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0867 IYANNOUGH ROAD/RTE 28 - HOTELS/MOTELS - FOOD
�a�2-f'�e- 1� �n n 7Fo� tS �`'1 �'`�A.�r►ri c�q�CZd N�a�nri i S .- - --- ---- - - - - _ _ _ _ �----- - -- - - ----- - _ ._. a94�- o4� a- i H �µ BOARD OF HEALTH Town of Barnstable John T.Norman Board OIt Health Donald A.Gaudagnoli, M.D. BMtNSTAOM F.P.(Thomas)Lee,. MAC Daniel Luczkow,M.D. Alt. $ 6 9• 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 350 Issue Date: 01/01/2022 DBA: FAIRFIELD INN &SUITES BY MARRIOTT OWNER: 867 HYANNIS HOLDINGS LLC Location of Establishment: 867 IYANNOUGH RD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IncloorSeating: 44 OutcloorSeating: 0 Total Seating: 44 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent i FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: PVT L4 - ) _ - �tNE Tpk For Office L Initials: Town of Barnstable Aa , ; Inspectional Services at Armed �9. cne�it# I a t639. �0 �Eo �a Public Health Division - Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-464.4 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 12/01/2021 NEW OWNERSHIP RENEWAL.X NAME OF FOOD ESTABLISHMENT: 867 Hyannis Holdings LLC,.DBA Fairfield inn&Suites.by Marriott ADDRESS OF FOOD ESTABLISHMENT: 867 lyainnou,gh Road, Hyannis,MA 02601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: ttolentino@waterfordhotelgrooip.com TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5( 08 ) 771 _ 6100 Ix TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES_NO X ..:.(ANNUAL V�'.ATER ANALYSIS.REQUIRED) ANNUAL: X SEASONAL: DAT141S OF OPERATION: / / TO / NUMBER OF SEATS:INSIDE: 44 OL=TSIDE: 0 TOTAL: 44 SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. "*OUTS.ID.E DINING,REMINDEW" OUTSIDE DINING.MUST BE APPROVED BY THI HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINI14G? IS AN.AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CRECK ALL THAT APPLY.BELOW) X FOOD SERVICE _RETAIL FOOD-ONLY required for TCS foods.(foods requiring refrigeration/freezer) _BED&BREAKFAST _CONTINENTAL.BREAKFAST ._COTTAGE FOOD INDUSTRY(formerly resideatial:kitchen) MOBILE FOOD _FROZEN DAIRY DESSERT MACHINES...(MONTHLY LAB ANALYSIS REQUIRED) _CATERING....(CATERING NOTICE REQUI11186 BEFORE EVENT(SEE PAGE#2) ' SEASONAL,MOBILE&NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV..FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Appfication FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT 867 Hyannis 0gerating LLC SOLE OWNER: YES/NO OWNER PHONE#508-771-6100 51 ADDRESS CORPORATE OWNER:867 Hyannis Holding., LLC CORPORATE ADDRESS: 100 St. Paul Street, Ste 800 Denver, CO 80206` PERSON IN CHARGE OF DAILY OPERATIONS: Tomas Tolentino List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have I Certified Food:Protection Manager PER.SHIFT., **ATTACH COPIES OF CERTIFICATES''*'The.Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at.your food establishment. Certified Food Managers Expiration]Date Allergen.Awareness Expiration Date 1.Tomas Tolentino 04. / 23 I2023. 1., Tomas Tolenitno 12/ 28 /2023 2.4ennifer Greaney 11 / 12 / 2023. 12 _/ 06/2021 SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL'FOOD SERVICE:All seasonal food establishments,including mobile trucks; must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7).days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must to tested by a State Certified lab prior to.opeiing and monthly thereafter, with sample results submitted to the Health.Div. Failure to do so will result.in the suspension.or revocation of your Frozen Dessert: Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You:must:complete a catering notice found at httli:/hvww.townofbarnstable:usLhealthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any,food p"roduct by a food.establishment is probibited. NOTICE: Permits run annually from January 1 st to Dec.31'each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED AP.PLICATION(S)AND REQUMED'FEES..BY DEC Ist. Q:\Application FormsTOODAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. a F.P.