items} Critical violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non- critical [Niviolatlons must be corrected immediately or within 90 days as determined by the Board 23. Management and Personnel (FC-IZII590. 003) 24. Food and Food Protection (Fceusso. 004) 25. Equipment and Utensils (FC- -4)(590. 005) 26. Water, Plumbing and Waste (FC- -5)(5eo. 005) 27. Physical Facility (FC-BIIEQD. 007) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Allergen? Awareness 590.009 to) El 12. Prevention of Contarnination from Hands [j 13. HandvIIasIh Facilities 1 PROTECTION FROM CHEMICALS El 14. [Approved Food In Color?Adlditives D15. Toxic Chemicals . TIMEITEMPERATU RE CONTROLS (Potentially HazardoUs Foods) El 16. Cooking Temperatures . 17. Reheating I [118. Cooling 19. Hat and Cold Holding 20 Time As a Public Health Central; REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSF) 21. Food and Food Preparation - - CONSUMER ADVISORY 22. Posting of ConeumerAdvisoIries Number of Violated Previsions Related To FoOdborne illnesSes Interventions and Risk Factors (Red items Official Order for Correction: Based on an Inapection today. the items checked indicate violations of1D? CMR 596 DUDIIFedcral Food Cede. 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 offood establishment operations. If aggrieved by this order you have a right to a hearing. Your rednest 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 REJNSPECTIONI Inspector' Warm/1C1 {Imerj? were 743 ram/JV r? I (3i) It ?a Pa chOfiTa-gcs FORM T34A A. M. SULKIN CO. GTMHI. ESTUWN. MA TOWN OR CITY OF Establishment Name: THE OF MASSACHUSETTS ?77912v?dum ff}, C'sz"? r534?. fit-4L fin fr {h?rrE?f 1:72:37 ,{rr $7 . [2-9/2 aim I 5x35?? . 5233,97 I Aggie?! 95,12 Ifw?tr'} . ?12551 Mg}? x1 ?xed]; .f/g glee: if? {Ix-1&5 n?fr-q I ff, ?we: max) 3 at 42L Discussion With Person in Charge: .r .-5 I, A .I Corrective Action Required: azno El Yes figVoluntary Compliance Employee Restriction! 7; ,rl} lIJVCi/gq Aria: {wt-1 . - . Exclusion . El Re?ins'p?otion Scheduled Emergency SUspension Eli "Embargo -. El Emergency Closure El Volimtary Disposal El O??ier: ii OF MASSACHUSETTS ir- OR CITY ?3 ?Tove/?ee Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name I, . . a e. oflns ection ?3 xii/i qr 3&5 i ?3 E-nFood Service 4% Routine Address :l 3} (n I ,1 3/7 Risk Retail Re-inepection Level-7 Residential Kitchen Previous inspection Telephone f? Mobile Date: . Temporary Pie?operation own? . . HACGP YIN Caterer Suspect illness person in Char 9 'x . . Time Bed 8. Breakfast DGeneral Complaint 9 (z I?L?lilmxl ?wt/30 DHACCP Each violation checked requires an explanation on the narrative page(s} and a citation of specific provisi?n(s) violated. Non-compliance with: Related to Foodborne illness Interventions and Risk Factors (Red items) Antl~Choking 590.0095) 3 Violations marked may pose an imminent health hazard and require Immediate corrective TOhacco action as determined by the Board of Health. ?9'59" Awareness 590-009(5) D12. Prevention of Contamination from Hands - El 13. Handwas?h Facilities FOOD PROTECTION MANAGEMENT 1. PIC AssignedilinowiedgeablelDuties EMPLOYEE HEALTH El. 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections RestrictediExciuded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. ReceivingiConditicn 6. TagisecordsiAccuracy cf Ingredient Statements El 7. Conformance with Approved ProceduresiHACCP Plans snore-coon rnom condemnation 8. El. 9. Food Cbntact Surfaces Cleaning and Sanitizing 10. ProperAdequate 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 oi Health. Non-critical (NI violations must be corrected Immediately or within 90 days as determined by the Board 23. management and Personnel 24. Food and Food Protection 25. Equipment and Utensils 005) 26. Water, and Waste (FC- 006) 27. Physical Facility 007) 28. Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other PROTECTION FROM CHEMICALS Approved Food or Color Additives El 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods} E116. Cooking Temperatures D17. Reheating El 18. Cooling D19. Hot and Cold Holding El 20. Time As a Public Health Central REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Feed Preparation for CONSUMER ADVISORY . El 22. Posting of CdnsumerAcivisor?ies Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk. Factors (Red Items Official Order for Correction: Based on an inspection today. the Items checked indicate violations of 105 CMR 590.000lFederai Food Code. This repert; when signed below by a Bo'ar?i' of Health member or its agent constitutes an order or 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 requestlmust 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: Iris-yam," IiSignature: [ii/f" Print: in n: FfC?s Signatuwi?.? puff! I (-3 PngeLofi-Pages MA Ctr/Miss ?Ci Ho. e57 Establishment Name: Hf?l?xu FA THE COMMONWEALTH OF MASSACHUSETTS . Vi TOWN OR CITY OF ?lms U. . Date: ?fig/T?? Page: _of item Bade - .G: Cntcalltem DESCRIPTION OF 0F CORRECTION- Date Reference Red item M- mas-E ELEM-1LT .. Vent" ed IT: 2- 0 .r'59:7?3 (?354+ 151?.th fl/ fa 3 E: - 7/23? 