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HomeMy WebLinkAbout0131 OCEAN STREET - HOTELS/MOTELS (3) Ci�2 )+r-ee'�" i 's �, y _ 11+F Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. t aAWNSTABLE Paul J.Canniff,D.M.D. 200 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: 387 Issue Date: 01/01/2021 DBA: OCEAN STREET INN OWNER: 131 OCEAN STREET LLC Location of Establishment: 131 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: BED AND BREAKFAST Annual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEESFOOD SERVICE ESTABLISHMENT: YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: $30.00 — ------ -- -- MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent i FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE l Restrictions: Continental Breakfast Only! f T 7 I E . For Ofllcc Ilse 1Wy: Initials: Town of Barnstable nd lot Inspectional Services Public Health Division chcd —� �3 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Officc: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE Mar 17,2021. NEW OWNERSHIP X RENEWAL NAME OF FOOD ESTABLISHMENT: OCEAN STREET INN ADDRESS OF FOOD ESTABLISHMENT:. 131 Ocean Street Hyannis MA 02601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE) 28 Jaeome Way Middletown Rl 02842� E-MAIL ADDRESS: dmccall@newporthotelqroup.com `) TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 775 _ 1639 ( 508) TOTAL NUMBER OF BATHROOMS: 1 s WELL WATER:YES_NO X ..(ANNUAL WATER:ANALYSIS REQUIRED) ANNUAL: SEASONAL: X DATES Op,OPERATION:5� 7 f 21ro 10 16 121 NUMBER,OF SEATS: INSIDE: 12 OUTSIDE: 0 TOTAL: 1:2 SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DTV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,'MUST BE APPROVED BY THE HEALTH DIV AND LICENSING.AND MEET OUTSIDE DINING REQUIREMENTS. is IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? F N/A IS AN AIR CURTAIN PROVIDED AT.WA ITSTAFF SERVICE DOOR(S)? N/A TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) _FOOD SERVICE _RETAIL FOOD-ONLY required for TCS foods'(food$requiring refrigeration/freezer) _BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD F FROZEN DAIRY DESSERT MACHINES...(MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE R2) -- *** SEASONAL MOBILE&NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUE PLEASE CALL 508-%2-4644 PP 1A lication FemsWOODAPP 2020.doc Q- i t OWNER INFORMATION: FULL NAME OF APPLICANT Donald McCall: SOLE OWNER: YES]NO D.O B 1/29/56 OWNER PHONE#`. 401.-662-2540 -V<____ ADDRESS 28 Jacome Way Middletown, RI 02842 }/ CORPORATE OWNER: Harborview Hotel Investors i_ ��� (7(P(LI� S L-L-C E CORPORATE ADDRESS: 28 Jacome Way Middletown;RI 02842 PERSON IN CHARGE OF DAILY OPERATIONS: Velma Francis, GM 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 Exntration Date Allife-en Awareness. Expiration Date is 1. NIA I' / '' 1: N/A / 2. 3 1/PI 2 N SIGNATURE OF AP LICANT DATE **'*FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,.including mobile trucks must be inspected by the Health Div Prior to aoeningll Please call Health Div.at 508-8b2-46 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 httu•ltwivw townotbarnstable us/hesithdivision/aanlieatians.asu. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by food establishment is prohibited. t NOTICE: Permits run annually.from January Ist to Dec.31"¢each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION($)AND.REQUIRED FEES BY DEC 1st: i i S s I Q%Appl cation Forms\FOODAPP REV3-2019.doc i t it i f 3- lj OCEAN INN F'. s t> 3 t is {1 t N.Jqeakast Buffets { Continen'tai Divide Buf fet Assorted Pastries of Chef Choice Fresh Baked Muffins,Bagels and Breads .Accompanied,with Jams,,Jellies,Cream Cheese,Peanut Butter and Butter Assorted Flavored Yogurts with House Made Granola` Assorted Cold Cereal Selections,with Whole and Skim Milk $ll I' Y f gf{- f, p� f, McCall, Donald S. From: Bellaire, Dianna<Dianna:Bellaire@.town.barnstable.ma.us> Sent: Friday, March 5,2021 12:49 PM To: McCall,Donald S. Cc: Bellaire, Dianna Subject: 2021. Food Permit for Ocean Street Inn Er Importance: High Mr.McCall, You will receive a renewal notice in the mail that was computer generated. This notice will show a fee for the Ocean Street Inn for a renewal of a continental breakfast..You are anew owner and this is not a renewal. If you are continuing with the continental breakfast,as previous owners had done,I need the following: 1. Completed application which you will receive in the mail 2. Copy of continental breakfast menu-.A true continental breakfast ONLY has pre-packaged foods and UNCUT whole fruits. There is no opening,cutting or cooking any food of any kind. 3. Check made payable to Town of Barnstable for$130.00. This is comprised of a new fee and the annual fee of $30 4. Tentative date of opening? You will need an inspection by one of our health inspectors If you are changing this establishment to a full breakfast,you must speak with a health Inspector. You would also pay more money..This would be a$155.00. You would be required to have 2 Servsafe Certified Food Managers and One of them would need to be allergen trained., THIS IS NOT REQUIRED FOR CONTINENTAL BREAKFAST,PLEASE.PUT N/A ON THE APPLICATION when you receive,if you keeping continental breakfast. I just wanted to clarify the computer generated letter is incorrect and you might not be aware that this establishment had continental breakfast. If you are not going to have any kind of breakfast.orbeverage service,please let me know:and I will close you out of the database. Thank you. is 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 The information contained in this electronic transmission{"e-main")-includingany attachment(the"Information") may,he confidential or otherwise exempt from.disclosure.It is for the addressee only.This Information may be Privileged and confidential work-product or a Privileged and confidential communication:The Information'may also be deliberative and pre-decisional in nature.As such,it is for intemal:use only.The Information may not be,disclosed without the prior written concur of the Director of Public Health and/or the Town Attorney's Office of the Town of Barnstable.If you have eceived.this e-mail by mistake,please notify the.sender and delete it from your system.Please do not copy or forward it.'Thank you for your cooperation. i i ` 1 BOARD OF HEALTH Town of Barnstable e John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARlV3rABM Paul J.Canniff,D.M.D. 6519. . 