(Thomas)Lee NAM 200 Main Street,Hyannis, MA 02601 Daniel Luczkow,M.D.,Alt. Phone: (508)862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L.Chapter 94 Sections 305A,305B, 146, 189 and 189A;Chapter 111,Sections 5 and 127A,a permit is hereby granted to: Permit No: 350 Issue Date: 07/01/2021 DBA: FAIRFIELD INN & SUITES BY MARRIOTT OWNER: 867 HYANNIS HOLDINGS LLC Location of Establishment: 867 IYANNOUGH RD HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 44 OutdoorSeating: 0 Total Seating: 44 FEES FOOD SERVICE ESTABLISHMENT $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE- ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS,CHO,Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: f pTME r°� For Office 1 • Initials: ti Town of Barnstable .. Date Paid Amt Pd$i AIJ BA ASTABLE, : Inspectional Services MAM 1639. ,• Public Health Division Check# I� ds.P � CEO MA'S A Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP Y RENEWAL NAME OF FOOD ESTABLISHMENT: &.,-4 Hyannis Qp�: a-�tr�q LLC DBA Fairfield HwnNiS � ADDRESS OF FOOD ESTABLISHMENT: G )4 ZVO��1nOl.JC1 Rd , N��` y1 is MA 02(co I MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAILADDRESS: - ©lenr�c� �va �r- rcha(�I arn�� CC)fYl TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (5a - 00 TOTAL NUMBER OF BATHROOMS:I WELL WATER:YES NO V1 ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: 44 OUTSIDE: a TOTAL: L4 4 SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpplication FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT S b-4 fficm6 S opc a- i rp L-LC SOLE OWNER: YES/NO OWNER PHONE# ADDRESS CORPORATE OWNER: S(o-4 H! jan In l S i i M lA i nas L UC CORPORATE ADDRESS: I OO Sk `QaW U.xJ my-par CO 8020C PERSON IN CHARGE OF DAILY OPERATIONS: OI'�YJI j UI.2.1'l�I ) List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. T0mo,s Tdcn--hro *i(o303o4 i oz3 1.Mrrr,�Tc�ert mi 3!o513 IS 1 20Z3 2. jen6t lI / 12- / 2,3 ZI SIGNATURE F ICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. i CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townotbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 31s1 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Application FormsWOODAPP REV3-2019.doc Fairfield Inn & Suites Cape Cod Hyannis 867 Iyannough Road, Hyannis, MA 02601 508-771-6100 Food Prep Area and Breakfast Seating Area IA 13 Tj 11 nil 3 I� 1p - T — GL .` I Y \el t a r � 1 e 1 r 1 r t I •�":. i'tV r „i�' '. "�` � I I • :; dam: . II tI r' - 1� Fairfield by Marriott Cape Cod Hyannis 867 lyannough Road, Hyannis, MA 02601508-771-6100 Complimentary Continental Breakfast Offerings Selection of Chobani Yogurts Selection of Kellogg Cereal Selection of Quaker Oatmeal Nature Valley Granola Bars Assorted Danishes Assorted Muffins Assorted Fresh Fruit ie. Bananas, clementine's, watermelon Hard Boiled Eggs Scrambled Eggs Pork Sausage Veggie Sausage Milk— Regular, Chocolate, Soy Coffee— Regular and Decaf Orange Juice and Apple Juice Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAR.NffrA8LF_ Paul J.Canniff,D.M.D. 0200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 350 Issue Date: 01/01/2021 DBA: FAIRFIELD INN & SUITES BY MARRIOTT OWNER: K HYANNIS HOSPITALITY LLC. Location of Establishment: 867 IYANNOUGH RD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 44 OutdoorSeating: 0 Total Seating: 44 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: I For Office Use Only: Initials: 21-5 V Town of Barnstable rr� ~� Dad paid MB Inspectional Services BAM9.61 Public Health Division Check# W15 3 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 11/16/2020 NEW OWNERSHIP RENEWAL X. NAME OF FOOD ESTABLISHMENT: K Hyannis Hospitality, LLC, DBA Fairfield by Marriott ADDRESS OF FOOD ESTABLISHMENT: 867 lyannough Road, Hyannis, MA 02601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: ttolentino@waterfordhotelgroup.com 1K — ql# i 4U 4ea�no e r f YM 1 i C C + �J��,y� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5( 08 ) 771 _ 6100 TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES NO X (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: X SEASONAL: DATES OF OPERATION: / / TO / / NUMBER OF SEATS: INSIDE: 44 OUTSIDE: 0 TOTAL: 44 SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING` N/A IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S),, N/A TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) X BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD . . . .. .... ... .. . FROZEN DAIRY DESSERT MACHINES...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ..,(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** _REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormskFOODAPP REV3-2019.doc OWNER INFORMATION: FULL NAME OF APPLICANT K Hyannis Hospitality LLC X SOLE OWNER: YES/NO OWNER PHONE# ADDRESS CORPORATE OWNER:JCSK Holdings LLC CORPORATE ADDRESS: 342 North Main Street, Suite 200, West Hartford, CT 06117 PERSON IN CHARGE OF DAILY OPERATIONS: Tomas Tolentino List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES" The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Exl)iration Date v\ 1. Tomas Tolentino-Cert#16367704 04 / 23 /2023 1.Tomas Tolentino Cert#3705393 12/ 28 / 2023 2. jennifer Greaney 11 / 12 / 2023 ( ) 11 /16 / 2020 SIGNATURE OF APPLICANT DATE **"FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments, including mobile trucks must be inspected by the Health Div. Frior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.tow noibarnstable.us/healtlidivision/aDDlicatioiis.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31s`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC I st. Q:\Application Forms\FOODAPP REV3-2019.doc Dp IKE 7 TOWN OF BARNSTABLE, ,.. ;., -• ,, .,. ,..HEALTH iNSPECTOR's Establishment Name: i6 `A ._. �lmr' Date: .Page:,.. „ of..' OFFICE HOURS - PUBLIC HEALTH DIVISION _. 8:00-9:30A.M. BARNSTABLE. ' 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,Ass.� •� HYANNIS,MA 02601 MON.-FRI. :a�9• No Reference R.-Red Item PLEASE PRINT CLEARLY 508-662-4644 p a - ` rFD Mph F OD ESTABLISHMENT INSPECTION REPORT. - - - Name ; ` Dated! Type of Tyne of Inspection -3 // Operation(s) Routine Address ^� Risk Food Service Re-inspection ` Level Retail Previous Inspection 1 Telephone Residential Kitchen Date: Mobile Pre-operation Owner �. .5 HACCP Y/N Temporary Suspect Illness oun Caterer General Complaint Person in arge(PIC'-- Time Bed&Breakfast HACCP \Y-� Q/'�'a In: Other I I . - D CQAQ Al) Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated.. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Y P q Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives. ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals ` FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating - ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) �� S `, ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY - ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories a Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations - Critical(C)violations marked must be corrected immediately. (blue&red items) 3�I'1 Corrective Action Required: No ❑ Yes Non-critical(N)violations must be corrected immediately or 0 within 90 days as determined b the Board of Health. Overall Rating Voluntary Compliance y ❑ ry p ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items , checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Poisonous u Toxic Materials (FC-7)(590.008) g violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspe s re f� 31.Dumpst rscreened from public view Permit Posted?�' N Grease Trap Previous Pumping Date Grease Rendered Y N Outside Dining Y N PIC' ignature Print:#Seats Observed Frozen Dessert Machines: Self Service Wait Service Provided Grease Trap Size .Variance Letter Posted Y N1;Iz_'W Dumpster Screen? Y N 1 Violations related to Foodborne Illness - - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION- PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 6 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 - - PHE Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH _ 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* - - - - Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Se azation-Storage* 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control. 7-202.11 Restriction-Presence and Use* - 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* - 590.004 11 Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer -- 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q __ - 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* - REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources F 9 - - - Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( P 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations * 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts PacNotkage Served Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* -4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.1IA(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Contact Surfaces o Utensils and Food Contt Surfaf E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg ceve 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3 401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* _ 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS - r 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A),(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' P � Game and Wild Mushrooms Approved By_ * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices _ 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the, 6 TagsiRecords:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision i 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8_103.12 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF,NEroy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: ) ! Date: 1 age: of . 4p OFFICE HOURS D PUBLIC HEALTH DIVISION 8:00-9:30 A.M. i BARNSfABLE. = 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. MON� 0� HYANNIS,MA 02601 08-8 -62-464644+a79• 58-8 No Reference R-Red Item PLEASE PRINT CLEARLY a. 'EDN1�' FOOD ESTABLISHMENT INSPECTION REPORT Name Date Tyne of Tyne of Inspection O era io ou Address Risk -rood Sery , spection Level RetaT Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other - Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) 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. Allergen Awareness 590.009(G) ❑ i „/ �` ,� . FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals -- FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ` o, 1 ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating U 1 ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY �Q ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations I llj�1 Critical(C)violations marked must be corrected immediately. (blue&red items) I�1 Corrective Action Required: o ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Voluntary Compliance y ❑ p ❑ Emergency P y ❑ ry p ❑ Employee Restriction/Exclusio Re-inspection Scheduled Emer enc Suspension C N Official Order for Correction:Based on an inspection today,t it ms ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Foo Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. FC-4 590.005 B=One critical violation and less than 4non-critical violations g 25.Equipment and Utensils ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of FC-7)(590.008) be in writing and submitted to the Board of at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials ( violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF E-INSPEC 10 nSpec nt: 31.Dum ter screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date l �!�V� �v Gr a Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signat a Print: Self Service Wait Service Provided Grease Trap Size Variance.Letter Posted Y N ,/� (� ct) .To�, n f Dumpster Screen? Y N - P `" Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each * 590.004(F) 7-101.11 Identifying Information-Original Containers 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-]02.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(13) Exclusions and Restrictions* 3-306.14(A)(B)Resumed Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* I Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of Eggs 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* of cfi e 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11 C 3 Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* ( )( ) Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.11 Package Integrity* g g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F item Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 ■ 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. �p 114 ro TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: C \rQ4-1 .Y� _Date: Page: of 4 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MAS S. �m� HYANNIS,MA 02601 MON.-FRI. No Reference- R-Red Item PLEASE PRINT CLEARLY 508-862-4644 p'FDN1P`A OOD ESTABLISHMENT.INSPECTION REPORT Name ��� Date C Tvoe of ectio V on s Routine Address Risk Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness n Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other n Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation-of specific provision(s)violated. Violations Related to.Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009 F `tea YP q O ❑ 1 O Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives 1 ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items] Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Voluntary Compliance Employee Restriction/Exclusion Re-inspection Scheduled Emergency Suspension Y ❑ rY P ❑ ❑ P ❑ 9 Y P C N Official Order for Correction: Based on an inspection today,7eddems F] Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005 B=One critical violation and less than 4non-critical violations 9 ) cited in this report may result in suspension or revocation er the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007 aggrieved b this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of y y ) 99 Y Y 9 g q violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 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. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspe r s na r Pri \ 31.Dumpster screened from public view \\\ ) Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's ture Print: . Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N V Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F * 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* * 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rlated or of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources rg Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid 1'vlilk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment* gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Egg°"°e innooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.1l(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 3-201.14 Fish and Recreationally Cough[Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C CommerciallyProcessed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remainin Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated O g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashin Facilities 3-501.14 A g 3-202.18 Shellstock Identification* g ( ) Cooling Cooked PHFs from 140°F to 70°17 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 1.003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance * 590.004 Labeling of In radiants' Supplied with Soap and hand Drying Devices Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 (J) 9 g 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 106 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. HEALTH INSPECTOR'S Establishment Name: fA1 Date:tr�ro TOWN OF BARNSTABLE '� ., � i Page: of ti OFFICE HOURS PUBLIC HEALTH DIVISION PE i 8:00=9:30'A.M. BARE. � 200 MAIN STREET '� 3:30;:4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. g. - /- MON -FRI. "rEn Mn+ HYANNIS,MA 02601 �{!s0s 862-4s44 No Reference R-Red item PLEASE PRINT CLEARLY rl� / Tt�. - FOOD ST B I HMENT INSP C 10 F Name Dat T e o f Inspection Roue Address s Food Sery = ect� n el a Previ.V I p Telephone Residential Kitchen Date: Mobile Pre-op Io Owner HACCP YIN Temporary Suspect II e i Caterer General Complaint Person in Charge(PIC) Ti a Bed&Breakfast HACCP Other ' Inspector t Each violatio ecked requires an explanation on the�narra Nepa e(s)and a citation of specific provision(s)violated. 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. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ Approved Food or Color Additives' ❑ 3.Personnel with Infectious Restricted/Excluded 15. Toxic Chemicals FOOD FROM APPROVED SOURCE IME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures. ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling i ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE /POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY Vy� Lo ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items). Corrective Action Required: ❑ No Yes . Non-critical(N)violations must be corrected immediately or Overall Rating ❑ within 90 days as determined by the Board of Health. ( ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on a insp c�intodgFode. checked indicate violations of 105 CMR 590.000/Federal ❑ Embargo Emergency,Closure ❑ Voluntary Disposal Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the•Board of Health. Failure to correct violations B=One critical violation'and less than 4 non-critical violations regardless of the number of critical,results in.an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have aright to a hearing. Your request must C=2 critical violations and less.than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8non-critical vio ations. If 1 critical refrigeration. 29.Special Requirements, (590.009) within 10 days of receipt of this order. tion,4 to 8 non-critical violati ns= 30.Other DATE OF RE-INSPECTION: Ins for Signature 9 Q nt: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N IC's Si a re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y :. N Dump ster Screen? Y N Violations related to-Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination L 14 Food or Color Additives _ Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12•--- Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* - - . - 2-103.11 Person-in-Chazge Duties - - 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F)- 2 590.003(C) - Responsibility of the Person-in Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F * 7-`]02.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se azation-Storage* Applicants* - 3-302.11(A) Food Protection* P20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An .3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590:004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils ( ) 9 590.003(G)- Reporting by Person in Charge*- 7-203.11 Toxic Containers-Prohibitions* 1 ' Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* _ _ REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 - Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.0.04(A-B) Compliance with Food Law* -4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) I Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs*_ _ - Sanitization Temperatures*. TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.I1A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg I Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eb ce°e 11112001 4-602.11 _ Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* R 590.006(B) Water Meets Standards in 310 CM 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell ShelMsh and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702:11' Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish*' - 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009 A -(D) Violations of Section 590.009 A 3-201.15 t Molluscan Shellfish from NSSP Listed Chemical* ( ) ( )-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority I 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices -1� Reheating for Hot Holding practiceRequires should be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 * (Blue Items 23-30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome * 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated �) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked and nd Fr from 140°F to /45 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours From 70°F to 41'F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45`F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006- 590.004(J) labeling of Ingredients• Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen.Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000`. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. - - 1 f ' Fairfield ®t Breakfast Food Preparation Biscuits and Sausage Gravy-Step by Step Wash your hands. . M Remove thawed and labeled biscuits from the fridge. ° Replenishment and Quality Set the microwave on high and Standards cook for 2 minutes. • Prepare a new batch of biscuits and sausage gravy when the'chafing dish is less than 1/3 full. • Biscuits should be tender i and moist. I W % Place sausage gravy in a large Gravy should be hot _ _..r 4 saute pan. throughout. a • 'Discard after 30 minutes on the buffet' � Heat over medium to high heat w a until an internal temperature of A A X 165° F is reached. r Stir to avoid scorching. t" - Using tongs,transfer the biscuits to an appropriate half-pan chafing dish. - . With a spoon/ladle, transfer F.. the gravy from the pan into an appropriate half-pan chafing dish. FATRFfELD Marriott International I Confidential and Proprietary Page 42 f r� 1WWA"M@ GI-I( Large Capacity Tag: Grease Interceptor SPECIFICATION:Watts Drainage GI-K Series recessed or floor mounted epoxy coated steel grease interceptor with gasketed epoxy coated steel skid-proof cover secured with hex head center bolt(s),double wall deep seal trap, integral stainless steel flow control plate,and no hub(standard)connections. I I l D(length)x E(Width) _ %``��l4iyr,��gte�$Ol4Ct:�1!.Dl#'>•';`> I Flow Control Plate _Z¢ 75 GPM _. i ❑ C 100 100 GPM ❑ 150 150 GPM ❑ A _ 20D 200 GPM ❑ 250 250 GPM ❑ �— 30D 300 GPM ❑ Inlet Outlet 400 400 GPM ❑ F 50D SOD GPM ❑ g >tlpcts{SeleJr fllzre} `S u�!X�:iSs'isz<'?%E`CASU!RitC1.1.i;i%? z:? : .............. •B SeddmentBucket ❑ i •E Extension ❑ EC Flange&Clamp Device ❑ ! -HD Heavy D.y(10,00016.) ❑ TraBta Cover •O Inlet&Outlet other$on ❑ Stondord.Size SS' Stainless Steel ❑ •THD Threaded Connections ❑ 'US Buy AmericanCompllont MR I i I ( I i I :«i;q,6tr! <•;:Rafe.; ''Cd 1Dtet6; ....8oia:1'o"t•:;%%� .�:�a�a�:%::?::,•.::::,. %;I;>Umber 'PM. s:•. ;;t?idlets?<;?:?;tenfP.Ci': [...4"e»fie7 :::. t._ .:: ::...... .....:.. , GI.75-K 75 150 4"(102) 18.1/2"(470) 4.1/2"(114) 39-3/4(1010) 30-3/4"1781) 23"(584) GI.100-K 100 200 4"1102) 28.1/2"(724) 4-1/2"(114) 39-3/4"(1010) 30.3/4"17811 33"(838) I GI-150-K 150 30D 4"1102) 38.1/21(978) 4-1/2"(1141 39.3/4"11010) 30.3/4"(781) 43"11092) ) GI-200-K 200 400 4"1102) 36.1/2"(927) 6-1/2"1165) 52`(1321) 34"(864) 43"(1092) GI.250-K 250 500 4"(102) 39-1/2"(1003) 6.1/2"(165) 52"(1321) 34"(864) 46"(1168) GI.30D-K 300 600 6"(152) 38"(965) 10"(254) 76"(1930) 48"(12191 48"11219) GI-400-K 40D 800 6"(152) 42"(1067) 10"(254) 83"(2108) 55-11397) 52"(1321) GI.500•K 1 500 1 1000 6"1152) 53"(1346)1 10`(254) 91"(2311) 1 60-11524) 63`(1600) I I i Job Nome Contractor ' a Job location Contractor's P.O.No. i Engineer Representative I . WATTS Drainage raerve>the right to modiy or change product design or cooilrudlon without pl or notico and vMhour Incurring any oUlgallon to make similor changes and modification!Io poduds • prevlousiy a subxquen�y sold.Seeyoor WATTS Drainage mpr.s.nlaltve for any clarification. Dimen9onsare subject tomonulacNring tutatonwi.: AIW I Specs leatlon Dralnage Products USA:100 Watts Road,Spindale,NO,28160.2298;TEL:828-288-2179 TOLL-FREE:1-800.338-2581 www.watts.com ES-WD-GIK USA 13U G4-K I i I -V ................ DAMATO BUILDERS AND A. VISC>RS,LLC D'Amato Builders & AdvisorsLLC Submittal 40 Connecticut Avenue Submittal Number: 15400-11 Norwich,CT 06360 Date: 01/21/2015 Page 1 of 1 To: From: Job Site: Ed Diamond John Hogan Fairfield Inn&Suites;Hyannis Russell and Dawson LLC D'Amato Builders+Advisors 877 lyannough Road 1111 Main Street 40 Connecticut Avenue Route 132 East Hartford, CT 06108 Norwich, CT 06360 Hyannis,MA 02601 I— CC: Utkarsh Patil - Russell and Dawson LLC 1111 Main Street East Hartford, CT 06108 John Wilcox - Russell and Dawson LLC 1111 Main Street East Hartford, CT 06108 Glenn Raymond - E. F.Winslow Plumbing& Heating 8 Reardon Circle South Yarmouth, MA 02664 Regarding: 15400-11 Interior Grease Trap Remarks: SHOP DftAWI.NG SUBMITTAL REVIEW its:°Rf�'':'>fr piFSrr�: R=. lJE3ftfl(1 HOP DRAWING F EVIEW PUSC XPP-F VEDASI`40 ED D RUECTED AfitCHIT I I I I &lAAtNNSTTR FIT E r tNG EAST HARTPt' RD,CT 06#(36 SUBMITTI'M,WAS RLVIEMf-.0 €DESIGN (OW(J-040Y ARD REVIEW IS FOR GENERAL COMPLIANCE WITH CONTRACT oocutAENrs. fi;P$F Al {l'N i7Rf.1rlyilC ToQtITPAF.T f7f i l.1?JsFf#i4 Tlfi7{;Y. NO RESPONSIBILITY IS AS LIMED FOq THE COINTRt'A710R IS R„-5110�61B!-F F(7)R C`,03Nr11R?V'41K(1 AND CORRECTNESS OF DIMENSIONS OR DETAILS. C( PRH.ATIN(it r)#tJeFNYON-'s AT 1�1R-3TF r'OR T071E1R:;WT, NQL=EPTONTAKEN 0 tAAKEC/)AR4=CTIONS C#LAPANC E, IXIJ."E#v #f'If� FABRICATION' ' OC U-•,SSLS A,h,�Fl NOTED ILI wltvlC21�L5 CE �"iJ'Nis Cvi i#s f--coriogm-nON OF 1ry115 WORK K 'Al!P I OTI01 IT;f=LIES AND f LILL tfSPOPLIANCL %,V rf1 �`ICE D ® Rl REVISE AND RESUBPdri ' G SUSFAITSF`ECiFIED ITEM I CON'TRAICUDOCUMEN1S. y/ A l3v Date 01/21/15 DATE By E;Anaato Builders&Advisar-%LLC 40,(7ojnnPctie.tru Avenue Norvich,CT 06360 Please respond by: 0.1/28/2015 =r airfouei¢i Not Breakfast Food Preparation Turkey Sausage-Step by Step .; Wash your hands. Put on latex/ vinyl gloves. Shingle frozen patties, as shown, into microwaveable container. * 5 Replenishment and Quality Cover and label the container Standards 1:1P. with the name of the item and the • Prepared patties should be . , date. -golden brown, moist; and .x x glistening. • Prepared patties should not appear dry, crispy, or shriveled. � When less than 6 patties Store overnight In the refrigerator • �„� are left in the chafing dish, to thaw. 'discard there and replace Thawed items can be kept in the }' them with anew batch, fridge for up to three days and following these instructions. , cannot be refrozen. • Patties should be.discarded after 30 minutes on the buffet. ®mm To heat, place covered container in the microwave and heat for 3 minutes or until heated to an internal-temperature of at least 165°F. Remove container from f � microwave. Using tongs, carefully move • , ;,. patties to a clean chafing dish insert. FAIP,F[ELD Marriott International I Confidential and Proprietary Page 40 INN&MTEBO Fairfield ® area fast Food Preparaticn Freshly Prepared Oatmeal(optional)-Step by Step Wash your hands. ..r Plug in the machine. Remove the stainless steel insert. Replenishment and Quality a�: " Add 2 cups of water to the kettle �Standards base. Prepare fresh batches of Replace the stainless steel insert. oatmeal as needed. Turn the machine setting to #10. • Do not add water to an existing batch of oatmeal'to make it last.' • Discard all unused oatmeal Add 2 quarts of water to the at the end of service. stainless steel insert. Allow to heat for 5 minutes. i Add 4 cups of Quaker Oatmeal to the stainless steel insert. .. Stir to combine ingredients. e ; Cover insert with lid. Reduce temperature setting to #5. Oatmeal will be ready in 20-30 minutes. FAIRFIELD Marrio l.Imernational I Confiden=ial and Proprietary Page 46 t Fairfield Hot Breakfast Food Preparation 4 Scrambled Eggs(liquid)-Step by Step (When prepared correctly, yields the best scrambled egg product) Wash your hands. Empty 1 quart liquid egg product into a microwaveable container. Replenishment and Quality Standards Cover and place in microwave. • Prepare a new batch of r Set microwave on high. scrambled eggs when the chafing dish is less than Cook for 5 minutes. 1/3 full. b, Scrambled eggs should be fluffy and moist. They should not be dry or watery. F 1 a - Remove container from • Discard after 30 minutes on d65� microwave. L the buffet. Carefully remove lid. Fluff egg mixture with a whisk. If necessary, re-cover and place in microwave. Cook on high for an additional 90 seconds. s� Remove container from microwave. Carefully remove lid. Re-fluff egg mixture with whisk. Transfer the scrambled eggs to a warmed chafing dish insert. INNSFIEL ITUO Marriott International I Confidential and Proprietary Page 38 iR L Bellaire, Dianna From: Miorandi, Donna Sent: Monday, September 24, 2018 9:03 AM To: Bellaire, Dianna Subject: RE: Fairfield Inn Dianna: They only serve breakfast. Does that help? Donna S`vw,�-d Pal From: Bellaire, Dianna Sent: Monday, September 24, 2018 8:53 AM To: Miorandi, Donna Cc: Bellaire, Dianna Subject: RE: Fairfield Inn It states they have 44 seats and they are a restaurant. I am trying to determine if they only serve Continental Breakfast or if they have an "actual" restaurant that serves food/other meals. Do you know? If they are only full continental then they are over paying, if they are a full restaurant,they are underpaying. Thanks. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us From: Miorandi, Donna Sent: Monday, September 24, 2018 8:33 AM To: Bellaire, Dianna Subject: RE: Fairfield Inn Hi Dianna: Yes, they have a very full continental breakfast. They have a good size kitchen and do have seating. I think they should be food service/restaurant. Why,what have they been paying? Donna From: Bellaire, Dianna Sent: Tuesday, September 18, 2018 4:14 PM To Miorandi, Donna Cc: Bellaire, Dianna Subject: Fairfield Inn Donna; Can you confirm what they are serving at this hotel? Do they serve a full continental breakfast AND have a restaurant? I know they have 44 seats as well. Can you let me know. I am thinking they are paying the wrong amount every year. Dianna Bellaire