2/1/15 51,73 $1172.?? Kain 4mm 5/4 9/34 5704/)? 9? ?35m i6" ?7 g-gz-u/AALL New {in SK/vx?/ 3:th ?z?a 4,29%? {Iii Mg 'r713317;?4 J?f/Jd LL21 L/Cera 5? 2?7 Lu or" ear?I ?trienm {vi/aim fi?tlm in?! 1' If .w (Ajax? ELLE, Kaw- 7?1 IL im-eeyeiw?l {Wu-63"? Li {t 5,1 . . fri- Discussion With Person in Charge? f} Corrective Action Required: ?=Er?No El Yes - . 55!? Murine" - El Voluntary Compliance El Employee Restriction! 7g - - ExclUsion El Re-inspection Scheduled El ?Emergency Suspension El Embargo El Emergency Closure El Voluntary DispoSal El Other: l. I 2 :3 .r-r THE COMMONWEALTH OF MASSACHUSETTS TOWN 0R CITY OF sou glove Maesachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name I 11-1 . 1 . 1 . Dat Type - ?114de it! ?aw/fir;- -13'??Faed Service .1 insuring Address 115-711 10 1; 1r 1_ Risk Retail BRIE-inspection . . ?riU PM Level a; Residential Kitchen Previous Inspection Telephone Mobile 7 Date: . Temporary Pro-operation Owner HACCP YIN Caterer Person In Char Time. Bed 8: Breakfast General Complaint Inspector 11115:?? 111;__ 11-41;; .111 1 Du?; Permit No : Other Each. violation checked requires an explanation on the narrative page(s)l 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 enorecnoe MANAGEMENT . El 1. FIG assigned I Knowledgeable} DutIes EMPLOYEE El _2 .- Reporting of Diseases by Food Employee and FIG 3. Personnel with Infections Restricte'dexcluded more APPROVED SOURCE El 4. Food and Water Source [1 s. ReceivinglCondltion E. 'TagsiRecordsiAccuracy ofingredlent Statements T. Conformance with Approved ProcedureslHACCP Plans Recreation robin commentaries E. Food Contact Surfaces Cleaning and Sanitizing 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Eracticeg (Blue Items) Critical violations marked must be corrected immediately or within 10 days as determined by the Board of violations must be corrected Immediately or within 90 days as determined by the Board . . - 23. Management and Personnel 24. Food and Food Protection 25.? Equipment and Utensils (Fe-4111599305) 26. Water, and Waste lac-511590.005) Nan-compliance with: Ann-choking 5911. 909(5) Tobacco, 690.009 (F) Allergen Awareness 590399113) El D12. Prevention of Contamination from Hands El 13. Handwash Facilities . 1314'. Approved Food or CoiorAdditives El 15. Toxic Chemicals I I 1:1 TIMEITEMPERATURE CONTROLS (Potentially Hazardoliie Foods) 16. Cooking Temperatures 17. Rehe?ating . :5 I318. Cooling Is. Hot and Cold Holding 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS IHSP) I321. food and food Preparation for HSP .. cousuuessovrsosv 22. Posting of Consumer Advisories Number of Violated Provisional 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 59D. Food Code. This report, 'when signed below by a Board of Health member or Its agent constitutes an order ofthe 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 (PC-Bll5902007'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 (690.009) within 10 days of. receipt of this order. 30. Other OF RE leafecfor?s lg Print Dd. Wipff?t (/41:th? I :?fi'l Olil ?ie/f .9 lie? PageLot'J?Pi?ges AM suuon co. MA Establishment Name: -A??/Ifm ?347.15. MEIUJ COMMONWEALTH OF MASSACHUSETTS 1' TOWN OR CITY 09 972)?: ?Date '3 - Page . 5-13-1111 ?mun: manner - Hen: ?nds-:1? DESCRIPTION OF VIOLATION I. PLAN OF CORRECTION ?Dateh Referenae ?27: VeTIerd (ax/FM) {4753770 [in 2.6% 53/1014. . Lye/97?: meDr/r? ?731%?5/ Jac?dx/ai?af game/Day'- . . - ?gs?of?w?b/?xm .1, 364% 43m 17. 241' -5: i Ii? is Discussion With Derson in Charge: 21* - . Corrective Action?Required: No - /47? 29?ng %24Jx 1. . 1 Je- - Welunta?fjomplianee t] Embai'gof :1 . Retn?s'pe'c?oh' SenedUled 1311:! Employee Restriction . -'Exclu510n 1:1 Emergency Suspension Emergency Closure; 'O?jen - 35mm 734 AM.?Sulkjn 00.. 9L THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF iI Ow? 147/7214 Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name it . ..I, Ir Date -erations ecf ?section yI/m?? I 0/76:? 7 I-"Food Service :l-Routinc Address Risk I Retell Re-inspeciion . w? if. . M: Level Residential Kitchen Previous Inspection Telephone 2.- Mobile Date: Temporary Pre-operation Owner HACCP YIN El Caterer Suspect Illness Person in Char p10 I . ,e I Time El Bed Breakfast CIGeneral Complaint 9 no 1" MI 7? it) my?; .2 DHACCF Inspector 1,73? ?(In -. Dun/W :ng Permit No. Other Each violation checked requires an explanation on the narrative pageis) and a citation of specific provisionls) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Antl~0hcking 590.009 (E) Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590-009 (F) :l action as determined by the Board of Health. Allergen Awareness ?0309(3) FOOD PROTECTION MANAGEMENT I3 1. PIC Assigned Knowledgeable I 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 5. ReceivinglCondItion 6. Tags/RecordslAccuracy of ingredient Statements 7. Conformance with Approved ProceduresIHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items} Critical (C) violations marked must be corrected Immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the Board 23. 