200 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, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 387 Issue Date: 01/01/2020 DBA: HYANNIS HOLIDAY MOTEL —� FjUj( S— OWNER: HAWTHORNE PROPERTIES, INC �brT/n� Location of Establishment: 131 OCEAN STREET HYANNIS, MA 02601 nD Pe-rr� Type of Business Permit: BED AND BREAKFAST Annual. Seasonal. YES Indoor5eating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: $30.00 MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Continental Breakfast Only! v Bellaire, Dianna From: McCall, Donald S. <dsmccall@newporthotelgroup.com> Sent: Wednesday, June 24, 2020 9:06 AM To: Bellaire, Dianna Cc: Desmarais, Donald Subject: RE: Hyannis Harbor Inn- Formerly Hyannis Holiday Motel Dianna It does not look like we will be doing food at the Hotel this year. If this should change I will let you know. Don From: Bellaire, Dianna <Dianna.Bel laire@town.barnstable.ma.us> Sent:Thursday, May 28, 20201:37 PM To: McCall, Donald S.<dsmccall@newporthotelgroup.com> Cc: Bellaire, Dianna <Dianna.Bellaire@town.barnstable.ma.us>; Desmarais, Donald <Donald.Desmarais@town.barnstable.ma.us> Subject: FW: Hyannis Harbor Inn- Formerly Hyannis Holiday Motel Hi; I haven't heard a response from you regarding the breakfast for this hotel. I've attached the application again. The old owner had a continental breakfast. Please read email below for more details. Thank you. 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 1be information contained in this electronic transmission("e-n.aail."),including any attachment(the"Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only.Thus Information may be privileged and confidential work-product or a privileged and confidential communication.The Information mayy also be deliberative and pre-decisional in nature..1.s such,it is for internal use only.The Information may not be disclosed without the prior written consent of the Director of Public Health and/or the Town Attornev's Office of the Town of Barnstable.If you have.received this e-m.ail by mistake,please notify-the sender and delete it from your. s�-stern.Please do not copy or forward it.Thank you for your cooperation. From: Bellaire, Dianna Sent: Wednesday, April 15, 2020 8:50 AM To: dmccall@newporthotelgroup.com Cc: Bellaire, Dianna; Tripp,Vanessa; Desmarais, Donald Subject: Hyannis Harbor Inn- Formerly Hyannis Holiday Motel Hi; 1 i I received a form from Building Department that you are the new owner of the Hyannis Holiday Motel. You will need to fill out an application for the continental breakfast(attached) if you are going to continue with that program. If not, please let me know and I will close you out of my files. A continental breakfast has no cooking or heating involved.The foods are all pre-packaged. You will need to pay$100.00 for a new fee and $30.00 for the breakfast permit. The total of $130.00 for the breakfast permit. You should check with Vanessa Tripp (copied on this email) regarding application for hotel. Once I've received your new application and payment. We can contact your health inspector regarding inspection needs. Thank you. 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.Bella ire@town.barnstable.ma.us 71le.information contained.in this electronic traslsmission ("e-mail"),including any attachn.ient(the"Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only.This Information may be privileged and confidential work-product or a privileged and confidential communication.The Information may also be deliberative and pre-decisional in nature. Lks such,it is for internal use only.The Information may not be disclosed without the prior written consent of die Director of Public.Health and/or the Town.Attornev's Office of the Town of I.3arnstable_If you have received this e-mail by mistake,please notify the sender and delete it from your system.Please do not copy or forward it.'I'liank you for your cooperation. CAUTION:This email originated from outside of the.Town of Barnstable! Do not click links, open attachments or reply,.unless you recognize the sender's email address and, know the content is safe! 2 i �► , Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. A.Ga Board of Health Donald A.Gaudagnoli,M.D. aA%NSTABLE. John T.Norman MAC 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate xtl'39 a♦ Phone: (508) 862-4644 Fax: (508)790-6304 t 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: 387 Issue Date: 03/01/2019 DBA: HYANNIS HOLIDAY MOTEL OWNER: HAWTHORNE PROPERTIES, INC Location of Establishment: 131 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: BED AND BREAKFAST Annual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: . 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: $30.00 -- - - -- MOBILE- FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE 1 ' fi Restrictions: v ti Initials; Town of Barnstable + BAR .E, MASS. � Inspectional Services ��$�� y A99. 4jA i6J9. 'F°MAV° Public Health Division M.� Thomas McKean, Directory 200 Main Street, Hyannis,MA 02601 Al -" Office: 508-862-4644 Fax; .508-790-6304 t,I^y APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT; - � l a� MAILING ADDRESS (1F DIFFERENT FROM ABOVE): E-MAIL ADDRESS: ,. SFIle ��-%:s�0������®� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS:_Z WELL WATER; YES NO— " (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL; —Z' 7DATES OF OPERATION: S l //�TO /D //er/ IR NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. _-..._.***OUTSIDE DINING --- 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 ONTINENTAL 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) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) ' SEASONAL MOBILE &NEW FOOD ONLY*�*x REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:1Application FomisTOODAPPREV2018.doc f OWNER INFORMATION: PLEASE CALL 508-862-4644 FULL NAME OF APPLICANT ?_ eSOLE OWNER: YES/NO D.O.B 3 OWNER PHONE # ADDRESS_____tl�i/ CORPORATE OWNER; FEDERAL ID NO. ; CORPORATE, ADDRESS: vl'AX �, ---1-1 PERSON IN CHARGE OF DAILY OPERATIONS: e 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 AIlerryen Awareness Expiration Date • t F 2. i SIGNATURE OF AP ICANT DATE I I ._ FOOD POLICY INFORMATION***-.__ SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile h-ucics 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 suet, 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://wwtiv,townofbarnstable us/healthdivic' r ion/applications asp, OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited„ TOBACCO ESTABLISHMENTS; All tobacco establishments must complete an Application for Tobacco Sales Permit and mployee Signature Form. 4 I! NOTICE: Pennits run annually from January Istto Dec. 31"each calendar year.-IT IS YOUR RESPONSIBILITY TO RETURN II THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC l st. Q:�/\pplivalion P0rms\F00DAPPREV2018.d0c I I f. oF. r TOWN OF BARNSTABLE HEALTH wSPECTOR,s Establishment Name: e Date: Page: of . _ OFFICE HOURS ' P ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. ennNSTna�e. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified `0$ HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �i0ren MPS s 508-862-4644 FOOD ESTABLISHMENT INSP CTION REPORT Name Date Type of Tyoe of Inspection Operation(s) Routine Address j Risk Food Service Re-inspection allLevel Retail 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) ❑ 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 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 ❑ 1,0.Proper Adequate Handwashing CONSUMER ADVISORY L D dA ❑ 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) 11 If Corrective Action Required: 0 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 an inspection today,the items ® Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food 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. 25.Equipment and Utensils (FC 4 590.005 B=One critical violation and less than 4 non-critical violations 9 )( ) 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. 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 C=2 critical violations and less than non-critical. p,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must . If critical water,sewage back-up, 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 anon-critical violations. 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to tical violations=C. 29.Special Requirements (590.009) Y P 1111 30.Other DATE OF RE-INSPECTION: Inspect gn re 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 Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster 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* 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* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation g 7-202.11 Restriction-Presence and Use* 20 Time as a Public Health Control 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* 590.003(G) Reporting by Person in Charge* 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 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* 590.004(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* 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* TIMEITEMPERATURE 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 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Eggs 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* Ef cti-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) I Ratites,Injected Meats-155'17 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)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* 10 P ing,mobile food,temporary and residential 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. * 2-301.14 When to Wash* 3 403.11 A 1 All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )(b) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g. g g 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 3-202.15 Package Inte * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) " Commercially Processed RTE Food-140°F* (Blue Items 23.30) g 8nty 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 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* Lill_ 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 3-202.12 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 5-204.11 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 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 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"WETow TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: n \� Date: b 11 Page: . of, q OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-430A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 9cbp 639:p�m� HYANNIS,MA 02601 M-8 -FRI.624644 No Reference R Red Item PLEASE PRINT CLEARLY Teo MPS 508-8 FOOD ESTABLISHMENT INSPECTION REPORT Name `_ Date Tvue of Type of Inspection ion 1Ooeration(s) Routine Address % Risk Food.Service. Re-inspection . Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP O In: Other Inspector Out:-15 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) ❑ 0 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' 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 'V3 ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violation 1 Critical(C)violations marked must be corrected immediately. (blue&red items) I 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 y y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection to ay,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food 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. 25.Equipment and Utensils FC-4 590.005 B=One critical violation and less than 4npn-critical violations. g ( )( ) 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. 