24. 25. 26. 27. 28. 29. 30. Management and Personnel Food and Food Protection Equipment and Utensils Water, Plumbing and Waste (Fc-sitssocue) Physical Facility Poisonous or Toxic Materials Special Requirements (590.009) Other 12. Prevention of Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or Color Additives E115. Toxic Chemicals TIMEITEMPERATU RE CONTROLS (Potentially Hazardous Foods) D16. D17. D18. Cooking Temperatures Rehea?ng CooHng [319. Hot and Cold Holding I 20. Time 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 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 writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. DATE OF RE-INSPECTION: Lemme Inspector?s Sif?t?rhff Print: If.? I a" my I .Irrj PIC'SSigm?ile'H? Page_ of ?T?Pages FORM 734A A..M EuyR/Ivzivc NM THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY Establishment Name: rum-imam.- vrs?r?fi: 45-h; .- Date: 1/49/11? (7 Page: of 4 Item 60?? Critical - - DESCRIPTION OF.- VIOLATION l' PLAN OF CORRECTION.- -- - - ?at? No. Reference Redltem - - -PLEASE PRINT - Veri?ed - . 1V 02 ?54) .t/Z'x 2135,? .54 I1. 213/ f? if? I 57?? I. . a f?yu?li?zr 1 2" AZ- if); . :3 Lr/i 1? Cy}? r5371elm/wk. .5 112w zw-x a} x. fez-trip-?2; in} F7 - "Cr-"I?Ern_x-x-ze/z 5 729.45.. 5 Discussion With Person' In Charge' Corrective Action (/Q?iwf? . 4, . .- Eli? Voluntary Compliance El Employee Restriction! ?:be Iffx?-z-L?. 4? far?" 2.2.1544, Exclusion I, .- I El Re-inspection Scheduled El Emergency SUSpension El Embargo El Emergency Closure El Voluntary Disposal El Other: THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs- FOOD ESTABLISHMENT REPORT Name .1 Data museum?Mist WW . i. 7? Ilrm 7/ ,7 he ?nd/0M .. 57/7373 Eamon Service - Routine Address (I )4 .- Risk l3 Retail - Elias-inspection. {if v? .7 7? -. Level' ,7 Residential Previous inspection Telephone '39 Mobile . . Temporary Pro?operation Owner HACCP YIN Caterer Suspect Illness Bed Breakfast General Com Iaint Person in Charge (PIC) f) . l:l HACCP Inspector .7713; .4. UUMO Permit No. Other Each violatiOn checked requires an ex'planatiOn on the narrative page(s) and- a citation of specific provision('s) violated. . Non- -compiiance with: Related to Foodborne ll_lness Interventions and Risk Factors (Red Items) Anti-Choking 590.00.90.23 - Violations marked may pose an imminent health hazard and require immediate corrective ??3600 590-009 (F) action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT 1. PIC Assigned Knowledgeable Il' Duties .- EMPLOYEE HEALTH . . - --. 2. Reporting cf Diseases by Feed Empidoyeo and Pic El 3. Personnel with Infections RestrictediExcluded FOOD FROM APPRoveo soun?ce El 4. Food and Water from Approved Source .D 5.- ReceivinglConditIOn - El 6. TagsiRecordsiAccuracy ch ingredient Statements 7. Conformance with Approved ProceduroslHACCP Plans FROM CONTAMINATION - El 8 El 9. Food Contact Surfaces Cleaning and Sanitizing El 1 0 Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue lthSI} Critical (C) violations marked must be con ected immediately or within 19 days as determined by the Board of Health. Non-criticai (N) violations must be corrected. immediately or within 911 clays as determined by the Board 0 hi - . 28. Managementand PerSonnel (PC-zxssocoa) 24. Food and Food Protection 25. Equipment and Utensils (FC- -4)(sso. nos) 26. Water, PiI'meing and Waste (FC- one} 27. Physical Facility (FC- 007) 28. Poisonous or Toxic Materials 29. Special Requirements (scanner 30. Other I Allergen AWareness 590.009 i] 12.- Prevention of Contamination frorn Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved FOod or ColorAddltives El 15. Toxic Chemicals; TIMEITEMRERATURE CONTROLS (Potentially Hazardous Feeds] El 16. Cooking Temperatures E117. Reheating 18. Codiing El 19. Hot and Cold Holding 20 Time As a Public Health Control REQUIRIEMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) El 21. Food and Food Preparation for HSP CONSUMER El 22. Posting of Consumer Advisories Number Of Violateci Provisions Related To_Foodborne Illnesses Interventions and Risk Factors (Red items Official Order for Correction: Basodon an inspection today, the items checked indicate violations of 105 CMR 551i]. UDUIFederal 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 clted' In this report may result' In siIspensiorI _or_ revocation of the feed 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?sSigIIature: X: /yM/i7ll #34 Print: W?x?f?f?a? 7% Signat?l??/ f/lff Prim/.7. .77 a: 1.7.7? JI . PageLofiPages FORM 734A Agrd/m CO. MA xI..-Ir! TOWN OR CITY OF fx/ij/ (F9 LII-I Jain?~? Establishment Name: I THE COMMONWEALTH OF MASSACHUSETTS strawAh? x04 3'33 (ff/1" I 3?54 ?yr-?3 CD {21:7 314? ?9161;" 7* 7:4 ?es: 7' e? 2. {145 2.1? (/5172 5.Discussion With Person in Char e: mi? Corrective Action Required: . 273:: No Yee 9 Wu" 5* 7x? 5/522?; - jg? :EI-I?Vomntary Compliance El Employee Rest-Idiom if") i?x i473}? - MAI 71:27- 3? ?My 92$: EXcIusiOn a? - 1-.- x? Rev-inspection Scheduled. mx 5 . CI - Embargo 'Voluntary bisposa? Emergency Suspension Emergency Closure Other. .i .l COMMONWEALTH OF MASSACHUSETTS . TOWN QR CITY OF ms . (it Massachusetts Department of Public Health Division or Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name J?n. Date of oration a cot Ins action I rial/?1? t-J'ir/ Hm I or wicket/arid" ?Iii-Food Service J, iEi'R-Juline Address p. Risk? Retail Pie-inspection 2' ably. I .- Residential Kitchen Previous Inspection J. eve! Telephone Mobile Date: Temporary Pro-operation Owner . HAOCP YIN a Caterer Suspect Illness . i Bed Breakfast General Com laint Person in Charge (PIC) 5* A) Jan}? HACCP l3 inspector I. Jr) I A r" .J.J .. Permit No. Other Each violation checked reqllires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non- compliance with: V__iolations Related to Foodborno Illness Interventions and Risk Factors (Red Items} Anti-Choking 690.009tE) Violations marked mayr pose an imminent health hazard and require immediate corrective 5530-0090:) action as determined by the Board of Health. 590'009 El FOOD PROTECTION - E112. Prevention of Contamination from Hands El 1. PIC Assignodi KnowledgeableiDuties D13- Han dwac Facilities EMPLOYEE HEALTH [3 2_ rt fD' dE PROTECTION FROM CHEMICALS 9P0 "190 Isoases 00 mp an D14. Approved Food orCoIorAddiliveS El 3. Personneiwithinfections RestrictedlExciudcd FOOD FROM APPROVED SOURCE 4. Food and Water fromJApprovad Source El 5: ReceivinglCondition 6. TagsiRecordsiAccuracy of Ingredient Statements El 7. Conformance with Approved ProceduresiHACCP Plans PROTECTION FROM CONTAMINATION El 15. Toxic Chemicals CONTROLS (Potentially Hazardous Foods) 16. Cooking Temperatures [:117. Reheating 18. Cooling E119. Hot and Cold Holding 20. Time'As a Public Health COntrol - - - REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONB (HSP) El 9. Food Contact Surfaces Cleaning and El 21' Food and Food Preparation for l-iSP El 10. ProperAciequate Handwashing' 8.. . . . . CONSUMERADVISORY El 11' Good Hygienlc Practlces . 22. Posting of ConsumerAdviSorios Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related ItemS) Critical (C) VlOlatlonS marked must be corrected To Foodborne [?nesses 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 __immediately or 90 days as determined by the Board today. the items checked Indicate violations of 105 CMR SQGCOEIlFecleral Food Code. This report, when signed below - - . - by a Board of Health member or its agent constitutes an 32' ili?anggegint (Fe-antiseptic) order of the Board of Health. Failure to correct violations 0? an 0? ro es lo" cited in this report may result In suspension or revocation of 25' Equipment ?Id Uten?lls (Fc?4?l590'005) the food establishment permit and cessation of food 25-" Water. Plumbing and Waste (Fc'5ll599-005l establishment operations. If aggrieved by this orderll you 27- Physical Facility (PC-Bil590-007l have a right to a hearing. Your request must be In writing 28. Poisonous or Toxic Materials (FC-7II590-008I and submitted to the Board of Health at the above address 29. Special Requirements 1 (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSFECTION: l(l 7e? grit Jamie/2 arm/id PIC ?s l?I iatrm got/twatrlo?o w? TOWN OR CITY OF A. - . Establishment Name?" ?74th2 THE COMMONWEALTH OF MASSACHUSETTS Z2) riff/?? 3511,. I 24592? 4.37.221; Date: til/)1: Page: lii-?c DESCRIPTION OF OF IGQ REC ION Red Item . . . .l . (5-) - um {mu 773:: 5 . 1y r) {Iggy}: ?207 5.414?35; a Discussion With Person' In Charge. ,4 . 3 ?lJr? r2. Corrective Action Required: El No .0731 Jim 4:6? APTJ 7? 55." Compliance [3 Employee Restrictien I @779 . l3 Re-inspection Scheduled El Emergency Suspension Embargo El Emergency Closure Voluntary Disposal El Other: ?i r. TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT 0? I THE COMMONWEALTH OF MASSACHUSETTS Vat/Wm Name 51:; Date IeOfOIeretions oflns lion Id {22/4 ?/43 JUL 5/ ?E?Food Service . genouiine . Address . . Rick Retail Fte inspection (IV-W {j 4' Level 4 .7 Residential Kitchen PreVious Inspection Telephone - Mobile Date: Temperary Prevoperation Owner HACCP YIN Caterer Suspect illness Bed Bre'akfaSt General Corri laint Person In Charge (PIC) If: A [2350' J) El . EHACCP inspector' 2 H4 outy-r)_ . ?35? Permit No". EIGther Eath violatIon checked requires an explanation on the narrative pagels) and a citation of specific provisionts) violated Violations Related to Foodborne Illness Interventions and Factors [Red Items] Violations marked may pose an Imminent health hatard' and require immediate corrective . action as determined by the Board of. Health. FOOD PROTECTION MANAGEMENT 1. FIG Assigned I Knowledgeable I Duties EMPLOYEE HEALTH -- 2. Reporting of Diseases by Food Employee and PIC El 3. Person nol with Intentions. ResirictadIExciuded - FROM APPROVED sounca 4 Food and Water irom Approved Source 5. ReceivingiCondItion 5. TagisecordsiAccu racy of ingredient Statements Conformance vrith Approved ProceduresIHACCP Plans PROTECTION . - B. 9. Food Contact Surfaces Cleaning and Sanitizing El Proper Adequate 11. Good Hygienic Practices Violations Related to Good Retail Erectices (Blue items) Critical (C) violations marked must be corrected immediately or within 10 clays as determined by the Board 'of Health. Non- critical violations must be corrected . immediately or within 90 day's as determined by the Board -CI. .23. Management and Personnel ire?zirsamai 24. Food and Food Protection {Fc arisen. till-t] 25. Equipment and Utensils I105) .26. Water.- Plumbing and Waste (Fc-sirsari. one} 27. Physical Facility (Fe-'sirseir. iIn'r) EB. Poisonous or Toxic Materials (Fe-mean one) 29. special Requirements {590.509} 30. Other. ilion Compliance with: - Anti-choking see. one (El El Tobe non 0.009 (F). . Allergen Awareness El 12. Prevention of Contamination from Honda D13. Handwash Facilities PROTEOTIOII FROM E114.- Approved Food or Color'Additivas . I CI 15. Toxic Chemicals 1 . TIMEITEMPERATURE CONTROLS (Potentially Hazerdotls Feeds} CI 15. Cooking Temperatures 17. Reheating [j 13 Co'oling 19. Hot and Cold Holdingpi' CI 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY POPULATIDNS iHsPi 21. Food and Food Preparation lor ltiSP - .4- CONSUMER novrsonv El 22. Posting of ConsumerAdvisorles Number of Violated Provisions Related To Illnesses Interventions and Risk Factors (Red Items 1- Official Order for Correction: Based on an inepection today, the Items checked indicate violations of 105 CMR 590.1}illiiFedersl Food Cede. 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 vlolatiOns' cited In this report may result In suspension or revocation of the food establishment permit and cessation of feed establishment operations. It aggrieved by this orderI you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the obeys address withln10 days of receipt of this order. DATE OF RE-INSPECTIONI Inspector?sSignat/E? 72?? ?agwm Print: [if Vm? IL/tlr??ti?t?i 3 Signature: If fir/La! Pm?i film?) La?, I FORM734A snooth??o. on - 1.. or CITY OF {fl/179% {it . Establishment Name: Milky/Hp SEEKQM Date Pagg; I '7 CORRECTION Reference Ilf' Praise P'm?ir: CLEARLY be? 7m@? - Hem-i3 9/2? 2:5 2m; 6814?? Hmoicznx/r 1.03}; r? 2? 3 mew (142% ram Wadm aw 24;: - (View Discussion With Person in Charge: I - ICorre eAction Required' 52% 215. Am iggz??qgfm??j . - r? . El .Yes gay/2 gel/m am 741. - . . _;:Voluntar3r Compliance ?wg?H- 4/4: ?/fgm El Relnspec?on ScHeduled' ?vuw-_r Embargo - Voluntary Disposal :7 Employee Ree?i??on Exclu?sion Emergency Suspension Emergency Closure chrr- Form 734 ALMZ-Sulkin 00.. Chad?stovm. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR OF diff m. Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name 51%th . . T_vpe of Operationtsl Type of Inspection frFood Service Routine Address 1 ,7 x- Risk Retail [1 Re-inspection I I I . I I Level Residential Kitchen PreVIous Inspection Telephone Mobile Datg'. Tem orar re-o oration Owner HACCP YIN Catgrer Person Charge ti" r_.i Fit Em? 2? )5 -- Bed BreakfaSt 3:23:38: Complaint Inspector IL (?fl/2U: ii"? if"! r. )1 Out: B. 21.30 Permit No. Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.009 (E) Violations marked may pose an imminent health hazard and require immediate correctiva ??8000 590009?) action as determined by the Board of Health. Allergen Awareness 590-009 (G) :1 FOOD PROTECTION MANAGEMENT El 1. PIC Assigned I Knowledgeable I Duties EMPLOYEE HEALTH 2. Reporting of Diseases by Food Employee and PIC El 3. Personnel with Infections RestrictedlEchuded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source 5. ReceivingICondition 6. TagisecordslAccuracy of Ingredient Statements 7. Conformance with Approved ProceduresIHACCP Plans PROTECTION FROM CONTAMINATION 8. 9. Food Contact Surfaces Cleaning and Sanitizing El 10. Proper Adequate Handwashing El 11. Good Hygienic Practices Violations Related to Good Retail Practices (Blue Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected Immediately or within 90 days as determined by the Board 23. 24. 25. 26. 27. 28. Management and Personnel Food and Food Protection Equipment and Utensils Water, Plumbing and Waste Physical Facility Poisonous or Toxic Materials El 12. Prevention of Contamination from Hands 13. Handwash Facilities PROTECTION FROM CHEMICALS 14. Approved Food or ColorAdditives 15. Toxic Chemicals TIMEITEMPERATURE CONTROLS (Potentially Hazardous Foods) 16. El 17. 18. Cooking Temperatures Reheaiing Coohng Ci 19. Hot and Cold Holding El 20. Time 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 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 590.000I'Federal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing. Your request must be In writing and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: {hi . . [.15 If, I 141-bp?; 5.1111151" .- I. fit" Pu??g?il?i?fikplfifi Ki 1 Print-rag?: iv.- ?1 PageLofJ? Pages - II FORM 734A AM. SULKIN on!) f'ciwettestova-I'M. MA THE COMMONWEALTH OF MASSACHUSETTS r: 4 TOWN OR CITY Establishment Name: is .0 2-177: :11 Date: 3 ?f r" a? Page: of Date OF VIOLATION I PLAN- OE .. PLEASE PRINT CLEARLY .C - Criticai Item - Red Item Item Code 0. Reference Verified Ifan EI Yes Corrective Action RequirecQL, NO ?Dr?Voluntary Compliance Rea-inspection Scheduled El Embargo 0 Voluntary Disposal i El El Cl Employee Restriction Exclusion Emergency Suspension Emergency Closure Other. I H. ti. . THE ,p-v?u TOWN OR CITY 3 ti? L?it . Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT REPORT Name 211* 5- ff Date so the action 91 if so out LIL: {fired/W 7 ?Food Service 'Routine Address 2""71? Risk El Retail Flo?inspection - . i .11 Level ,2 Residehtial Kitchen Previous Inspection Telephone . Mobile Eats: Temporary Pre-operation Owner. - HACCP YIN l] Caterer . E1 Suspect Illness Person in Charge (PIC) Eb pf}; Tim}; [1 Bed Breakfast 35228;! Complaint In: lzi?il?g {:13 Out: .993"- DOther - It Each violation checked requi es an explanation on the narrative page(s) and a citation of-specifi?c provision(s) Non-compliance with: violated. - Violations Related to Foodhorne illness ll?i'tel'vel'ltiDI'lSind Risk Facto?iRed items) Anti-Cttuitlrig cocoons) Vioiations marked may pose'an Imminent health hazard and require Immediate corrective 590-009 {Fl action as: determined by the Board of Health. - . - ?mg? Awareness 590-99? (Gt FOOD PROTECTION mannoensnr Prevention of Contamination from Hands 1. - PIC Assigned KnowiodgeabielDuttes . El 13-. Handwash Facilities EMPLOYEE HEALTH 2 rt' . iD' 'b i PIC: - PROTECTION FROM CHEMICALS . EH4. Approved Food or ColorAdditives actions Res nctediExcluded I: 15- Toxic Chemicals . FOOD Fnorn APPaoveo sconce. - . . 4? Fund and Water from Approved so? we TIMENEMPERATUBE CONTROLS (Potentially Hazardous Foods) CI 5. RecaivingiCondition El 6. TagsiRecordsiAccuracy 7. conformance with Approved ProcedureslHACCP Plans PROTECTIONFROM contmnarlon . [j 8. CI to. Cooking. Temperatures El 17. Beneath-g D13. Cooling 3 - 19.. Hot and contracting I 20.. Time As a Public Health Control 9. Food ContactSurfaces Claitljing and Sanitizing - El 10. ProperAdequate . .. consum?eeaovrsonv . .- 11.- 5000? Hygienic Pt?fimes . . . 22. Posting of Concom?rAdvisories Violations Related to GoodRetail Practices (Blue Number of Violated Provisions Related - items} Critical violations marked must be corrected To Fgodhome? ?1.195535 interventions If?) immediately or within 10 days as determined by the Board and RiSk Factors (Red items 1.22); . Of Health. Non?critical! iNl violations must be ?3??th Official Order for Correction: Based on an inspection immediately or within 9t! days 35 determined by tholBoard today, the items checked indicatevioiations BMR 590.cl??lFederal Food Code. This report, when signed below - by a Board'of Health member or its agent constitutes an :13; $231232: Order of the Board of Health. Failure to correct violations . - . cited in this report may result in suspension or revocation of 25' Eqmpmont ?3er Utensils the food astabiishmentpermit and cessation offood 26-. Water, Plumbing and Waste (Fc'?lw?'LmW establishment operations. If aggrieved by this order. you 27- Physical Facility . (FC-BKEBO-OOT) have a right to a hearing. Your request must be in writing 28. Poisonous Toxic Materials and submitted to the Board of Health at the above address 29'. Special Requirements . (599.009) within 10 days of receipt of this order. 30. Other; - . DATE oF RE-INSPECTION: (If Prior}? ?11; i? (j-?Pl?i??/H b} - Page?Cufjages v- 4- -..- FORM rots AM. co. {cilanLESTov-mmn, CITY OF Establishment Name::. 33% Li 513*?: TEE 0's MASSACHUSETTS - i I a) a) ?-?Xz?izjh ?mi? . 4-, ?i nibbm Zr (9'7 :ix'zl??rfz?is?x .. mos-M aim-w - - ,r . 775,1?? #17. a; 1' f? 5.1.2 a an.) mm a (30/4 rw Iowa; r; 6 Discussion With Person in Charge: 7 Corrective Action Required_.-, Volun'mry Compliance. El Employee Restriction! I '24! HA ?i 7 .7 - Exclusion 1:1 Re-ihspection SC?eduled El EmergencyiSuspension El Embargo El rErnergenoy Closure Voluntary Disposal Other?. I. I - THECCOMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name I i: Date Tine of Ogemtlonisi of Ins -ectior 7 LI but: by" .- I I I 57?? _iI-?Food Service m??outine Address ?1 q. Risit Retail EIRe-inspeotion If I Level Residential Kitchen Telephone . Mobile Date: . Temporary Pro-operation Owner HACCP YIN a Caterer ESuspect Illness person In Char 9 Pic Time Bed Breakfast General Complaint 9 I I Gigi?p til" in?ll? EIHACCP Inspector I:ri Lilian-1, - .Ijl? )3 . I Out/Z KI) Permit No. Other Each violation checked requires an explanation on the narrative pageis) and. a citation of specific provision(s) Non- compliance with: violated. Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.0095) Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590-009 (F) action as determined by the Board of Health. ?fame? Awale?assv 590909 FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1. PIC AsSignedi Knowledgeablei Duties CI 13. Han dwasli Facilities, EALTH . 34"?sz . fEii i? i In :33 PROTECTION FROM CHEMICALS . senses ?co an . .. 999m? E114. Approved Food or ColorAdd?was 3. Personnel w' In ections RestrictedlExcluded . U15. TOXIC Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS {Potentially Hazardous Foods) El 4. Food and Water from Approved Source 5. ReceivingiCondition I 6. TagsiRecordslAccuracy _of Ingredient Statements El 7. Conformance with Approvali ProceduresiHACCP Plans PROTECTION FROM 8. 16. Cooking Temperatures D17. Reheating 18. Cooling I119. Hot and Cold Holding El 20. Time As a Public Health Control REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) [j 9. Food Contact SurfaceS Cleaning and Sanitizing 21. Food and Food Preparation for HSP . El 10 ProperAd?qUate - CONSUMER ADVISORY 11'- G_0?d Hygienic Practices - I i 22. Posting of Consumer Advisones violations Related to Good Retail Practices (Eilue Number ofViolated Provisions Related Items] Critical (C) violations marked must be corrected - To Foodborne ?Inasses Interventions C) Immediately or Within 10 days as determined by the Board and Risk Factors (Red Items 1 of _.Heaith Non- critical (Nivloiations must be corrected Official Ord?r for Correction Based on an inspection iminedlateiy or w'th'n 9.0 days as determined by the Board today. the items checked indicate vIolations of 105 CMR - 590. DOUIFederal Food Code. This report virhen signed below by a Board of Health member or its agent constitutes an 2: yanggeigint ad": (FC ?ms? 003) order of the Board of Health. Failure to correct violations 2 0? an 0? r0 9? (Fc' -3)(590. 004) cited in this report may result in suspension or revocation of 25? Equipment and UtenSIIs the food establishment permit and cessation of food 26- Water, Plumbing and Waste ?95599-00" establishment operations?. if aggrieved by this Order, you PHYSICHIVFBCIIW 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 4 )n pi: tcr?ii Signature all, WI 5317;, Wf?myh Print: K, 4314? V/frf 22?" K79. 14.74 M: If fill": Piigeiof??l?ngcs F??walsumnw cn?mf MA If? I I THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF 3? I . 7 - Establishment Mama?:36 Lib/meext? Date: ?5 Page: of DESCRIPTION oF. VIOLATION PLAN OF CDERECTION . Edith?? :5 PLEASE PHINTCLEMLY II-. tram-?3' :93? fl) 15:30 . 25/ era/J91?) It": I) 4?7 fix? 1an 1" .. . 5, lair/1.47: 37 0 I germ? HI 5? . (I ,?I/Iafif- (I 3. 210v Icy-r? {jg/MI: '5 a/mm Swag/dz.? .. Ii?? V5 :3 Discussion With Person In Char . - Corrective Action Required: No A KYES -Moluntary Compliance El EmpIOyee Restriction! . 3:171:11! -. Exclusion El.) Re?inspection Scheduled El Emergency Suspension El Embargo - El Emergency Closore El Voluntary Disposal Other. - f: . I THE COMMONWEALTH OF MASSACHUSETTS ?7 TOWN OR CITY OF AA, MassachNSetIs Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name:Pood Service outine Address? I i 4.1? I Risk Retail - Re- -Inspeclion ?7 it Level Residential Kitchen Previous Inspection Telephone . .3 Mobile Data: . Temporary Pre~operaiion Owner HACCP YIN El Caterer FIB-mun in Char a Tim Bed&Breakfasi DG'eneralComplaini 9 1 I) cut Lem-1? In. 5.. - IZIHACCF- Inspector Out: I. ?7 Permit No. Other Each. violation checked requires an explanation on the narrative page(s) and a citation of specific provisioms) violated. Violations Related to Foodborne illness interventions and Risk Factors (Red Items) Violations rnarked may pose an imminent health hazard and require immediate corrective. action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT. 1.. PIC Assigned I Knowledgeable! Duties EMPLOYEE HEALTH El 2. Reporting of Diseases by Food Employee and PIC I: 3. Personneiwlth Infections RestrictediExcluded FROM APPROIJED SOURCE- El 4. Food and Water from ApproVed Source 5 ReceivingICondition 6. TagisecordslAccuracy of ingredient Statements 7. Cenforrnance with Approved ProcedureslHACCP Plans PROTECTION FROM CONTAMINATION [j 8.- 9.2 Food Contact Sudaccs Cleaning and Sanitizing ?10. Proper Adequate I CI 11. Goad HygierIic Practices ViOlatiOgs 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 90 days as determined .by the Board 23. Management and Personnel 24. Food and Food Protection {FooIIsecno-u 25. Equipment and Utensils {Foolissuoes} 26. Water.IPlumbing and Waste {Fe-susceoosi 27. Physical Facility 28.- Poisonous or Toxic Materials 29. Special Requirements (590.009) 30. Other Ncn- -compiiance with: Anti-choking 590 .009 (E) Tobacco 590.009 (F) Allergen Awareness 590439985) El 12. Prevention cl Contamination from Hands El 13. Handwash Facilities PROTECTION FROM CHEMICALS E114. Approved Food or Color Additives 15. Toxic Chemicals - .. it TIMEITEMPERATURE CONTROLS (Potentially Hazardous :dsII 16-. Cooking Temperatures? El 17. Reheatlng 18. Cooling . I119. Hot and Cold Holding' 2 El 20; Time As a Public Health Control REQUIREMENTS FOR HIGHLY POPULATIONS (HSPI 21. Food and Food Preparation for HSP I . . -_ur CONSUMER ADVISORY .- 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne 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 590.0[llilFederal Food Code. This report. below by a Board of Health memberor its agent constitutes an order at the Board of Health. Failure to correct violations cited In this report may result In suspension or revocation of the food establishment permit and cessation of food establishment operations. it aggrieved by this order you have a right to a hearing. Your request must be In writing and submitted to the Board of Health at the above address within 10 days Of receipt of this order. DATE OF RE-INSPECTIDN: s?f?r own I: new. (/?fil I ewe-ca 6.) like!? me. 'T'i'iE oli' MASSACHUSETTS TOWN OR CITY OF . EStEb'HShmentName ?15 Mia?U??Zm ?9 Date: Page: 2' of' 2? .. . nate-w . 5 1'??th I) 29 sub?ML; ??ww 5% 5 07mm L3 1244 HAM fa: ?3759x11 A 3 32? {4:0 65 [132.52. . - . - Wm 915Discussion Person in Charge: Corrective Ac?on Required: El No \?les . . - - . @Votuntary Comp?ance Emp1oyee Restriction! 74"} . - - - I Exclusion I . 5 -. u- Re?mspectlon Scheduled; El IEmergenCy Shsp'e?'s'ion Embargo 'El gEmergencyf ?lojsme . {If '1 - Volumai'y Disposal El (lathe; - Form 734 AM. Sulkin go? Cha?estoWn. MA I THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF )m . Massachusetts Department of Public Health Division of Food and Drugs ESTABLISHMENT INSPECTION REPORT Name . .. 7 Dat?? Tylpe of Operation?sl eoflns action .- -. .- .-I..- - . --Food Service i I-Routine Address .3 I.. Risk El Retail Re-inspection 4' Level, Residential Kitchen Previous Inspection Telephone 3 Mobile Eerie: Tem orar Pre-O eration Owner HACCP YIN Catgrer IZISuspeit Illness Person in Charge (PICTime Bed Breakfast General Complaint .. ..L.. . . In. .1 DHACCP Inspector II, . I . 0"th ;i Permit No I: Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) viola ted. Non-compliance with: Violations Related to Foodborne Illness interventions and Risk Factors (Red Items) Anti-Choking 590.009 (E) Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590-009 (F) action as determined by the Board of Health. Aliergen Awareness 590-009 (GI FOOD PROTECTION MANAGEMENT 12. Prevention of Contamination from Hands 1. PIC ASSIgnedi KnowledgeabieiDutIes [:113. Handwash Facilities EMPLOYEE HEALTH 2 ortin of Diseasesb Food Em to and PIC PROTECTION FROM CHEMICALS 9P 9 9 CI 14. Approved Food or CoiorAdditives I315. Toxic Chemicals TIMEITEMPERATU RE CONTROLS (Potentially Hazardous Foods) 3. Personnel with Infections Restricted/Excluded FOOD FROM APPROVED SOURCE 4. Food and Water from Approved Source El 5. ReceivingiCondition 6. TagsiRecordsiAccuracy of Ingredient Statements El 16. Cooking Temperatures D17. Reheating El 7. Conformance with Approved ProceduresiHACCP Plans 18' Cooling . - II PROTECTION FROM CONTAMINATION I3.19.._H_ojand 00? I 8. 20' Time AS a Health COHIIOI . . . . REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS (HSP) 9. Food Contact Surfaces Cleaning and SanItIzmg CI 21. Food and Food Preparation for HSP 10. ProperAdequate Handwashing CONSUMERADVISORY 11' 600d Hygienic Practices 22. Posting of Consumer Advisories I I a . . Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical (C) violations marked must be corrected To Foodborne Illnesses interventions I 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 immediately or within 90 days as determined by the Board 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 23. Management and Personnel 24. Food and Food Protection 25' Equipment and Utensils the food establishment permit and cessation of food 26- WateI', Plumbing and Waste establishment operations. If aggrieved by this order, you 27- Faculty have a right to a hearing. Your request must be in writing 28. Poisonous or TOXIC Materials (PC-7it590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: I I . InspIgL'ffn" II Sigllatum (W I -- Plint: If} . . A. P1615 Printf (x well If? .- It) Lad/?w? PageLofiiIages FORM CD. MA THE COMMONWEALTH OF MASSACHUSETTS TOWN OR CITY OF Establishment Name?)? Date: 7 Page: Code Reference Item - Critical Item . DESCRIPTION OF VIOLATION i' PLAN OF CORRECTION No. ~