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 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 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 anon-critical violations. If 1 critical refrigeration. Within 10 days of receipt of this order. violation,4 to Snon-critical violations=C. 29.Special Requirements (590.009) Y P 30.Other DATE OF RE-INSPECTION: Ins or in u 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 Si re Print: Self Service Wait Service Provided Grease Trap Size - Variance Letter Posted Y N Dumpster 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 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 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(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 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 Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and RestrictionsA Disposition ofAdulterated 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 g 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 Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y Pe 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* TIMEITEMPERATURE 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.I IA(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 Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens*590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game g * Effective I112001 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 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 Surf 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 Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical 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 aoryAutnd YWId Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory 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 es should violations relating to good retail ( ) practices should be debited under 929-Special 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-2.02.11 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 foodborne * 12 Prevention of Contamination from Hands 3-403.11E 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* 18 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 3-202.12 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 5-204.11 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 Supplied with Soap and hand Drying Devices 590.004(J) Labeling of Ingredients* 27. Physical Facility FC-6 .007 6-301.11 Handwashing Cleanser,Availability 7 Conformance with Approved Procedures/ 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 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. AQpIKEr TOWN OF BARNSTABLE... LTRINSPECTOR�s Establishment Name: ' Date: N/YPage: of O FICE HOURS PUBLIC HEALTH DIVISION :00-9:30 A.M. BARNSrABLE. ' 200 MAIN STREET 3:30-4:30P.M. Item Code C-Critical Item DESCRIPTI N OF 4IOLATION/PLAN OF CORRECTION Date Verified MARS. �' HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item - PLEASE PRINT CLEARLY 'OrFD MPS°� 508-862-4644 01 FOO ES L S ME T INSP C I REPORT Name Dat Tyne of T e of Ins a tion Oberation(s) Routine t Address Risk Food Service Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer eneral Complaint Person in Charge(PIC) Time Bed 8 pBa ast ACCP ther Inspector O ut Each violation checked requires an explanation on the narrativ s d a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Ri an s 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 ❑ 14.Approved Food or Color Additives ❑ 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 Cj ❑ 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 aPublic 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 c. 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: TO No i ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating f 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 an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food 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. 25.Equipmen B=One critical violation and less than 4 non-critical violations t and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if critical violations observed;4 4 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= critical violations and less thari 9 nory-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 8 non-critic #'violation . If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. vio a Io ,4 to 8 non-critical violati =C. 30.Other DATE OF RE-INSPECTION: ctor's _ print 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 Signatur nt: Self Service Wait Service Provided Grease.Trap Size Variance Letter Posted. Y N Dumpster 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* 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 3-262.12 Additives* 4 - 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 7-101.11 Identifying Information-Original Containers* 2 590.003(C)- Responsibility of the Person-in-Charge to-- - - Other* 7-102.11 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* _ _ _ _ 7-201.11 Separation-Storage* 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 : 1 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) q 590.003(G) i Reporting-by Person in Charge* - - - - 7-203.11 I Toxic Containers-Prohibitions 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 Reated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP S90.003(E) Removal of Exclusions and Restrictions g � ) Disposition of 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 y 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 Wazewashing-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* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501-1 j2 Mechanical Wazewashing-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 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 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* Eggs Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg ctiw 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 FisliFrom.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* -Shell'fisti* - 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- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' P �Y 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 I 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 77 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g. g g 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) Commercially Processed RTE Food-140°F* (Blue Items non-critical 23-30) 3-202.15 Package Integrity y Critical and non-critical violations,which do not relate to the foodbome * 12 Prevention of Contamination from Hands 3-403.11E 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 5 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* 3-501.i4 13 Handwashing Facilities Cooling Cooked PHFs from 140°F to 70°F (A� g 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 590.000 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- Handwashing Cleanser,Availability i 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 1 '' 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* 1 S:590Forrnback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1909 Food Code or 105 CMR 590.000: