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TIKI PORT - FOOD
TIKI PORT�r�' 9Z ` 90 xydn"04kPA HYANNIS, MA Town of Barnstable BOARD OF HEALTH rt , John T.Norman Board of Health Donald A.Gaudagnoli,M.D. rrAscaoLL F.P.(Thomas)Lee,. MASS Daniel Luczkow,M.D. Alt. 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: 169 Issue Date: 01/01/2022 DBA: TIKI PORT OWNER: PACIFIC BAY INC Location of Establishment: 790 IYANNOUGH ROAD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IncloorSeating: 235 OutcloorSeating: 0 Total Seating: 235 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: MOBILE-ICE CREAM: G�� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: =^'' For-O Use • Initials: °f�"�'°"y Town of Barnstable Date Paid AmLPd$S _ BAMSTABLE. : Inspectional Services MAWL prED►,ut� Public Health Division Check it 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 r NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: n C P44 Ad ADDRESS OF FOOD ESTABLISHMENT: VTVhNNJ&C7�1 O # 4, NY k4e 6Qr MAILING ADDRESS(IF DIFFERENT FROM ABOVE): V� E-MAIL ADDRESS: ( _ All �(QM // � Ap �Oi A O � � CQ '►'/ �� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: /�_77/- _r.2.�v TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: v SEASONAL: DATES OF OPERATION:/J1.30�0 �n ? � s NUMBER OF SEATS: INSIDE:cx.I � OUTSIDE: ' TOTAL: o�.�,d 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 REOUIREMENTS. 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) N/PE 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*** REOUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q\Application FormsTOODAPP 2020.doc k, OWNE" cEr� �Ay. u NER INFORMATION: IPA- Zh/� FULL NAME OF APPLICANT- �j�II// / "�/!�, /���/;�/�i�� P , / ` 1 t ,e' SOLE OWNER: /NO D.O.B OWNER PHONE# ADDRESS CORPORATE OWNER: Ph C t, CORPORATE ADDRESS: ` O �/t /Y �V D �G7� �y /��/T Z GQ/ PERSON IN CHARGE OF DAILY OPERATIONS: 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 2. SIGNATURMF 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 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.townofbarnstable.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 I st to Dec.3 V each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1 st. Q:\Application FormsTOODAPP REV3-2019.doc BOARD OF HEALTH Town of Barnstable John T.Norman Board Of Health Donald A.Gaudagnoli,M.D. BARNSTAOM Paul J.Canniff,D.M.D. MASS F.P. Thomas Lee Alternate 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: 169 Issue Date: 01/01/2021 DBA: TIM PORT OWNER: PACIFIC BAY INC Location of Establishment: 790 IYANNOUGH ROAD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 235 OutdoorSeating: 0 Total Seating: 235 FEES FOOD SERVICE ESTABLISHMENT: $300.00 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: pFIKE Tp� Initials: Town of Barnstable I ' �e� Q + ■A MASS.LE. ` Inspectional Services Date Paid` v� .0� Check# prEo��e Public Health Division 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 O NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ( , ZW ADDRESS OF FOOD ESTABLISHMENT: d�/WoQ l? 0 �� Qp�2jl MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: (� �y,/7 TELEPHONE NUMBER OF FOOD ES�TABLISHMENT: (sA 7/I- oZ� TOTAL NUMBER OF 7BTHROOMS: _ WELL WATER: YES NO ... ANNUAL WAT ER TER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: C2�r OUTSIDE: TOTAL: ,Sr 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 REOUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR 11D T ,ITST�FF SERVICE DOOR(S)? CURTAIN Y1[lJviiU r,D Ai �1 Al1Jl Al _\_� -- TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) V 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:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: �✓ f FULL NAME OF APPLICANT t' v/C��•� SOLE OWNER: YES/NO D.O.B OWNER PHONE # ADDRESS CORPORATE OWNER: C 4, CORPORATE ADDRESS: zy � PERSON IN CHARGE OF DAILY OPERATION'S: 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 mist provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration fate 1. Ale 2. SIGNATUR 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 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•//-,vww townofbarnstable.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 I st to Dec.3 V each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Application Forms\FOODAPP REV3-2019.doc a Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. f' RARN$TASM Paul J.Canniff,D.M.D. 6 A a , 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: 169 Issue Date: 12/10/2019 DBA: TIKI PORT OWNER: PACIFIC BAY INC Location of Establishment: 790 IYANNOUGH ROAD HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 235 OutdoorSeating: 0 Total Seating: 235 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: �� Gay FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: i-� oFt r For Office Use Only: Initials: - Town of Barnstable Date Paid A.mt Pd$ 4 szAB , ) Inspectional ServicesMASS. — :t Public Health Division Check# `I { QED MAC a Thomas McKean, Director 200 Main Street, Hyannis, NIA 02601 i t� Office: 508-862-4644 Fax: 508-790-6304 U1 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE Q� $ r� NEW OWNERSHIP RENEWAL Act 11 k\ Po *11z77 NAME OF FOOD ESTABLISHMENT: )9\lC— �? ' �S- ADDRESS OF FOOD ESTABLISHMENT: —1 CA© SCAN t,)G U (*q �D � �� 40 OLS ►Y 1 0 l�OI MAILING ADDRESS(IF DIFFERENT FROM ABOVE): nS k�� E-MAIL ADDRESS: C 11 ViV\.O.T�-T\ 8i 1�7 1 V $ !Act a• r-b LAI TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (bog) TOTAL NUMBER OF BATHROOMS: L WELL WATER: YES NO *)( ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/ TO NUMBER=OF--SE'ATS:-INSIDE:-(:) 3rOUTSIDE:t TOTAL:---�.. SEATING: MUST OBTAIN A COMMON VICTUA LER'S LICENSE FROM LICENSING DIV. ***OUTSI DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROV D FOR OUTSIDE DINING? IS AN AIR CU IN, 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 Q1Application FormsTOODAPP 2020.doc OWNER INFORMATION: J� FULL NAME OF APPLICANT (� A- C' G/k4' 6�� SOLE OWNER: YES/NO D.O.B OWNER PHONE ADDRESS CORPORATE OWNER: lei /A/C CORPORATE ADDRESS: N� /C � D / PERSON IN CHARGE OF DAILY"OPERATIONS: V-Ai 1, G q 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 SIGNATURPOF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! 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 httv://www.townofbarnstable.us/healthdivision/applications.asy. 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.31`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC lst. Q:Wpplication FormsTOODAPP REV3-2019.doc �rt r Town of Barnstable BOARD OF HEALTH b Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. BaazN A = John T.Norman p$ 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate � �� Ufa i 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: 169 Issue Date: 12/20/18 DBA: TIKI PORT OWNER: PACIFIC BAY INC Location of Establishment: 790 IYANNOUGH ROAD HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: . YES Seasonal: IndoorSeating: 235 OutdoorSeating: 0 Total Seating: 235 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR: 2019 �- RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: -- MOBILE-FOOD: MOBILE-ICE CREAM: CQ� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE - Restrictions: r300LA) n� , of Toyti Initials: o� Town of Barnstable Date Paid Amt I'd MAW. ` Inspectional Services C — prFD�"� Public Health Division Check# Thomas McKean,Director f 200 Main Street,Hyannis,MA 02601 I I v Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE FOOD ESTABLISHMENT , DATE I I q NEW OWNERSHIP RENEWAL `, p p c(FIG, f N G -t> Or NAME OF FOOD ESTABLISHMENT: T�kti Q o C-( 45 T A U k H P—t ADDRESS OF FOOD ESTABLISHMENT: 'l qd ��� N O U,6t 6-I P•D , A-�y A-It3 W M l� 61(o(3 MAILING ADDRESS(IF DIFFERENT FROM ABOVE):E-MAIL ADDRESS: _��u�� �11 �G� I I� g @ (.jqQ1 oo ,C°Z)K4 TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5( D$) 1 q I TOTAL NUMBER OF BATHROOMS: I WELL WATER: YES NO ✓... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: y SEASONAL: •0l 01 I /al 3/ /DATES OF OPERATION. / / �TO / / NUMBER OF SEATS: INSIDE:d35- OUTSIDE: NIA- TOTAL: 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© ''11 IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? DJ V 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) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL, MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FormsTOODAPPREV2018.doe - .. . ... a, P EASE CA 08-862-4644 OWNER INFORMATION: 1��-7 - 7 FULL NAME OF APPLICANT " V 'r' L F"- '8 a-Y lt'3 G `Pr N 1 K c O 2-T iZ S'TA U K lko7 SOLE OWNER: YES O D.O. OWNER PHONE# ADDRESS /11_0G CORPORATE OWNER:Q h C 1>r`G 641 , I F� l FEDERAL ID NO. : � �Z CORPORATE ADDRESS: �o (}a N OLt G a-I �� ' 7�.N p1 S IA Az- 62 6 r PERSON IN CHARGE OF DAILY OPERATIONS: LB U 0 G �7-pto 1M (A- 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 Alkrgen Awareness Expiration Date e7 SIGNATURE OF APPLICANT DATE W N1 rrPrk Ywmi G�cz-0 rn 4tN A fsE'L ***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. 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 htti)://www.townofbarnstable.us/healthdivision/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 Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec.31 S`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPPREV2018.doc HEALTRINSPECTOR'S Establishment Name: w' 1 Date: 1 2 Page:�_of \eF��ro TOWN OF BARNSTABLE „ . 9 4 OFFICE HOURS PUBLIC HEALTH DIVISION - 8:o6-9:30A.M. BARE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 9�A 6 v:a�0� HYANNIS,MA 02601 M-8 -FRI.s2 4saa No Reference R-Red Item..-. PLEASE PRINT CLEARLY 5oa-a FOOD ESTABLISHMENT INSP CTION REPORT Name r� Date Tvoe of Tyne of Inspection Routine Address I Risk Food Sery Re-inspection R Level a ail Previous Inspection Telephone ( Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary JArZ t4 aVh �a-t Caterer General Complaint - r Person in Charge(PIC) �t/I/\ Time Bed&Breakfast C[ CL In:I)`,'56 Other 1(y� Inspector S Out: Each violation checked requirel 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) ❑ Ile W' .� 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 t d FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) li 7� �v ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures �//��-r te' r� wi� ❑ 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) f ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP tl ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY i I ,p ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories �� , e � If <J 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: 0 Grp( jes�C�C� 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 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) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-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 i 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.i anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to 8 no 'iCal violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other - DATE OF RE-INSPECTION: Inspect s Sign ure Print: 31.Dumpster screened from public view t(� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signa Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N f�/ Volations related to foodborne Illness Violations Related to Foodborne Illness Interventions r- Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) . is 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.*2-103.11 Person-in-ChazgeDuties - 3-302.14 Protectionfrom'UnapprovedAdditives* 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 Identi in Information-Ori coal Containers 2 590.003(C) Responsibility of the Person-in-Charge to Other* g g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers* I 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* - � - -'"_ 3-302:1'1(A) - Food Protection* j 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302,IS 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* Requirements 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(11) Variance Re q 590.003(G) Reporting by Person in Charge* - Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)($)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-By Compliance with Food Law* _ _ * 3-801.11(D) Raw or Partially Cooked Animal Food and " 4-501.111 - Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations 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* 4-501:112 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 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 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 Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg dive 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 i 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* 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. * 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) I Wild Mushrooms ( )( )( ) 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 Game Animals* 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. g - - Receiving/Condition - g• g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received ai 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 * (Blue Items 23-30) 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 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* 40 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 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 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 Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 590.004(J) 9 9 y� tY 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 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 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CM-R 590.000. "Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. F,NE roy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: L• I lyl Date: Page:, of J, P� OFFICE HOURS .. PUBLIC HEALTH DIVISION 800-9:30A.M. snaNsrne�s. = 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified asq: <0� HYANNIS,MA 02601 sos-862-46644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSP TION REPORT _ - I Name < Date Z Tvoe of Type of Inspection Routine (/t Address Risk Food Re-inspection ection / . i 1 Previous Ins Level Retail P Telephone Residential Kitchen Date: �- Mobile Pre-operation / Owner HACCP Y/N Temporary SY� Caterer 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) ❑ r1 L.Q j 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 ❑ 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 Overall Rating within 90 days as determined by the Board of Health. E� ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ go Closure Other: Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Emergency Voluntary Disposal ❑ 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) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 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 i 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 anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8npn-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Si u 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 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* * - * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection'fi6in,Unapproved Additives Contamination from Raw Ingredients i` 3-501.16(B) Cold PHFs Maintained At or Below 41 _ 15 Poisonous di Substances 590.004(F) EMPLOYEE-HEALTH - 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g g 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 3-501.16(A) Roasts Held At or Above 130°F 7-201:1'1' Separation-Storage* Applicants* - 3-302.11(A) Food Protection* P g * 20 Time as a Public Health Control 7-262.11 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 * 7-204.11 Sanitizers,Criteria-Chemicals* 3 590.003 D Exclusions and Restrictions REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and RestrictionsEll 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 -' 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* -- - 4-501:11.1 - 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* 7-206.13 Tracki%Powders,Pest Control and Raw Seed Sprouts Not Served 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 QONTROLS 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. Clean Utensils and Food Contact Surfaces of Animal Foods That are Raw,Undercooked or 5-101.1 I Drinking Water from an Approved System* 11A( ) Eggs-Immediate Service 145°F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 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 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 temporary and - ide 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)(I)(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 3-202.1 Package Integrity* 3-403.11(3-301.12 Preventing Contamination When Tasting* C) y Commerciall Processed RTE Food-140°F* Blue Items 23-30) 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions and non-critical violations,which do not relate to the foodbomeions 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 * Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 590.004(J) 9 9 Y ty 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. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 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. TOWN OF BARNSTABLE HEALTH iNSPECTOR,s Establishment Name: f Dater age: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTARLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �A MASS.aa MON HYANNIS,MA 02601 08-8 -FRI. No Reference R-Red Item PLEASE PRINT EARLY lFn MAC 508-862�644 FOOD ESTABLISHMENT INSP C ION REPORT Name ) P ��' Date Type o - ection 7 era s Address Risk Re-inspection QJYr Level Retail Previous Inspection Telephone Residential Kitchen Date: v� 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) ❑ �1 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 "may ❑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 ` 1 ^V�T� �C 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 I ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories n Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) iv q wired: ❑ No Corrective Action Re 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,th items F] Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. Emergency Closure El 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.)Physicall nd 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. bing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27. cility (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 9non-critical. If no critical water,sewage back-up,infestation of rodents orinsects,or lack of 28. r 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-critical violations. If 1 critical refrigeration. 29. uirements (590.009) within 10 days of receipt of this order. lation,4 to 8non-critical violations=C. 30. PATE OF RE-INSPECTION: Inspe o Si at a31. reened 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 ature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted. Y N Dumpster Screen? Y N (�i 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* L 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* e 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* 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers* 2 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 1 Separation-Storage*g * 20 Time as a Public Health Control Use 7-202.11 Restriction-Presence and " 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 590.003(G) Reporting by Person in Charge * 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and p 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 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 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. L16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* I 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* g8 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-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* Effective 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 r f ces of Equipment* 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 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 Proper,Adequate Handwashing ing,mobile food,temporary and residential 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. 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 929-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 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 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 g 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 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 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 5205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* - 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 I FC-7 1.008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 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 590.0D0: HEALTH INSPECTOR'S Establishment Name: Date: Pa e: of oF, row TOWN OF BARNSTABLE - ®r7� OFFICE HOURS9AR E. PU6LIC HEALTH20 MAN STRETSION 11 / - 3:00 30-4:3 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF ORRE TION Date Verified �! 3:M -4:30 P.M. s mAss. MON.-FRI. A ,p39,a�� HYANNIS,MA 02601 - � 508-Ssz-4644 No Reference R-Red Item PLEASE PRINT EARLY rEO MPS , - FO. D ESTABLISHMENT INSP ION REPORT ���!!! Name ` / to Tyne of oection /yy ! iZS imr - Ro Address isk ood Se e-inspec"on evel a ail Previo Ilion sp i Telephone Residential Kitchen . Date: Mobile Pre-op fa Owner HACCP Y/N Temporary Suspect IIess /^ Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 1 Other Inspector t: 0) Each violation hecked requires an explanation on the nar ativ 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) ❑ A AA 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 r/ ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals 04 FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) y ❑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) r ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.ProperQ 9 Adeuate Handwashin CONSUMER ADVISORY All ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories VVV W11®rViolations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations _ Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective ction Required: ❑ No ❑ Yes! - Non-critical(N)violations must be corrected immediately or Overall Rating r �� within 90 days as determined by the Board of Health. ` ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspensio C N Official Order for Correction:Based on an inon today,th ite s Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ 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 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 9non-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-crytical vi lations. If 1 critical refrigeration. 29.Special Requirements, -(590.009) within 10 days of receipt of this order. vi lion,4 to 8non-critical viola ions=nat Print•or's - 6 a i ; 30.Other PATE OF RE-INSPECTION: In>? 9 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N P C's I natu Print: #Seats Observed Frozen Dessert Machines: Outside Dining Y N 9 J Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N C____ /� J `�F /V.� /Z7 -4 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 _ I 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) I Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-262.12 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 * I 590.004(F) -- ( )( P 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 3-501.16(A) Roasts Held At or Above 130°F* Applicants* - 3-30231(A) Food Protection* 7-201.11 Separation-Storage* 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 Il 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 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 Reared or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g ( ) 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 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 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 J I2 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 Drink --ing Water - Concentration and Hardness* 3-001.11A(1)(2) Eggs-155°F 15 sec dness* - 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or v rem* - .. gg 5-101.1-1 Drinking-Water from an Approved Sys - - - * Not Otherwise Processed to Eliminate Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 Frequency f Utensils and Food 4b02.11 - Cleaning eque cy o U s s oo 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 Shellrish.and Fish From an Approved Source 3-0Ol.l1(B)(1)(2) Pork and Beef Roast-1 1 min* Eggs* 4-702.11 - Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) 155 Ratites,Injected Meals-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, . 3-201.15 Molluscan Shellfish from NSSP Listed - _ _ _ Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* 10 Pro ing,mobile food,temporary and residential Proper,Adequate Handwashing - Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under 2-301.11 Clean Condition-Hands and Arms the appropriate sections above if related to Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave 3-202.18 Shellstock Identification Present* - 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C)_ _. Wild-Mushrooms* 3 401.11(A)(1)(b)All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices _ 1 7 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 Commercially 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* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) g Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F hem Good Retail Practices FC 1590.000 3-203.12 Shellstock Identification Maintained* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* 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 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 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* f 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. / ' TOWN OF BARNSTABLE, HEALTH INSPECTOR`S Establishment Name: Date: Page;. of �p(MEr .. 'I e ° �' OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MON.-FRI. 'q�p ,,39,p.0 HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item ®LEASE PRINT C EARLY rFDM FOO ESTABLISHMENT_INS 10 REPORT ( i` Name Dat T e o Tvge of Inspection era to Routine Address Isk a Re-inspection - 6 evel tail Previous Insp o ` Telephone Resi en lal Kitchen Date: ALL- Mobile Owner HACCP Y/N Temporary S f3 Caterer H eral Comp Person in Charge(PIC) Time Bed&Breakfast �h dn Other Inspector QUA /J!F) Each violation checked requires an explanation on the narrative page )and a citation of specific provisions)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) ❑ S FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities i EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 4,21 ❑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 Food ts� ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures �{ / n ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling Iv ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding r PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control b4 V ❑ 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 -' s Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: I❑ 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 checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ mar g 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) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4 non-critical violations 6.Water,Plumbing and Waste if no critical violations observed,4 to 6 non-critical.violations=B. Seriously Critical Violation=F is scored automatically if: no hot g (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 8 non-criti al vio tions. If 1 critical refrigeration. violation,4 to 8 non-critical violati s= 29.Special Requirements (590.009) within 10 days of receipt of this order. - 30.Other DATE OF RE-INSPECTION: In or's i at rint. I-Pl.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 C's Signat re J 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 r ~• 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 1 q 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 * 590.004(F) ( )O p 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 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* 3-304.11 Food Contact with Equipment and Utensils 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* 7-203.11 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 Foam* 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed S routs Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and P 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-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* 3-401.11A(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* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg c"°e iiuZooi 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 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 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 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 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 1 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3403.11(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 Tune* 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 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 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 3-203.18 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 Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* * 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 3402.12 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. 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. TOWN OF BARNSTABLE . HEALTH INSPECTORS Establishment Name: PO Date: Page_: of OFFICE HOURS : BAR E.O` PUBLIC 2 0 MAIN DIVISION 3:30-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. MASS. $, MON.-FRI. %679•p.• HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY _ rED MP+ d FO STABLISHMENT INSP C ION REPORT Name I Date T o lype of Inspection I R 1 11' - Operation(s) Routine Address Risjvj IFood Service Re-inspection Level Retail Previous Inspection ro r _ Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint I AM ; 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) ❑ t Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) AP Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ ' FOOD PROTECTION MANAGEMENT ❑1'2-Prevention of Contamination from Hands / ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities r 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 4Q i ❑ 5.Receiving/Condition ❑ 17.Reheating / 0 ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling c. ❑ 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) C' ❑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 y y ❑ ry ❑ 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 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 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 g 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 C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up, 29.Poisonous u Toxic Materials (FC-7)(590.009) within i i writing and submitted to the Board of Health at the above address violations observed,7 to 8 viol critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. viola' to 8 no -crit' I violations'= 30.Other DATE OF RE-INSPECTION: Inspe s 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 PI&Signat a 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 L14 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 Other* 7-102.11 Common Name-Working Containers* 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* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003 F Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* O P Y3-302.15 Washing Fruits and Vegetables * 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 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 Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g � ) 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 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 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* 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 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meals&Game Pathogens* eg crave!a/zoor 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* min* Eggs 3-302.13 Pasteurized Eggs Substitute for Raw Shell * Shellfish and Fish From an Approved Source 401.11(B)(1)(2) Pork and Beef Roast-130°F 121 4-702.11 Frequency r f 3- 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By * 3-401.1 l(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. 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) 3-202.15 Package Integrity* g g 3-403.11(C) Commercially Processed RTE Food-140°F 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* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-202.18 Shellstock Identification 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 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 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention 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 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. ,17 °F�He row TOWN OF BARNSTABLE HEALTH iNSPECTOR's Establishment Name: I IOC Date: ks� Page: OFFICE HOURS r + �-i - ° PUBLIC HEALTH DIVISION e.00-9.30A.M. � �� of BAR- NSTABLE.� 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. p .a3v.p.• HYANNIS, MA 02601 eo ON.-4644 No Reference R Red Item PLEASE PRINT CLEARLY rFD1A`� FOOD ESTABLISHMENT INS E TION REPORT Name / Date Type of f Inspection l t Operationn(s) Routine Address /� ' isk �- Food Servic Re-inspection lJ I �• r i i Level Retail Pre Ins iY� j Telephone Residential Kitchen Dater 1 Mobile Pre-optib Owner HACCP Y/N Temporary Suspect Illness n Caterer General Complaint Person in Char e_(.PIC) Time Bed&Breakfast HACCP 0 I Other Inspector / �u 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) ❑ i� V v Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ I . Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands f IV-0 ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS Q ❑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 liza�I ❑ 10.Proper Adequate Handwashin m 9 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 Overall Rating within 90 days as determined by the Board of Health. FA ❑ Employee Restriction/Exclusion p y Voluntary Compliance ❑ Em to ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the tem 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 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 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 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-cfiticalviolfons. If 1 critical refrigeration. . within 10 days of receipt of this order. ,e-viQLation,4 to 8 non-critical viol ions- ! 29.Special Requirements (590.009) y P , x 30.Other DATE OF RE-INSPECTION: Inspect 's_ ignature / ' 31.Dumpster screened from public view „ (� (.�. nt: Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI s Sign ture V _ Print: I Self Service Wait Service Provided Grease Trap Size Variance.Letter Posted Y N y Dumpster Screen? Y N - � Violation related ttrFoodborne`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 3-202,1-L-• Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* -• Imo * _ 19 PHF Hot and Cold Holding_ 2-103.11 Person-in--Charge Duties - -- ' 3-302.14 Protection froni'Uriappioved Additives� _ Contamination from Raw Ingredients l 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 1.5 _ Poisonous or Toxic Substances EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each i - 590.004(F) - P 7-101.11 Identifying Information-Original Containers* V 2 590.003(C) Responsibility of the Person-in-Charge to - _ - Other* 7-402.11 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 7-201.11 Se 3-501.16(A) Roasts Held At or Above 130°F* 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* I_ _. --590.004 11 - _ 3-304.11 Food Contact with Equipment and Utensils ( ) Variance Requirements 590.003(G) Reporting by Person in Charge* _ - - 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* -REQUIREMENTS FOR 3-3.06.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g � ( ) 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* 59.0.004(A-B) Compliance with Food Law* 4-501.111 - Manual Wazewashing-Hot Water 17.206.12 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 3-201.1-3 1 Fluid-Milk and Milk-Products* - - 4-501.112 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. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinkirg 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 Eggs-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* Ef ctiw 1112001 _ . _ 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-Hat Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 590.009 A Violations of Section 590.009 A - D in cater- Chemical*3-201.15 Molluscan Shellfish from NSSP Listed ( ) �) ( ) ( ) Ratites-165°F 15 sec* ' Sources* - 1 p Proper,Adequate Handwashing ing,mobile food,temporary and residential 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 I 3-202.18 Shellstock Identification Present* ' ' - 2-301.12 __. .Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004 C Wild Mushroo 3 401.11(A)(1)(b) All Other PHFs-145°F 15 sec 2-301.14 When to Wash* * Other 590.009 violations relating to good retail ( _ ms* - ) Good Hygienic Practices practices should be debited under#29-Special 3-201.17 Game Animals* _ 17 Reheating for Hot Holding 2-401.1-1. _ 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* r. 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 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employces* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashin Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification* g ) 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F[0 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 Labeling of Ingredients* Supplied with Soap and hand Drying Devices (J) 9 9 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 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. i *Denotes critical item in the federal 1999 Food Code-or 105 CMR 590.000. - S i OF THE 1p� Town of Barnstable + BA KAST& LE.� Board of Health y MASS 039. 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 — Paul J.Canniff,D.M.D FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi August 29, 2017 Pacific Bay, Inc. Fan Fay DBA Tiki Port Restaurant 790 Iyannough Road Hyannis, MA 02601 RE: Board of Health Decision, Show-cause Hearing Held on June.2-7i 2017 Dear Ms. Fay: A show-cause hearing was held before the Board of Health on Tuesday June 27, 2017 concerning the recurrence of critical and non-critical violations at Tiki Port, 790 Iyannough Road,Hyannis. The hearing was held because on May 9,2017 there were two (2) critical violations as well as a potential third critical violation concerning use of insecticide on site. On May 18,2017 during a scheduled re-inspection there were three (3)critical violations and on May 23, 2017 during an unannounced re-inspection there were four critical violations and all four critical violations were repeat violations. (Please see attached detailed list). You testified that you took this matter very seriously and will take all corrective actions necessary, including a change of management. Before the date the show-cause hearing was held, you hired Pamela Ross-Kung, a food safety consultant. Ms. Ross-Kung testified that her company was immediately hired to work with you to make corrective recommendations including to: (a) correct all outstanding violations, (b)provide training to Tiki Port food handlers in regards to proper food safety and sanitation practices, and(c)replace malfunctioning equipment(i.e. rice cooker, refrigerator, etc.). After hearing the testimony presented and reviewing the documentation,the Board voted unanimously in favor of issuing the following orders: • . A private food safety and sanitation consultant shall be hired at the food establishment owner's own expense. Q:\WPFILES\Tiki Port Show Cause Hearing Decision Letter 2017.docx h i • The consultant shall return to the next Board of Health's regularly scheduled meeting on July 25,2017 to provide an up-to-date status in regards to corrections made. • The consultant shall provide written procedures for proper food preparation methods, cleaning, and maintenance. On June 28, 2017, a re-inspection was completed by Thomas McKean, Health Agent. He was accompanied by Ms. Pamela Ross- Kung, consultant and Wai Faimah, person-in charge during the re-inspection. All seventeen critical and non-critical violations which were cited during the previous three May 2017 inspections were corrected. There are no outstanding critical violations at this establishment. Also, new equipment was purchased and installed including a new refrigerator, rice cooker, and ice machine. In addition, a new pesticide company. (E.H.S. of Norwood)was hired. On July 24, 2017, Ms. Pamela—Ross Kung submitted a three action plan documents which detail food preparation procedures, safety and sanitation issues/procedures, a daily operational checklist, and a bar area cleaning and sanitizing check list(see attachments). During the_pubhc meeting of the Board of Health held on July 25, 2017,the Board members were pleased with the progress made at this food establishment to date. You are ordered to ensure the employees strictly adhere to the food preparation and cleaning procedures, as provided by Pamela Ross-Kung, each day. Inspections will continue to occur regularly by a health inspector as required. These inspections will occur without any future notice to the establishment; the inspections will continue.to be unannounced. Sincerely, 0 U401�A Z%1 Paul J. anni M.D. Chairman Cc: Donna Miorandi Q:\WPFILES\Tike Port Show Cause Hearing Decision Letter 2017.docx Dates of Violations and Recurring Violations: May 9, 2017 (Score=C)_ - Broken refrigerator containing pork and vegetables—refrigerator air temperature was at 58 degrees F. (too warm, not 41 F or less); - Beverage tubing is in contact with ice bin at bar;tubing is not separated from drinks and ice; -Slicer has build-up of foreign debris on it. March 18,2017 (Score= F, Failed) - Rice was left in the rice cooker at overnight at 115- 119 degrees F. ; - Bain Marie holding Shrimp, beef,and chicken- at 45-55 degrees F (too warm, not 41 F or less); - Raw poultry stored above cooked chicken; - Broken refrigerator(previously cited) still 58 degrees F, no foods kept inside, however not being used on this date; - Beverage tubing is in contact with ice bin at bar;tubing is not separated from drinks and ice; -Soda guns at waitstaff area and at bar contain build-up of foreign debris inside them. May 23,2017(Score= F, Failed) - Rice stored in rice cooker at 77-78 degrees F. ; -Cold unit containing lobster at 45-55 degrees F (too warm, not 41 F or less) - Broken refrigerator with air temperature at 58 degrees F, foods kept inside, being used again; - Beverage tubing is in contact with ice bin at bar; tubing is not separated from drinks and ice; -Soda gun holder contains build-up of foreign debris; - Product on floor of walk-in cooler; -Slicer has same build-up of foreign debris on it. Q:\WPFILES\Tiki Port Show Cause Hearing Decision Letter 2017.docx Y' i r? gong9 management July 24, 2017 Thomas A. McKean, R_S.,CHO Director of Public Health Town of Barnstable, Regulatory Services 200 Main Street Hyannis. MA 02601 Dear Mr. McKean: This letter comes to inform you of the corrective actions taken in response to repeated violations at the Tiki Port Restaurant, located at 714 lyannough Road, Hyannis. As stated during the hearing, Mrs. Wong and Mr. Mah accept full responsibility for the events that led up to the hearing. The problem became acute and escalated because the facility lacked effective communication and proper management oversight. They were quite embarrassed to find themselves in this situation and would like to apologize again for any inconvenience this may have caused you or the department.They realize how serious this situation is, and that repeated critical violations will not be tolerated. They take pride in the operation and have implemented the following management changes to ensure that this situation does not happen again.Mr. Fai Mah will:be returning to the facility to oversee operations during.peak daytime hours..Mr.Fan Mah has been promoted and will be in charge of the kitchen and overseeing operations on the night shift. Mrs. Wong will be visiting the establishment on a regular, unannounced basis to verify that practices and policies are being followed. They have also started searching for a manager to assist with daytime duties.This have proven to be more of a challenge than first anticipated. The ideal candidate must have a working knowledge of the restaurant business, be willing to travel to and from the Cape and be fluent in both English and Chinese. In addition to the above mentioned management changes,they contracted our services to conduct a comprehensive needs assessment to pinpoint gaps and potential trouble spots in existing practices, operations efficiency and equipment design. We began working with them on Thursday,June 22, 2017.. At that time,we conducted a.full needs assessment of the facility. Combining our findings, along with health inspection.reports ` dating back to 201.4,Tiki Port has taken the following steps to ensure that past violations do not recur. l 38 Montvale Avenue,Suite 350,Stoneham, MA02180 phone:617-523-5450 prosskung@safefoodmanagement.com Personal Hygiene Issues Issues: Hands not washed between tasks and hands washed in sinks other than those designated for hand washing. . Action:Training has been provided,explaining when hands must be washed and where they can be washed. Signs have also been posted at each sink,clearly delineating the purpose. Time/Temp.Issues Issue: Stand up refrigerator not holding temperature. Action:Replaced this refrigerator with a new unit.All products now holding temperature. Issue: Open make table refrigerator on cook line not holding foods a proper temperatures. Action(s):Had the unit serviced.Problem is constant opening and closing of the lid and the doors on the underside of the unit during peak meal periods,especially during hot;humid days. Issue: Rice held overnight in thermal wanners. Action:Rice is not left in thermal containersAt is either discarded,or properly chilled for use in fried. rice the next day. Issue; Lacking temperature measuring devices in all cold storage units. Action:All units now have temperature measuring devices. A record has been created where all unit temperatures are monitored at least twice a day and food temperatures inside specific units are also monitored at least twice a day.This will help ensure that temperature measuring devices are available and that temperatures are in compliance.It will also ensure that if deviations are noted,corrective actions can be taken quickly to remedy the situation. Issue: No.food thermometer on site to take internal temperatures of food. Action:Purchased a thermocouple,which will provide a temperature reading in under eight seconds. Also purchased two digital pocket thermometers and have two analog thermometers as back up.Training was provided regarding proper calibration of each device.Food thermometers will be verified for accuracy at a maximum of every month. Food Protection Issues Issue: Cover foods in storage(dry and cooler)-Do not cover food with cloths. Action(s):They no longer use cloths to.cover food.They will make every effort to cover foods at all Times(unless they are in the process of cooling). Issue: Drinking ice is not protected from soda tubing at the bar and wait station. Action: All tubing has been relocated,or metal guards placed around the tubing to protect the ice,or metal plates'are now places on ice in separate pans,located outside the ice bins.New ice storage containers should be installed within.the next two months. 2 Issue: Improper storage of knives. Action:Purchased a knife holder that is easily cleaned and capable of holding all knives. Issue: Cardboard lining shelves and on floor Action:All cardboard has been removed from the operation. Issue: Tablecloths and/or food under dish washer Action:No foods or linens will be stored under the dish washer. Issue: Proper utensils and use of utensils(duck sauce,dry products, ice). Action:They have purchased proper utensils for dispensing foods. Issue: Use proper food storage containers Action:Purchased more than 75 food-grade storage containers and lids, in various sizes,to meet their needs. Issue: Product on floor in.walk-in and cooler and other areas;do not use milk crates to store foods off floor. Actions: They have reorganized the coolers to allow for adequate space so that foods need not be stored on the floor or on milk crates.If more space is needed in the future,they will purchase: small dunnage racks to store foods intermittently(during peak business periods)or purchase another refrigerator for back storage in the basement.(They have ample space downstairs to add another refrigerator.) Issue: Prepared foods lack date marking. Action:All foods are now marked with the day the food was produced. Cleaning Issues Issue: Overall cleaning is poor throughout the facility. Action(s): • All food and non-food surfaces and equipment in the.facility have been thoroughly cleaned and/or sanitized. • Difficult to access floors,pipes,and equipment under and around the cook line were cleaned by an outside cleaning service(same company that cleans their hoods).Hoods and cook line area will be deep cleaned every three months. • Developed cleaning procedures for specific pieces of equipment to ensure proper cleaning and/or sanitizing(i.e.grinder,slicer,ice.machine,'in-place food contact surfaces,etc.). • `Developed an opening and closing checklist for the bar,which includes areas of past concern such as soda guns,floor under the bar,fixtures,etc.(checklist enclosed for your review). • Developed a self-inspection checklist for the kitchen to ensure that key areas of concern are addressed on a daily basis(checklist enclosed for your review). • Wooden dollies have either been replaced,or resurfaced with sheet metal to facilitate cleaning. • Floor drains are being cleaned nightly and deep cleaned weekly. Suggested cleaning steps were provided by the pest control company. Issue: Wiping cloths not in solution and/or solution at improper strength Action(s):Training has been provided to explain the proper use and storage of wiping cloths.They will now be mixing a large batch of sanitizing solution 3-4 times a day so they can fill wiping cloth buckets from that container.This will facilitate mixing the solution and ensure consistency. Wiping cloth buckets will be changed at a frequency to ensure proper strength solution at all times. 3 Issue: Dirty dishes overnight Action(s):Most dishes and glassware are cleaned at the end of the night.However,once a while, several glasses or dishes come to the kitchen very late. When this happens,those.items .will be rinsed and placed in a covered bucket to be cleaned in the morning. Issue: Light shields clean and not broken Action(v): Light shields have been cleaned and broken one replaced. Issue:Foods not stored separately from non-food items and many unnecessary items stored throughout the basement area. Action(s):The entire basement area has been reorganized using a racking system. Food and non-food contact items are stored separately and no foods are stored on the floor or on wooden pallets..They also discarded many unnecessary items and provided organized storage for items that are needed intermittently(like chairs,tables,Christmas decorations,etc.) Issue: Fruit flies Action(s): They have hired:a new pest control company to provide a fresh pair of eyes. In partnership with them, they were able to pinpoint problem areas and address them.The results have proven fruitful.They now.see only an occasional fruit fly. Maintenance Issues Issue: Back door must not have any gaps Action:A new screen door has been installed,with all gaps sealed. Issue: Repair floor under bar(linoleum torn) Action Floor has been resurfaced.to facilitate cleaning. Issue: Remove all wood from throughout the facility Action:All wood has been removed,or cleaned and resurfaced with sheet metal. We also spent a significant amount of time over the past four weeks, conducting a menu assessment and food preparation procedures, with a heavy focus on time and temperature controls. The menu assessment revealed that the following items are cooked and cooled more than 24 hours in advance of service: pork and celery egg rolls,vegetable egg rolls, BBQ pork, pork tenderloin, Peking ravioli,General Gao chicken and white rice(only the batch used for fried rice).. Preparation of these foods is staggered throughout the week to allow for safe preparation (avoiding cross-contamination)and adequate cooling space.. Taking a HACCP-based approach to these items, we developed the following written procedures. As long as they follow these procedures;they will consistently reach proper cooking, cooling and: reheating temperatures requirements. 4 Vegetable Egg Rolls(Cabbage,wood ears,bean sprouts,carrots, seasonings) • Cook vegetables in wok(temperature reaches excess of 145°F). • Allow product to cool on sheet pan(s)for about.30 minutes,until cool:enough to handle. • Egg rolls are then rolled into skins and fried for a minimum of 6 minutes(cooking 9 egg rolls per basket)to reach an internal temperature of 165°17..Fry oil is always a minimum of 325'F. • Egg rolls are then cooled on sheet pans,uncovered,until they reach.4l.°F.(The cooling process takes less than 2 hours for egg rolls to reach 70°;F and then less than another 3 hours to reach a final temperature of 41*F.The meets the two-stage cooling process requirements).. • Once fully cooled,egg rolls are then transferred to plastic containers with.lids to allow for stacking. • Counter(s)cleaned.and sanitized after use. The whole process takes 2 people approximately 90 minutes. Pork& Celery Egg Rolls :Step 1 • Case ofcelery taken out of cold storage. • :Leaves are trimmed and celery is washed,then placed into bus buckets. • Water is brought to a boil. • Celery is placed in boiling water for approximately 5-10 minutes for blanching. • After blanching,celery is placed into a sink filled with ice water where the temperature drops to 41°F or below within approximately 5 minutes.(Ice continues to be added as the water melts.) • The celery is then drained slightly and placed in bus buckets. • Celery is then put through the grinder(excess water drains into a bucket on the floor). • After grinding,celery is then placed in a large strainer,inside a large bowl,with a clean cutting board wrapped in cheese cloth on top,and a weight on top of the cutting board(to allow for faster draining).Both containers are then placed inside the walk-in cooler where the water is pressed out of the ground celery for about 2-3 hours. • Celery is then placed on sheet pans inside the cooler until time to mix with ground pork,which is usually done the next day. • Food sink is cleaned and sanitized after use. The whole process takes two people approximately 2 hours to blanch,chill and grrind the celery. Cooling Celery Ground celery,once it's pressed,is placed on a sheet pan,lightly covered to keep it from drying out until time to make the egg rolls. 5 Step 2 • BBQ Pork(cooked as usual)is ground and then mixed with celery and seasoning in,a large bowl. • .Egg rolls are then rolled into skins and fried for a-minimumof 8 minutes(cooking 9 egg rolls per basket)to reach an internal temperature of 165°F.Fry oil is always a minimum of 325°F. • Egg rolls are then cooled on sheet pans,uncovered,until they reach 41°F.(The cooling process takes less than 2 hours for egg rolls to reach 70°F and then less than another 3 hours to reach a final temperature of 4l°F.The meets the two-stage cooling process requirements). • Once fully cooled,egg rolls are then transferred to plastic containers with lids to allow for stacking. • Counter(s)cleaned and sanitized after use. The whole process takes two people approximately 2.5 hours to finish rolling and cooking approximately 180 egg rolls. Cooling Egg Rolls Egg rolls are cooled on a sheet pan,one layer only,uncovered and placed immediately into the cooler once a tray is filled(no need to leave at room temperature for any period of time),allowing for good air flow on all sides. By following this process,we learned that egg rolls can be cooled from the initial cook temperature (much higher than the 140°F start time allowed by the Food Code)to below 70°F within the first two hours and to 41°F within the next three hours(less than the four hours required by the Food Code). General Gao Chicken .Product is marinated for a short period of time.Tt is then deep fried(36 pieces per basket). Final temperature reaches approximately 181°F. Product is then cooled on sheet pans until it reaches 41°F. The product reaches 70°F within the first hour and then reaches 41°F within the next two hours. BBQ Park(bone-in or boneless spareribs) Approximately 20 strips are marinated in the cooler for 24-48 hours. The BBQ oven:is preheated and product(6-7 strips)are cooked for approximately 90 minutes. Final internal temperatures consistently exceeded .145°.F (temperature ranges between 158-160'F) :Product is removed from the oven and placed on sheet pans,no more than one layer,uncovered and.placed in the cooler. Product is chilled to below 70°F within the first hour and then reaches below 4l°F within the next 90 minutes. Product is cooked daily. i When reheated,these products reached temperatures of over 185°F under the grill. 6 Roast Pork Tenderloin Strips Pork strips(6-7)are marinated for approximately 30 minutes at room temperature.. The BBQ oven is preheated and product is cooked for approximately 90 minutes. . Final internal temperatures consistently exceeded 1.45°F(temperature ranges between 158-160°F) Product is removed from the oven and placed on sheet pans,no more than one layer, uncovered and placed in the cooler. Product is chilled to below 70°F within the first 90 minutes and then reaches below 416F within the next 2 hours. Product is cooked daily. When reheated, product reached an internal temperature of 168°F+ In addition, chicken fingers and chicken wings are often prepared in large batches ahead of a busy meal period. Therefore, I focused my time on observing preparation procedures for these products. l observed cooking for an entire lunch and dinner period on busy days and took the temperature of every item cooked."My observations revealed that, following their procedures,all foods were cooked from an initial raw state, or reheated to proper internal temperatures. Peking Ravioli Peking Raviolis come in frozen from the supplier in bags of 120 pieces. This product is cooked the first time to a minimum internal temperature of 155°F (ground meat). Product is then cooled on sheet pans until it reaches 4:1°F. The product reaches 70°F within the first hour and then reaches 41°F within the next two hours. When a customer requests this product, it is then reheated in one of two ways,pan fried or deep fried. Pan fired dumplings.are placed in boiling water for 8 minutes and then pan fried for another 3 minutes to achieve a crispy outer texture. Deep fried dumplings are placed in boiling water for 5 minutes and then deep fried for another 3 minutes to achieve a crispy outer texture. In.both procedures, the final internal temperature exceeded 183°F. White Rice Rice is cooked in rice cooker until done(over 170T)—no temperature requirement under the food.code. It is then spread onto a sheet pan;or shallow pans and place in the cooler for chilling. It takes approximately 90 minutes to reach 70 T or below and another 2/5 hours to reach 41 T. i Large Batch Cooking (cooked daily,not usually cooled, served in one meal period) Chicken Wings Wings are marinated and cooked 24 per basket. One basket takes approximately 8 minutes to reach 170T. If two baskets are cooked at the same time, with 24/basket, it takes approximately 20 minutes to reach 170T. Chicken Fingers Chicken is cut into strips. Strips are battered and deep fried until internal temperature reaches over 170T. Approximately 36 pieces are made per batch. In order to spot check internal cooking temperatures for products cooked more than 24 hours in advance of service or cooked in large volumes prior to meal service, we developed a cooking log (enclosed for your review). Management will review the log on a random basis and verify that data on the log is accurate and recorded in a timely manner. General Cooling Procedures Our findings revealed that if they followed proper cooling procedures, cooling times and temperatures were in compliance with current regulations. 'The primary rules for cooling areas follows: • Cool all hot foods on either metal sheet pans or shallow pans with a depth of 6"or less. • Cool products,uncovered,until they reach 41 T. • Containers should be time-marked when cooling starts in case the health department comes in and wants to know when the cooking process started. Once foods are fully chilled,they can be transferred to a covered container of their choice. In.addition to reviewing procedures for large batch cooking and.foods that are cooked and cooled overnight, I took the temperature of every order cooked during my v.isits..My findings revealed that all cooked to order items were consistently cooked to temperatures that exceeded those required by regulation. In some instances, in excess of 50T Examples: :Required Cook Temperatures: Beef,Pork,Fish,Eggs- 145°F Ground pork— 155T Poultry and Reheated .TCS Foods—165°F Notes: Reheated foods are ones that have been cooked and cooled at the;restaurant,not foods that were previously cooked by a commercial vendor. Commercially processed cooked TCS foods need only be reheated to a temperature of 140T TCS foods are foods that required time and temperature control for safety. 8 Actual Cook Temperatures: Stir Fried Products pork/chicken/beef to mein— 1.77°F+ pork fried rice—175°F+ cooked vegetables—190°F+ egg foo yong—200°F+ chicken chow foon—183°F+ Deep .Fried Products chicken wings—.180°F+ shrimp - 182°F+ chicken fingers—180°F+ General Gao chicken—185T+ "Crab Rangoon 175°F+ From the Grill beef teriyaki—165°F+ BBQ Pork— 185°F+ There were no problems with hot holding.All hot foods were held at or above 140°F. We also found that products in all cold holding units were held at temperatures at or below 40°F and that frozen products were frozen solid at all times There were no significant temperature fluctuations in any of the walk-in units or the new 2-door upright refrigerator. However, we did find that on very hot and humid days, during peak meal periods when the top was open, products in the upper section of the open top make table(previously referred to in reports as the Baine Marie),could become elevated by as much as 10°F. This was not due to a problem with the unit itself. It was dine to the fact that the l id has to be kept open during the meal period and the unit is across from the cook line,which generates quite a bit of heat. In order to ensure that.product temperatures remain stable, at or below 41°F, theypurchased special crock containers that are placed in the freezer overnight so that product can be held at lower temperatures for periods of up to four hours(just about the length of a peak meal period). They also have the option,to place ice directly on top of products in this section(since most of product is raw and will be stir fried), or they can place ice in plastic wrap or food grade baggies and place them on top of the products. Both of these procedures are designed to prevent hot air from blowing across the foods and elevating the temperatures. In order to ensure that both unit and food temperatures are being monitored on a regular basis,we developed a temperature log, which we have enclosed for your review. As previously stated, management will review the log on a random basis and verify that data on the log is accurate and recorded in a timely manner. 9 Training We also provided a language-specific food safety training seminar to personnel from both the front and back of the house on Monday,July 17, 2017. By bringing everybody together at the same time,we were able to cover key food safety.issues; explain changes that were implemented over the past few weeks, and deliver a consistent message that a successful food safety program requires teamwork,communication, and commitment to food safety. A copy of the training outline is included for your review.In addition, a copy of the signed attendance sheet, presentation materials, and participant handouts was provided to Donna,on Thursday,July 20, 2017. We are satisfied with the steps they have taken to address recurring issues.Donna visited the facility on Thursday and appeared satisfied with the changes as well. They have done everything we recommended. We believe they now possess the knowledge and tools necessary to maintain. compliance to health regulations on a consistent basis. We look forward to answering any questions you may have at the hearing, scheduled for Tuesday,July 25, 2017. In the meantime, should you need further information, please don't hesitate to contact me at(617) 523-5450, or Nancy Wong at(508) 364-2008. Respectfully submitted, Pamela Ross-Kung, M.S. R. President, Safe.Food Management C: Nancy Wong,Owner Fai Mah,Owner Fan Mah, Manager Delivered electronically ' I 10 Daily Operational Checklist Personal Hygiene ❑No food handlers with infections or illnesses working(diarrhea,fever,cold,flu etc.) ❑ Plastic disposable gloves available and used when handling ready-to-eat foods(include servers and bartenders) ❑ Gloves replaced with change of activity and hands washed before putting on clean gloves ❑ Open cuts or sores covered with bandages and gloves ❑No eating/drinking/chewing gum/smoking in food preparation areas ❑Hair restraints worn and clean;Aprons clean;No finger or wrist jewelry(servers and bartenders exempt) ❑ Hands washed for at least 10 seconds with soap and friction ❑ Before beginning work shift ❑ After handling raw foods ❑After using rest rooms and breaks ❑After cleaning(i.e.handling mops/brooms/chemicals/cloths) ❑ After changing tasks;before putting on new gloves Hand Sinks ❑Hot water,soap and paper towels available at all sinks ❑ Hand washing sinks accessible(not obstructed) ❑ Sinks in working order(draining ro erl ,plugs,no leaks) Food Protection ❑ Food thawed in refrigerator or under cold,running water(707 or below) ❑Foods stored so raw is below ready-to-eat and raw chicken is on bottom ❑Foods in storage covered and labeled as to contents(dry products also) ❑ TCS foods dated with production date ❑Food thermometers available/cleaned and sanitized ❑Thermometers properly calibrated ❑Hot foods held @ 1407 or above/stirred frequently ❑ Cold foods held P,41°F or below ❑ Hot foods cooled properly—sheet pans or metal pans,uncovered until internal temp reaches 41°F ❑Thermometers available in all cold holding units(including freezers) ❑ Food products stored 6"off the floor Proper Chemical Use and Storage ❑ Chemicals stored separate from food items ❑No chemical sprayed/used around open food ❑All chemicals properly labeled ❑ Brushes available for proper cleaning Manual/Mechanical Cleaning/Sanitizing ❑ Hot water available;sinks in working order ❑ Sinks set-up and used properly(food prep in double sink,hands washed in single sinks,pots washed near dish machine) ❑ Sanitizing solution available and in use ❑Dish machine final rinse between 180-194°F ❑ Sanitizer test strips available and in use ❑ Sanitizing solution in wiping cloth buckets at proper strength(50-100 ppms bleach) Cleaned&Sanitized Food Contact Surfaces ❑ Cutting boards ❑ Food containers ❑ Slicer ❑ Scale ❑ Grinder ❑ Knives ❑ Knife racks ❑ Utensils ❑ Work surfaces ❑ Food Sink ❑No evidence of pest activity(including flies)—contact EHS is sightings ❑ Floors,walls, drains, and doors maintained ❑Trash cans and trash areas properly cleaned ❑Floor drains clean and free flowing Cleaning supplies(mops,brooms,dustpans)clean and in good repair Corrections: Use back of sheet. Tiki Port Daily Operational Checklist—July 2017 Bar Check List Opening ❑ Wiping cloth buckets in place. o Hand soap, paper towels, hot water available at hand sink ❑ Check to ensure ice is protected from possible contamination Closing o Wash the bar tops (with hot soapy water) ❑ Melt ice in ice bin and wash, rinse and sanitize the bin following written procedure ❑ Store all soda guns and liquor pour spouts in soda water overnight ❑ Clean soda gun cup holders and clean the coils ❑ Put Dixie cups or plastic wrap over pour tops ❑ Gather and store all open plastic cups in covered containers or with plastic wrap a Return all supplies to proper storage areas ❑ Clean beer chest of any bottle caps, napkins, straws, broken bottles, etc. ❑ Clean blender base and all blender heads. ❑ Hand soap and paper towels available for next day. o Place rubber mats, blender jars, utensils and other food contact surfaces in dishwasher ❑ Clean dish machine (as needed) ❑ Remove all trash from trash receptacles (including catch bin for fruit) and ensure trash receptacles are clean o Sweep the floor, mop, then sweep again f July 2017 Town of Barnstable Regulatory Services 60 Richard V. Scali,Director J U N 27, 2017 Public Health Division 9 MASS. �, Thomas McKean,Director 2007 1639. A,� 200 Main Street Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 CERTIFIED MAIL: 7015 1730 0001 4990 3493 May 31, 2017 Pacific Bay,_Inc. DBA'Tiki .Port--Restaurant 790 Iyannough Road Hyannis, MA 02601 NOTICE OF SHOW-CAUSE HEARING Dear Mr. Wai Fai Mah: You are scheduled to appear before the Board of Health on Tuesday, June 27, 2017 at 3:00 pm at the Town of Barnstable Town Hall, Hearing Room, Second Floor, 367 Main Street, Hyannis for a show-cause hearing. This hearing will be held to show-cause why your food permit should not be suspended or revoked due to critical and recurring violations at your food establishment, Tiki Port Restaurant, 790 Iyannough Road, Hyannis. On May 9, 2017 there were two 2 critical violations as well as a potential Y ( ) third critical violation concerning use of insecticide on site. On May 18, 2017 during a scheduled re-inspection there were three (3) critical violations and on May 23, 2017 during an unannounced re-inspection there were four critical violations and all four critical violations were repeat violations. During this hearing, you will have an opportunity to be heard, present witnesses, and provide documentary evidence pertinent to this case. PER ORDER OF THE BOARD OF HEALTH G Pholm5kaps�A. McKean, R.S., C.H.O. Director of Public Health Town of Barnstable Q:\Order letters\SHOW CAUSE Letters and Samples\Tiki Port Show-Cause Hearing June 27, 2017, 790 Iyannough Road,Hyannis letter of 5-31-17.DOC Tiki Port - 790 lyannough Road, Hyannis list of Recurring Violations Mav 9.2017 (Score=Cl • Broken refrigerator containing pork and vegetables-refrigerator air temperature was at 58 degrees F.(too warm,not 41 F or less); • Beverage tubing is in contact with ice bin at bar;tubing is not separated from drinks and ice; • Slicer has build-up of foreign debris on it. May 18.2017 (Score= F. Failed) • Rice was left in the rice cooker at overnight at 115-119 degrees F.; • Bain Marie holding Shrimp,beef,and chicken-at 45-55 degrees F(too warm, not 41 F or less); • Raw poultry stored above cooked chicken; • Broken refrigerator(previously cited)still 58 degrees F, no foods kept inside,however not being used on this date; • Beverage tubing is in contact with ice bin at bar;tubing is not separated from drinks and ice; • Soda guns at waitstaff area and at bar contain build-up of foreign debris inside them. d Mav 23. 2017 (Score= F. Failed) • Rice stored in rice cooker at 77-78 degrees F.; • Cold unit containing lobster at 45-55 degrees F(too warm,not 41 F or less) • Broken refrigerator with air temperature at 58 degrees F,foods kept inside, being used again; • Beverage tubing is in contact with ice bin at bar;tubing is not separated from drinks and ice; Soda gun holder contains build-up of foreign debris; • Product on floor of walk-in cooler; • Slicer has same build-up of foreign debris on it. Rationale for hearing-Food Establishment received two consecutive'T' scores. (Multiple recurring violations observed.) Excerpt from the Board of Health Meeting Results for July 25, 2017: Hearing: Show Cause — Food: Tiki Port, 790 lyannough Road, Hyannis, recurring critical violations. CONTINUED TO JULY 25, 2017. Consultant Pamela Ross-Kung and owner Nancy Wong discussed all the changes and improvements made including the purchase of new equipment. One manager will take a leave of absence and the other will remain. The owners will add the position of a Senior Manager. The Board would like them to return to the Board at the next meeting, July 25th, 2017. I Tiki Port—Training Agenda Personal Hygiene Don't work sick—let manager know Hand wash between tasks Upon arrival at work After breaks(i.e.eating,smoking, using the rest room) After bussing dirty dishes Dish washer—between handling dirty,then clean dishware Wash hands in hand wash sink only No"picking",snacking or eating in the kitchen Remove aprons before going to the rest rooms Do not use the food sink for hand washing No bare hand contact with ready to eat foods(bartenders and servers—dry noodles) Time/Temp Open top unit—improper temps—must monitor the temps to ensure they are holding at or below 41F No rice overnight in holding units Need a food thermometer to take food temperatures Keep thermometers in all cold storage units Cook foods to proper temperatures Hold hot foods at or above 140F Hold and store cold foods at or below 41F COOLING—RULES 1. Cool only on sheet pans or in a shallow metal pan 2. Only one layer high 3. Do not cover until food reaches 41F 4. If you leave foods at room temp for any period of time,use tape to mark the time 5. Do not store under raw products Food Protection Cover foods in storage(dry and cooler) Do not cover food with cloths Proper utensils and use of utensils(duck sauce,dry products,ice) Use proper food storage containers Product on floor in walk-in and cooler and other areas—do not use milk crates to store foods off floor Cleaning and sanitizing Wash,rinse sanitize—in place procedures Do not use the food sink for ware washing Wiping cloths in solution and at proper strength 5-gallon bucket to 4 gallon line with 3 caps bleach. Label and cover. Fill smaller buckets from larger buckets Cleaning Can opener Floor under all cook line equipment Grease dripping from hoods over cook line Slicer Grinder Soda guns . No dirty dishes overnight Pest Control Back door must be kept close—in good repair Keep the floor drains clean Do not use pesticides—call the pest control company NOCLSS': Steps Steps in the Inspection Process: Steps in the Inspection Process: 1.Cooperate continued ■ Accompany the inspector 3.Keep the relationship professional • Answer all questions t 4.Be prepared to provide records ■ These will become part of the ■ Instruct employees to cooperate public record Correct deficiencies quickly If >" q Y� ■ If a request appears inappropriate, possible ' contact legal counsel or the 2.Take notes inspector's supervisor ■ Make note of deficiencies pointed out ■ If you question the inspector's accuracy contact his or her supervisor 1InspedionSteps Steps in the Inspection Process:continued Steps in the Inspection Process: S. Discuss violations and time frames for continued correction with the inspector 6.Follow up ■ Study the inspection report carefully ■ Act on all deficiencies noted ■ Discuss deficiencies in detail with ■ Correct critical deficiencies within the inspector.Make sure you understand, 48 hours or when Indicated ` ■ The exact nature of the violation ° ■ Correct other deficiencies as ■ How it impacts food safety soon as possible ■ How to correct it ■ Determine why deficiencies occurred ■ If the inspector will follow up ■ Evaluate SOPS,the master ■ Keep the inspection report on file cleaning schedule,training ■ Establish new procedures,or revise existing ones 1 • • • ••• eotential Hazards to Food Safety 1 Biological Hazards A.• ■ Bacteria,viruses,parasites,fungi r+ ■ Toxins 1 Chemical Hazards ■ Pesticides,food additives,cleaning supplies,toxic metals P Physical Hazards ■ Hair,dirt,metal staples,etc. r �"^'"^±rlk�.., •'rsa.vs.r. ,-s .s..rsraf. Microorganism 7Fod ■ Small,living organism e microorganisms require to grow.Specifically Pathogen k carbohydrates and proteins ■ Illness-causing microorganism ■ These are found in potentially VI hazardous food including: Toxin ■ Meat QW- ■ Poison ■ Poultry ■ Dairy products ■ Eggs 2-eIs e• • Food Favoring the Rapid Growth of Food Favoring the Rapid Growth of Microorganisms: Microorganisms:continued /J e < - � Meat:Keel.Pork... FIeM1 Baked D ••',-'•' lame poyytya IiawspreuMaM �•'1; l,t Feoda sprout seeds Mil—Milk plant Foed,such w PO aeC kea e. r; - smuenc Irrereaimro. unaeaaa oadm..w(a sucn,�Osee,'n L.. MixWres Meat Nternativea Eggs(eaceptgmae Tofu or ONer treaeed to eliminate poultry shaNahaM SOYA O..Foxe Sa/maarlls am) C—se sliced Melons a �3 5 �� 1 Temperature Time ■ Foodborne microorganisms grow ■ Foodborne microorganisms need well at temperatures between 41°F sufficient time to grow and 135°F(5°C and 57•C) I ■ 4 hours or more in TDZ=growth high , .em'ra.a enough to cause illness . e2-7 w ,gym x E E js"C1 .•-. , , ,: ., ,I y , III The two conditions you can control: Chemicals ■ Temperature ■ Store away from food,utensils, ■ Refrigerate or freeze food properly and equipment ■ Follow manufacturers'directions ■ Cook food properly Q for using them ■ Time ■ Label them properly if they are ■ Minimize time food spends transferred to new containers in the temperature danger zone(TDZ) 2"10 Common Food Allergens ■ Milk and dairy products ■ Eggs and egg products ■ Fish ■ Shellfish ■ Wheat ■ Soy and soy products ■ Peanuts ''._ ■ Tree nuts 313 2 �irr\ `"r' tar• ii """""��r• Behaviors That Can Contaminate Food i\\"nauorn� , dra■\{I\\taaQ717777 rrrrp■tartan■n■t rrr\una■•raan■a scratching the scalp Touching a pimple or •\tt\uunananw =t\arnuantu■r•t -`:;,,: open sore a ur\\`\roar. nn• ."�. 0 Running fingers � r���=nauun=Rose; nra n• a t .� Wearing through hair ��' ® di uuniformttrapn�77n7■a•'� 9 1 9 a nY rrtur �nn�rn• -'' � tl�trrta n rt ■r7ro Wiping or touching Coughing or sneezing into urrt mtuut r• _ rrrat7 I\■u"" No the nose the hand rr\tr lrn■■nn • tram\na.na...7�.0 _ uuuaor■tnnau Q Rubbing an ear :,r Spitting in the establishment N\O�■tt■r�n■n•■i \rtw■rtnnn7rt�• e ii`\f�'�ama6C�e� _ unr ■■u ■man � 20rra■■wo7lsi i J aMpirffl dwra man, so U.7N��■R • a go • �� arAi�i7npnw.97'�i�! az • •• • ••• • • •• Hygienic'Hand Practices: Handwashing Good personal hygiene includes: Proper Handwashing Procedure j The whole process should take 20 seconds ■ Maintaining personal cleanliness .' ■ Wearing proper work attire in Following hygienic hand practices r w ®wet hand.wdh—IN ©Apply soap ®Vigorou,ly scrub hands ■ Avoiding unsanitary habits and actions -ae a.h�a.y..ean .�.rm,� ent.m— comh bty.mnd(,t least seconds c4an urcNr ■ Maintaining good health '°°"`"g" fin;.°'°�d'°""°n in Reporting illnesses M,se thoroughly ®Dry hand..nd arm,coon under running'a'ater a,ingl.++ee paper towel ' rmsb hand dryer U.a ea paper tvesl to tum ' a5 art ma muter. 1 NO Bare-Hand Contact with When to Change Gloves Ready-to-Eat Food a As soon as they become . ■ Handle food with tongs,deli sheets, soiled or torn or gloves AL A m Before beginning a different tasl . .. ■ At least every four hours during continual use and more often when necessary ■ After handling raw meat and before handling cooked or ready-to-eat food � �S ar5ste� ,� �Seasate . op, Foodhandlers should: B Wear a clean hat or other hair restraint Wear clean clothing daily Remove aprons when leaving food-preparation areas ®- Q Remove jewelry from hands and arms © Wear appropriate,clean,and closed- toe shoes 2 ... F16 ... To keep food safe: f In Prevent cross-contamination ■ Prevent time-temperature e— Jp�' abuse Rb The o i 1 Flo SZ tion Create physical barriers between Create procedural barriers between food products: food products: In Assign specific equipment to each type ■ Prepare raw meat,fish,and poultry and of food ready-to-eat food at different times In Clean and sanitize work surfaces, (when using the same prep table) equipment,and utensils after Is Purchase ingredients that require each task minimal preparation s� d� �. � This includes: Ice-Point Method In Minimizing the time food spends in the temperature danger zone ' - r ■ Determining the best way to monitor time and temperature E In Making thermometers available $ { f 1.Fill a large 2.Submerge the 3.Hold the calibration container thermometer nut and rotate the with crushed ice stem or probe in thermometer head and water the water for thirty until it reads 32T seconds (0-C) ss � se �SwvSafe) 1 „,. When using thermometers: Label Food ■ Keep thermometers and their Potentially hazardous,ready-to-eat food storage cases clean prepared on-site must contain a label that ■ Calibrate them regularly to includes: ensure accuracy r` ■The name of the food ■ Never use glass thermometers ■The date by which it should be sold, to monitor food temperature consumed or discarded ■ Insert the thermometer stem or G probe into thickest part of product (usually the center) a w ■ Wait for the thermometer reading to steady before recording the temperature of a food item 7.2 Refrigerated Storage Store raw meat,poultry,and fish: ■ Used to hold potentially ■ Separately from cooked and hazardous food at 41'IF ready-to-eat food (5°C)or lower a I OR ■ Slows the growth of microorganisms ■ Below cooked and :. r -eady to-eat food Improper Storage 76 'CodkingRorK�8ii6f, I and Limb Poultry: Pork,Beef,Veal,Lamb (including whole or ground chicken, 9 erature:Minimum Internal Cooking Temp turkey,and duck) ; p Minimum Internal Cooking Temperature: . i Steaks/Chops: ” 145°F(63°C)for 15 seconds 165°F(74°C)for 15 Seconds , .�` Roasts: 145°F(63°C)for 4 minutes 2 .. .. F..• e' ire Fish Cool potentially hazardous Minimum Internal Cooking Temperature: food from: ■ 135°F to 70°F(57°C to 21°C)within 145°F(63°C)for 15 seconds 735'F ` 2 hours src And then from i,°•c Ground,chopped,minced fish 70° jr■ F to 41°F(21°C to 5°C)or lower �� 011 Minimum Internal Cooking Temperature: in the next 4 hours 5'c 155°F(68°C)for 15 seconds 616 C� 61B` •• . ••• • • •• . •• • ••. •• • Siegel Before cooling food,start by Safe methods for cooling food: reducing its size: ■ Place it in an ice-water bath ■ Cut larger items into smaller pieces ■ Place containers into a sink or ■ Divide large containers of food into ♦ large pot filled with ice water smaller containers or shallow pans ■ Stir the food frequently y ■ Stir it with an ice paddle ■ Food cools faster when placed in an ice-water bath and stirred with an ice paddle Food reheated for immediate service: ■ Can be served at any temperature if it was properly cooked and cooled S,� Potentially hazardous food reheated for hot holding: ■ Must be reheated to an internal temperature of 165°F(74°C)for 15 seconds within 2 hours ■ Discard it if it has not reached this temperature within 2 hours 3 f - a When holding potentially When holding potentially hazardous food: hazardous cold food: ■ Check internal temperatures using ■ Hold it at an internal temperature of a thermometer 41 OF(5°C)or lower ■ Check temperatures at least ■ Only use equipment that can keep it every four hours at the proper temperature z~, ■ Discard food not at 135°(57°C) ■ Do not store it directly on ice r or higher or 41°F(5°C)or lower ■ Whole fruit and vegetables and ■ As an alternative,check the raw,cut vegetables are the only temperature every 2 hours to exceptions leave time for corrective action ■ Place all other food in pans or on plates first 4 Cleaning / ■ Process of removing food and other v a 5 types of soil from a surface y i�t Sanitizing 1 ■ Process of reducing the number t of microorganisms on a clean surface to safe levels ■ Surfaces must first be cleaned and Y t rinsed before being sanitized 12-2 ti t x • • • ••• Food-contact surfaces must Food-contact surfaces be washed,rinsed,and sanitized: can be sanitized by: ■ After each use ■ Immersing them in a specific , ■ Anytime you begin working concentration of sanitizing solution with another type of food for a specific amount of time ■ After a task has been interrupted and OR the items may have been contaminated ■ Rinsing,swabbing or spraying ■ At 4-hour intervals if the items V"q_ them with a specific concentration are in constant use of sanitizing solution 12J 0 Concentration 7Higherature Machines ■ Concentration must be checked e of the final sanitizing rinse frequently with a test kit least 180°F(82°C) ■ Low Concentrations: May fail to sanitize objects ■ High Concentrations: _ May be unsafe,leave an odor or bad taste,corrode metals ■ Change the solution when it is dirty or when the concentration has dropped below the required level 1 f Chemicals ■ Only purchase those approved for use in a restaurant or foodservice establishment ■ Store them in their original container away from g food and food-preparation areas ■ When transferring them to a new container label it with: ■ The chemical's name aJ ■ The manufacturer's name and address ■ A description of potential hazards ■ Keep MSDS for each chemical 2 r MGM=AM ME MMI� To deny pests food and shelter: continued o Store food and supplies quickly and properly o Keep them away from walls and at least 6" (15 cm) off the floor o Rotate products so pests cannot settle and breed a Clean the establishment thoroughly n Clean up food and beverage spills immediately o Clean break rooms after use o Keep cleaning tools and supplies clean and dry 13-7 If pesticides will be stored on the premises: n Keep them in their original containers n Lock them in cabinets away from areas where food is prepared and stored o Store aerosol or pressurized spray cans in a cool place n Dispose of them as per local regulations n Keep corresponding MSDS on the premises 13-11 0: 1 Control : Hot Food Holding Food Without Temperature Hot food can be held without temperature control for up to 4 . hours if: ■ It was held at 1350F (57°C) or higher prior to removing it from temperature control ■ It contains a label specifying when the item must be thrown out It is sold ,, served , o di scarded iscarded within four hours 9_7 0ervSafe r oq good can be heOd w5thouq qe pe atuire c ongiro0 foir asp qo. 6 houirs 09. Ei It was held at 1350F (57°C) or higher prior to removing it from temperature control Ei It contains a label specifying when the item must be thrown out It is sold , served , or discarded within four hours s-7 OSe;rv&fe *.1 t. S T]NOR 99 /1 � N?$Ij 0 1-- it 119 ffi A t ;tp '16 r±V 1351E C F�571E 1:317 I1 T ig i MA Lh v 12, V"t 5+4 B ffi 1.k. 9 j 0.4 N L Ser�sSafe 9-7 f - ,a IN Biological Hazards ■ Bacteria,viruses,parasites,fungi ■ Toxins Chemical Hazards l ■ Pesticides,food additives,cleaning supplies,toxic metals ��' •-w -,,,, Physical Hazards ,e ■ Hair,dirt,metal staples,etc. • Microorganism Food ■ Small,living organism ■ Foodborne microorganisms require `' nutrients to grow.Specifically Pathogen carbohydrates and proteins ■ Illness-causing microorganism ■ These are found in potentially Pao d hazardous food including: Toxin ■ Meat ■ Poison ■ Poultry ■ Dairy products ■ Eggs .Z.Z 2. �r! Food Favoring the Rapid Growth of Food Favoring the Rapid Growth of Microorganisms: Microorganisms:continued ( � _ �i AA4 L f Meal FlaM1 �1. , sub antl ry lamM1 Pont Paod,such Po,amea I^r '®I SPnu,SeMa M1tik aM Milk as Cooked Rice, ( ~>�: •, SynNetic bryredienb, Producb Beano,and SucM1 as Teamred Soy �• Vepebbles Y� unbeateaoaiiiP+neon Rohm In eggs lessept Naae 3 ..v, `f Miamrca � MeatNhmaWea treatalmeNnWm TON MONet Sabnondta aP0.) � SM1ecfiaM1 and Soy-0,ohin Fm su.e Mdmu Cv- 1 _ 1 .. .. • . • Rem .. .. , . . e� Temperature Time ■ Foodborne microorganisms grow ■ Foodbome microorganisms need well at temperatures between 41 T sufficient time to grow and 135"F(5°C and 57°C) ■ 4 hours or more in TDZ=growth high T. enough to cause illness i 26 2.7 The two conditions you can control: Chemicals ■ Temperature ■ Store away from food,utensils, ■ Refrigerate or freeze food properly and equipment ■ Follow manufacturers'directions ■ Cook food properly Q for using them ■ Time ■ Label them properly if they are ■ Minimize time food spends transferred to new containers in the temperature danger zone(TDZ) 2.10 Common Food Allergens ■ Milk and dairy products r ■ Eggs and egg products ■ Fish y . ■ Shellfish ' ~ ■ Wheat .{ ■ Soy and soy products ■ Peanuts ■ Tree nuts J13 L CuuiiiiE■ '■ ■■■■■■aa ■a■■�`■■■■, Behaviors That Can Contaminate Food ■■■C■a■gq■Cai=■■■■ n■ aaaaaq■aaau ■■egnq■aa■alaq Scratching the scalp ®Touching a pimple or e■■aagaangw � ?r u■a■ganaaaaniCC r ■r■.■aa■■am I ■a open sore E�a■oaaaaa■■C999. _ Q Running fingers `�_, a■■Eau'EECEE9■iv�rZE through hair ®Wearing a dirty uniform ■uaaa€aramnu ++i■■+ ■sa■■�■■ ■ Wiping or touching Coughing or sneezing into ■uaa■ ■■.■qua■ a■■oaCC■anun■■■� the nose the hand a■■■■aq uua n .■■rr■arCi■a■.aC�a.0 ■■■■■a■gnnatann Q Rubbing an ear ®Spitting in the establishment maniWINS Iasi". ■ Sam Smamamwas mommuma■A■r a■a■Paaaa��. ■aii+EE■■9Ci■E■ru■ ilaiCECrr■■9■itiu��w t r+■+■nrauoru,9'C9C.,�■9 4.2 . .. �• ...�W'l:l\'lll'l� .. �raAaa�/Y a�MiMA�/ . • . ':,,r.at i Good personal hygiene includes: Proper Handwashing Procedure The whole process should take 20 seconds ■ Maintaining personal cleanliness i ■ Wearing proper work attire `�- ■ Following hygienic hand practices tt 4 _- �"" ®Wet hands wAh running ®Appty soap ®Vg=r=usly scrub hands ■ Avoiding unsanitary habits and actions water ea halaa yae=an and arms far ten to fifteen ambrlably sland(atleast se=onds Cl—under ■ Maintaining good health I 100FdB C) fin9eeme is end be wean ■ Reporting illnesses 4 eP... a Y Rinse thoroughly ® ry ha.nd—d arms with under sunning water aaingleuze paper towel air hand dryer Use erpaper towel to t— off lho 1 r NO Bare-Hand Contact with When to Change Gloves Ready-to-Eat Food ■ As soon as they become ■ Handle food with tongs,deli sheets, soiled or torn �5 or gloves #� ■ Before beginning a different ¢/ task r ■ At least every four hours during b continual use and more often when necessary ■ After handling raw meat and before handling cooked or ready-to-eat food Foodhandlers should: ® Wear a clean hat or other hair restraint Q Wear clean clothing daily ® Remove aprons when leaving ,L food-preparation areas Q Remove jewelry from hands and arms © Wear appropriate,clean,and closed- toe shoes 2 To keep food safe: �.. ' ■ Prevent cross-contamination ■ Prevent time-temperature a l 4 abuse jW a q 1 a Flawr ��g � of �� $f®� Fcud (�� 1 Create physical barriers between Create procedural barriers between food products: food products: ■ Assign specific equipment to each type ■ Prepare raw meat,fish,and poultry and of food ready-to-eat food at different times a Clean and sanitize work surfaces, (when using the same prep table) equipment,and utensils after ■ Purchase ingredients that require each task minimal preparation RIM . . . This includes: Ice-Point Method ■ Minimizing the time food spends in "..m the temperature danger zone ■ Determining the best way to monitor time and temperature l �• • Making thermometers available 1.Fill a large 2.Submerge the 3.Hold the calibration container thermometer nut and rotate the with crushed ice stem or probe in thermometer head and water the water for thirty until it reads 32'F seconds (0-C) 1 a, When using thermometers: Label Food ■ Keep thermometers and their Potentially hazardous,ready-to-eat food storage cases clean prepared on-site must contain a label that Is Calibrate them regularly to q includes: ensure accuracy ■The name of the food ■ Never use glass thermometers ■The date by which it should be sold, to monitor food temperature consumed or discarded ■ Insert the thermometer stem or a probe into thickest part of product � I f (usually the center) f ■ Wait for the thermometer reading to steady before recording the temperature of a food item �c ss � 7-z Refrigerated Storage Store raw meat,poultry,and fish: ■ Used to hold potentially a Separately from cooked and P hazardous food at 41°F ready-to-eat food (5°C)or lower — OR - "i ■ Slows the growth of ®`microorganisms ■ Below cooked and ready-to-eat food Improper Storage 79 79 ` Poultry: Pork,Beef,Veal,Lamb (including whole or ground chicken, r t turkey,and duck) r r ' Minimum Internal Cooking Temperature: Minimum Internal Cooking Temperature: Q f Y ', Steaks/Chops: 165°F(74°C)for 15 seconds 145°F(63°C)for 15 seconds .. ; Roasts: 145°F(63°C)for 4 minutes 2 Fish Cool potentially hazardous Minimum Internal Cooking Temperature: - - food from: 145°F(63°C)for 15 seconds ■ 135°F to 70°F(57°C to 21°C)within 135•F 2 hours sYc And then from z°c Ground,chopped,minced fish ■ 70°F to 41°F(21°C to 5°C)or lower �� 41'F Minimum Internal Cooking Temperature: in the next 4 hours s c 155-F(68°C)for 15 seconds �� Before cooling food,start by Safe methods for cooling food: reducing its size: ■ Place it in an ice-water bath ■ Cut larger items into smaller pieces 00 „ 3 ■ Place containers into a sink or ■ Divide large containers of food into .= o large pot filled with ice water smaller containers or shallow pans ■ Stir the food frequently ■ Stir it with an ice paddle ■ Food cools faster when placed . in an ice-water bath and stirred ! with an ice paddle `—� r I Food reheated for immediate service: ■ Can be served at any temperature if it was properly cooked and cooled '�•. Potentially hazardous food reheated for hot holding: ■ Must be reheated to an internal temperature of � .a 165°F(74°C)for 15 seconds within 2 hours r 1 ■ Discard it if it has not reached this 15 temperature within 2 hours 3 When holding potentially When holding potentially hazardous food: hazardous cold food: ■ Check internal temperatures using ■ Hold it at an internal temperature of F; a a thermometer 41°F(5°C)or lower ■ Check temperatures at least ■ Only use equipment that can keep it every four"hours at the proper temperature ■ Discard food not at 135°(57°C) ■ Do not store it directly on ice or higher or 41°F(5°C)or lower ■ Whole fruit and vegetables and ■ As an alternative,check the raw,cut vegetables are the only temperature every 2 hours to exceptions leave time for corrective action ■ Place all other food in pans or on r plates first 9 4 -r. �... Cleaning f ■ Process of removing food and other z, types of soil from a surface r' Sanitizing �. t ■ Process of reducing the number of microorganisms on a clean surface to safe levels ■ Surfaces must first be cleaned and t rinsed before being sanitized r •J` •.• • 1�1t�1111SJ1 Food-contact surfaces must Food-contact surfaces be washed,rinsed,and sanitized: can be sanitized by: ■ After each use �� ■ Immersing them in a specific , ■ Anytime you begin working concentration of sanitizing solution with another type of food for a specific amount of time OR ■ After a task has been interrupted and . the items may have been contaminated ■ Rinsing,swabbing or spraying ■ At 4-hour intervals if the items them with a specific concentration are in constant use of sanitizing solution 12J 126 Concentration High-Temperature Machines ■ Concentration must be checked ■ Temperature of the final sanitizing rinse frequently with a test kit must be at least 180°F(82°C) ■ low Concentrations: May fail to sanitize objects ■ High Concentrations: May be unsafe,leave an odor or bad taste,corrode metals e Change the solution when it is dirty or when the concentration has dropped below the required level 12.711150!! 129 1 Chemicals ■ Only purchase those approved for use in a restaurant or foodservice establishment ■ Store them in their original container away from food and food-preparation areas ■ When transferring them to a new container label it with: ■ The chemical's name �y ■ The manufacturer's name and address • A description of potential hazards ■ Keep MSDS for each chemical u-u�� 7 D - • U'l� • o • Gl�lrl To deny pests food and shelter: continued n Store food and supplies quickly and properly n Keep them away from walls and at least 6" (15 cm) off the floor n Rotate products so pests cannot settle and breed n Clean the establishment thoroughly n Clean up food and beverage spills immediately n Clean break rooms after use o Keep cleaning tools and supplies clean and dry 13-7 l�l+'�IIIl1 • 0 • If pesticides will be stored on the premises: n Keep them in their original containers n Lock them in cabinets away from areas where food is prepared and stored n Store aerosol or pressurized spray cans in a cool place n Dispose of them as per local regulations n Keep corresponding MSDS on the premises 13-11 1 Holding Food Without Temperature 'Control : Hot food can be held without temperature control for up to 4 . hours if: ■ It was held at 1350F (57°C) or higher prior to removing it from temperature control ■ It or a label specifying when the item must be thrown out ■ It is sold , served , or discarded within four hours 9.7 rServSafe Lo Mein (Soft Noodle Dishes) TIXI FOR Tiki Lo Mein Route 132, Hyannis (Consists of Chicken,Roast Pork&Shrimp)................ 8.00 RESTAURANT Lo Mein (Choice of Roast Pork,Chicken,Beef, SPECIAL LUNCHEON MENU Shrimp or Vegetables Only) ........................................... 7.70 Served daily from 11:30 a.m. to 3:00p.m. (except Sundays&Holidays) Take Out Menu Tel : 508-771 -5220 ANy KiNd of Lo MEIN by AddiNq (+) ThE FouowiNq Appetizers: Choice of; Speical Luncheon Combination Plates Chicken Wings(3) ................................. 8.70 • Egg Roll (1) ,,,, g,'70 ..................................... (NO SUBSTITUTES,ORDER BY NUMBER PLEASE) Boneless Ribs (4) .................................. 8.70 Egg Roll,Pork Fried Rice, Egg Roll,Bonless Spareribs, Teriayki Beef(3) ................................... 9.30 1• Subgum or Pork Chow Mein 5,90 92. Pork Fried Rice 7.10 .......................... .............................................. Pork Strips,Pork Fried Rice, 10. 0 Eg Roll,Chicken Wings, ' y ( ) Z Teriyaki• Chicken 3 .............................. 9.10 • Subgum or Pork Chow Mein ............................ 6.70 Pork Fried Rice .............................................. 7.10 Chicken Fingers (4) ............................... 8.70 Spareribs,Pork Fried Rice, Chicken Fingers,Chicken Wings, i 3. Subgum or Pork Chow Mein ............................ 6.70 10 a. Chicken Teriyaki,Pork Fried Rice .................. 8.60 � Barbeque Spareribs (3) .......................... 9.10 3 Boneless Spareribs,Pork Fried Rice, Egg Roll,Teriyaki Beefor Chicken, Crab Rangoons (3) ................................ 8.70 a. Subgum or Pork Chow Mein ............................ 6.70 11• Pork Fried Rice .............................................. 7.70 I Peking Ravioli(2) .............................. 4 Chicken Wings,Pork Fried Rice, Grab Rangoon,Teriyaki Reef or Chicken, � ••• 8.70 . Subgum or Pork Chow Mein ............................ 6.70 11 a. Boneless Ribs,Pork Fried Rice...................... 8.60 Vegetable E Roll 1 8.70 SFried Shrimps,Pork Fried Rice, Egg Roll,Chicken Fingers, g Egg ....( )• .... . ..._.._... • Subgu or Pork Chow Mein ............................ 6.90 12. Pork Fried Rice .............................................. 7.50 Pork Strips (4) 9.10 Fried Chicken,Pork Fried Rice, Peking Ravioli,Boneless Ribs, '6. Subgum or Pork Chow Mein ............................ 6.70 12a. Chicken Wings,Pork Fried Rice .................... 8.60 r Chinatown Style Dim Sums 1 Eggg Foo Yong,Pork Fried Rice, Egg Roll Sweet&Sour Pork Son Mai . Subgum or Pork Chow Mein ............................ 6.70 13• (or Chicken),Pork Fried Rice......................... 7.70 l Chicken Fingers,Fried Rice, Egg Roll,Chicken Fingers,Sweet&Sour (Meat in Thinly Wrapped Noodle Skin,Steamed)(8) .... 6.30 1 a. Subgum or Pork Chow Mein ............................ 6.70 13 a. Chicken or Pork,Pork Fried Rice ................... 8.60 j Har Gou Egg Roll,Pork Strips, Egg Roll,Pork Strips&Spareribs, ! � Pork Fried Mice ................................................. 7.10 14. Pork Fried Mice .............................................. 8.60 (Shrimp Thinly Wrapped in Rice Noodle Skin)(8)..........7.30 Egg Roll,Pork Strips, Crab Rangoons,Boneless Ribs, Water Dogs 82. Chicken Fingers,Pork Fried Rice...................... 8.60 14 a. Chicken Wings,Pork Freid Rice .................... 8.60 Meat Wrapped 6.50 j Egg Roll,Spareribs, Egg Roll,Boneless Spareribs, ( pp in Wonton Noodle Skins,Steamed)(8) 9• Pork Fried Rice .................................................7.50 1 S. Chicken Wings,Pork Fried Dice .................... 8.60 ( Water Dogs(In Soup) Chicken Fingers,Boneless Ribs, ` 152. Chicken Wings,Pork Fried Rice .................... 8.60 (Chicken Broth with Roast Pork or Chicken)(6)........... 6.50 SubstitueofChickenChowMein50#extra. Rice Noodles and Chow Foon I� MANDARIN OR SZECHUAN STYLE RICE PLATES (Hot&Spicy,Served with White Rice or Fried Rice 50¢Extra or Lo Mein$1.00 Extra) Pan Fried Rice Noodles 16. Szechuan Beef,(Chicken,Pork or Shrimp).............................................................................................................8.80 (Choice of Pork,Chicken,Beef,Shrimp or Roast Pork) 7.80 11, Gung Bo Chicken,(Beef,Pork or Shrimp) ..............................................................................................................8.80 Pan Fried Rice Noodles-Singapore Syle 18, Hunan Beef or Chicken ......................8.80 ' (Thinly cut Roast Pork or Chicken .................................................................................................................... r 19, General Tso s Chicken 8.80 and Vegetables in Curry Sauce) .....................................7.80 Z0. Orange Flavored Beef or Chicken...........................................................................................................................8.80 Pan Fried Rice Noodles -House Style " ' "�" - -� - •�� �'!��"` (Combination of Roast Pork,Chicken and Shrimp)...... 8.30 HONG KONG STYLE RICE PLATES 8.80 per plate Chow Foon The most popular Hong Kong's style eating! Meat and vegetables sauteed in light brown sauce (Choice of Pork,Chicken,Beef,Shrimp or Roast Pork) 8.10 served on a plate of boiled white rice,or with Pork Fried Rice 50¢extra or Lo Mein$1.00 Extra. Chow Foon-House Style ONE CHOICE OF MEAT WITH ONE CHOICE OF VEGETABLES (Chicken,Shrimp&Roast Pork).................................... 8.10 BEEF Broccoli Peppers Pad Thai(Thai Noodle Dish,Sauteed with Choice of CHICKEN Mixed Vegetables Tomatoes Shrimp,Chicken&Roast Pork).............................8.70 Pea Pods(in season) Onion SHRIMP WITH Bean Sprouts Mushrooms PORK Chinese Cabbage (Bok Toy) Bean Curd Pasta ROAST PORK Asparagus String Beans (House Style,New,Manager's Favor) (Chioce of Pork,Beef,Chicken,Shrimp or Roast Pork) A LA CARTE SERVED AT ALL HOURS Cooked with Chinese Vegetables in a Light Brown Sauce Not Responsible for Lost or Stolen Articles Gift Certificate Available Subject to 5%Mass.Meal&Liquor Tax. or Szechuan Sauce(Spicy&Hot).................................8.00 l MANDARIN- & SZECHUAN CUISINE INDIVIDUAL DINNER COMBINATION PLATES �� I (Please order by number, No Substitutes) MOO SHI STYLE COOKING (Substitute of Chicken Chow Mein 50¢ extra) The most popular dish form Northern China, this dish is tradtionally prepared with shredded meat, eggs, sun dried lily flowers, wood ears and selected Chinese CANTONESE STYLE (Traditional). vegetabbes;served with Mandarin pancakes. Each,dish is served with four(4) D1. Egg.Roll, Pork Strips, Pork Chow Mein and Pork Fried Rice.............9.80 pancakes; extra pancakes - 30o per pancake. Moo Shi Pork........................10.60 Moo Shi Beef.........................10.90 l D2• Egg Roll, Chicken Wings, Pork Chow Mein and Pork Fried Rice..............9.80 D3. Egg Roll,Fried Shrimps, Pork Chow Mein and Pork Fried Rice...........10.50 Moo Shi Chicken..................10.90 Moo Shi Shrimp...................10.90 I Meatless Moo Shi.................10.30 D4. Egg Roll, Chicken Fingers, Pork Chow Mein and Pork Fried Rice...........10.50 GULAG BO STYLE COOKING (Hot&Spicy) D5. Pork Strips, Spareribs, Pork Chow Mein and Pork Fried Rice If one likes a dish with a variety of tastes..spicy hot,sauteed with diced meat,green (or Boneless Ribs)..............................................................................................I.......10.50 peppers and diced Chinese vegetables, topped with roasted peanuts.. this is the one to order! D6• Egg Roll, Sweet& Sour Pork(or Chicken), Gung Bo Gai(Chicken) ......10.60 Gung Bo Gnow(Beef) .........11.80 Pork Chow Mein and Pork Fried Rice.....10.60 Gung Bo Yoke (Pork) ..........10.50 Gung Bo Delights 12.00 D7. Egg Roll, Spareribs, Chicken Wings and Pork Fried Rice.....10.60 . ................ Gung Bo Har (Shrimp).......11.00 (Chicken,Beef&Shrimp) k D8. Egg Roll, Boneless Spareribs, Chicken Wings and Pork Fried Rice.....10.60 SZEHCUAN STYLE COOKING(Hot&Spicy) D9. Egg Roll,Beef(or Chicken)Tleriaykis,Chicken Wings Pork Fried Rice.....10.60 D D The most popular Hot& Spicy dishes around here, slices of tender meat or seafood D 10. Egg Roll, Chicken Fingers, Boneless Ribs and Pork Fried Rice.....10.60 quick fried, then sauteed with shredded celery, red&green pepper, carrots, water D11. Crab Rangoons,Boneless Ribs, Chicken Fingers & Pork Fried Rice.....10.60 chestnuts etc., flavored with Szechuan brown bean sauce. D12. Peking Ravioli,Boneless Ribs, Chicken Wings and Pork Fried Rice.....10.60 ; Szechuan Pork(Yoke)....... 11.90 Szechuan Chicken(Gai).....12.30 CH INESE RESTAURANT Szechuan Beef(Gnow)...... 12.60 ' Szechuan Shrimp (Har) .....12.90 Plus Choice of D14. Beef w/Broccoli, Pork Fried Rice.....10.80 � aQy� " PEKING BEEF/OR CHICKEN ••••••••••••••••-••••••••••••••••••••••••.....•..............12.50 D15. Lobster Sauce, One Appetizer Pork Fried Rice.....10.80 �!! Slices of tender beef or chicken, quick fried then sauteed with straw mushrooms and D16. Chicken Lo Mein Chicken Fingers or Pork Fried Rice.....10.80 KXYNE IAN LOUNGE scallions in hot and spicy sauce. Crab Rangoons HUNAN BEEF/OR CHICKEN•••=••••••••••••••••••••••••••••••••........................•••14.80 D17. Chicken w/ Broccoli, Beef(or Chicken Teriyakis) Pork Fried Rice.....10.80 Slices of beef or white chicken meat quick fried and then sauteed with spicy garlic D18, Egg Foo Yong, Boneless Ribs Pork Fried Rice.....10.80 sauce, garnished with fresh broccoli Chicken Wings or _ D19. Cashew Gai Ding, Spareribs etc Pork Fried Rice.....10.80 GENERAL TSO'S CHICKEN ..................................................................12.90 Cubes of white chicken meat deep fried in thin batter, then cooked with hot&spicy „r 0 ginger sauce, garnished with fresh broccoli. SZECHUAN SHRIMPS AND/OR CHICKEN DING ........................•• 11.60 SZECHUAN or MANDARIN STYLE RICE PLATES Choice of baby shrimps or diced chicken meat quick fried with diced peppers, celery, (hot& spicy served w/white rice), W/Pork Fried Rice 50¢Extra . carrots etc., flavored with hot bean sauce, topped with crispy cashew nuts. D20, Szechuan Beef(or Chicken)............... Plus Choice of ONE:Appetizer ...10.80 �ry� If Both Shrimp & Chicken Combined Add $1.00JLJC.1.1 D21. Gung Bo Beef(or Chicken)................. Chicken Wings or ••••••10.80 SZECHUAN MA PO DOW FU ••••••••••••••••••••••••••••••••••...............................10.80 Hunan Beef(or Chicken 10.80 D22. ..................... ...... Popular Szechuan cooking with bean curd, diced cut pork, shrimp,pepper, green Chicken Fingers or 4 ROUTE 132 peas and bamboo shoots in a hot&spicy sauce. D23. Orange Beef(or Chicken ) .................. ......10.80 CAPETOWN MALL ORANGE FLAVOR BEEF OR CHICKEN •.•••••..•...............12.80 D24. General Tso's Chicken......................... Boneless Spareribs or 10.80.............•...... ...... Crispy aromatic beef sauteed with Chef's Spicy Special Orange Liqueur Sauce. D25 Egg Roll or .•.._ (opposite Cape Cod Mall) Szechuan Chicken Ding.. .10.80 s. LEMON CHICKEN....................................................................................12.30 D26. Sesame.Chicken....•..'..••..•.••."••'•••"••••'•' Crab Rangoons etc ......10.80 HYANNIS MASSACHUSETTS Crispy Chicken Breast Sauteed with Chef's Tangy Lemon Sauce. D27, Lemon Chicken................................... ......10.80 LUNCHEON SPECIALS A IERICAN CUISINE Note: D14 to D25 with Choice of Two Appetizer Add $4.00 Extra CHICKEN D31. Crab Rangoon,Sparerib(or Boneless),General Tso's Chicken,Pork Fried Rice.........14.80 EXOTIC ISLAND DRINKS / (� Broiled Half Chicken..................................................................... 10.00 D32. Chicken Wings,Sparerib(or Boneless),Orange Beef or Chicken,Pork Fried Rice...14.80 r ••• Breaded Boneless Chicken........................................................... 10.00 D33. Chicken Fingers,Teriyaki Beef(or Chicken),Rib or Boneless,Chicken Lo Mein......14.80 COCKTAILS SEAFOOD Fried Shrimps with Tartar Sauce .............................................. 12.60 All Items on the Menu are Subject to Current Massachusetts Meals Tax 5% OPEN DAILY YEAR ROUND Fried Scallops with Tartar Sauce .............................................. 12.60 STEAKS Duck Sauce and Mustard accompany all Appetizer Dishes BUSINESS HOURS: Broiled Sirlion Steak. 17.00 Bread accompanies all Main Dishes .................................................................... r Ham Steak........................................................................................ 13.00 INS SON: (Late June thru Early September) i For Your Heallli All Of Our Entree Are Cooked In Vegetable Oil.- EA at m Above Dinners Served with French Fries,Green Peas&Bread If MSG Is Not Your Preference, We Can Omit It. Open Daily to 1:00 A.M. (wee hours) We Only Use A Little To Enhance The Taste! Duck Sauce .......per 1/2 pint 2.20...............per pint 3.20 .......................per quart 5.00 TO ____-_ - Ro.,T- • ------------- TO TOWN... Mustard .,..........per 1/2 pint 2.00...............per pint 3.00 .......................per quart 4.80 OFF SEASON: (Mid Sept.thru Late June) Chinese Tea ... per quart 1.50 ""T`..................................... ....................................................... Mon., Tues. &Sunda to 10:00 PM Fortune Cookies................................................................................. per /2 dozen 0.75 [--K•NART Y French Fried Potatoes ..................................................................................per pint 2.00 Wed.thru Sat.to the wee hours Bread ....................................................... ...per order 0.50 tA►c TOWN NALL............................................... BrownGravy............................................................ .... per pint 1.20 d nw et ab TRANSLATION OF A FEW CHINESE WORDS IN THE MENU FOR TAKE OUT ORDERS Gee Gnaw • ..........................................................................................................................Pork CAM COD NALL >t,, .Beef Gai ......................................................................................................................Chicken scAws rOMrRwwNaTwaLc NYNN7PAL AIRPORT t PLEASE CALL Har ..............................................................................................................Shrimp AY INN 500-771 -5220 HOLID LungHar ......................................................................................................•••••. ..Lobster .-TO f A1.MOYTH RdITt a TO NYANNIa--- YARNq►TM..�. i Char Sue.........................................................................................................Roast Pork TO MooGoo...........................................................................................................Mushroom � Yoke. .. ........................................................................................ .... .Meat Chow Yoke.................................................... ..........Stir-Fried with Meat ,�,�►aT�►s Bok To ...................................................... ...... .Chinese Cabbage l % \ All items on menu subject Hong Sue ••�••��••••�••�••••��••��•••• •.•Deep Fried in Batter t0 5% Mass. Meal Tax. .. ••• Sorry.no personal checks accepted. ........................ ............................................................ Subgum.............................................................. ............Colorful Variety ■GAIN XMIZT DOWNTOWN HYANNy ' .......................... 0. Chicago.............................................................................The Sauce Color is Very dark SPECIALTIES TRADITIONAL CHINESE CUISINE APPETIZERS FRIED RICE Sm. Reg. Chefs Suggestions (Served with Duck Sauce and Chinese Mustard) TIKI GOURMET SPECIAI. 19.80 Meatless Egg Foo onng.............................7.00 Meatless Fried Rice ..................3.60 6.50 TIKI PLATTER ............. 28.00 ..................,................................... . ..... . ............ ............................ or ............................... . • • ' �•"� Roast Pork 730 Roast Pork 3 60 6.90 •••-•••••••••••••••••••••••••"""""'••••••'•'••""""""""""""' Combination of tender slices of beef, Chicken meat, roast pork, shrimps, crab meat and lobster A King's.treat for appetizer lovers,-Poik Strips, Spareribs, (or Boneless Ribs) meat sauteed with-mushrooms and choice Chinese vegetables in an exotic oyster sauce sur- Chicken..................................................7.60 Beef.....................:...................4.00 7.80 Egg Rolls, Fned Shrimps-cvwken Wings, Teriyaki Beef anu 51irunp cntps rounded by golden brown.wontons,nesting on top of delicious bean sprouts.A real treat for two! Shy „••,•,•,•...•,•,•••...............••••............8.20 Bean Sprout Pork..................... 4.00' 7.60 _ ................................................. ........ ................. 18.70 PU PU PLATT�' GAI POO LO.MEIN................... .....................:................,......................1&50 ......... . ...... ................ Chicken....................................4.00 7.60 , _.-ar fora appetizer lovers, Pork Strips, Spareribs, or Boneless Ribs SubgumPork 810 Chick A Que pp p ' p ( )' A combination of beef, roast pork, ham, shrimps, crab meat;lobster meat and Mushroom Pork ......................................8.10 Ham.........................................4.00 7.60 !�9-rro Fned Shrimps, Chicken Wings,and Shrimp Chips chicken meat in-batter, cooked with selected Chinese vegetables, in oyster sauce; ,-'ROYAL PLATTER(New).......................................................................... 28.CO nesting on top of to mein.This is a real Cantonese delicacy for two! 8.10 Shrimp .....................................425 8.30 Ham .. A princess.treat for appetizers lovers, egg rolls, crab rangoons, Chicken fingers, BLACK MAGIC............. .:.....14.00 Tild Special Egg Foo Yong.....................10.70 Subgum Pork............................425 7.80 ...... chicken wings,boneless spareribs, fried shrimps and shrimp chips Combination of slices of lean pork, chicken meat and jumbo shrimps sauteed SubgumBeefor Chicken...........425 830 APPETIZERDELIGHT...................................................:...:..................... 9.80 peapods in black can sauce Special Fried Rice 9% with baby snow pe bl k b CHOW MEIN Ttla Choice of A.Egg.Roll-Spareribs(or Boneless Ribs).&Chicken Wings MARCO POLO.............................................................. ... .......13.50 Plain$oiledRice.......................220 3.40 ""' """"' •"' (Traditionally served with Crispy Noodles) B.Egg Roll-Spareribs(or Boneless Ribs)-&Chicken Fingers Shrimps in lobster sauce and slices of tender beef nesting on top of pan-fried soft noodles. C.Crab Rangoon,Chicken Fingers&Boneless Spareribs SEA FOOD WONDER...............................................................................16.90 Sm. Reg. r� Combination of jumbo shrimps, scallops, crab meat and lobster meat fried in a thin batter, Meatless Chow Mein............'.... 3.90 6.90 ("Chow CHOW YOKE (BEEF) ow yoke" means stir fried with Meat) SEAFOOD DELIGHT...............:............................................................... 10.50 1 p , P . Beef&White Mushrooms........ 630 11.80 sauteed with water chestnuts, bamboo shoots, peapods and white mushrooms, Consists of:Shrimps, Scallops and Crab Rangoon's Pork.........................................420 7.40 nesting on a bed of delicious bean sprouts. ...................420 7.80 Beef&Bean Sprouts.................530 10.50 CHICKEN DELIGHTS (Chicken Fingers, Chicken wings&,Chicken Teriyakis) 10.30 Beef...................... Fried Chicken Wings EIGHT JEWEL CHOW MEIN .................................................................13.50 Beef&Mixed Vegetables...... . 5.30 10.80 . ..........:..................................................................... 7.50 Chicken...................... 4.20 7.90 ... Combination of chicken meat, roast pork and shrimps, sauteed with choice Chinese greens """""" Chinese Roast Pork Strips p p g Shrimp ................................4.50 8.4p Beef&Pea Pods(in season)......5.80 11.60 P •••••• ••••••••••••••••••••••••••••••••••••••••••••••�••••••••••••••• 9•� and straw mushrooms, nesting on top of special pan-fried noodles. S "' Bee f Oyster Sauce 5.80 11.80 Barbecued Spareribs ............................................ 9.00 A real Chinese dish for the Chinese food connoisseurs! Roast Pork ...4.30 7.90 Y Boneless Spareribs............... .................:................... 8.80 SEAFOOD"IN TIKI BIRDS NEST.........................................................17.50 Mushroom Chicken..................4.30 8.40 Beef&PepperBlack ean Sauce .......... 530 11.80 ................................ Egg Rolls (2) or Vegetable Egg Rolls (2).............................: 4.70 Shrimps,scallops and sealegs sauteed with selected Chinese vegetables in an edible nest MushroomPork .......................420 7.80 Beef&Peppers......................... 530 10.80 ................ Salt&Peppers Chicken'Wings (Mild Spicy)......................... (made of Chinese noodle) Beef&Peppers and Tomato ......530 10.80 .................. 8.50 Vegetable.................................420 7.80 . 9.70 SubgumPork............................420 7.80 Beef&Onions....:........:............ 5.30 10.80 Fried Jumbo Shrimps ............................................................................. Beef&Broccoli ..... 5.30. 10.80 Fried Scallops (Scallops in Batter)............................................................. 10.W CANTONESE CUISINE Beef...................................4.50 8.40 .' e" o Fried Wontons (Crispy, thinly wrapped Meat Dumplings)............. .. 4.00 Chicken..............................4.50 8.20 Beef&As ara s m season 10.80 CHICKEN (GAI) p ( ).........:.. . Chicken Fingers (Chicken Meat in Batter).................................................... 9.00 Chicago Pork............................4.50 8.00 CHOW YOKE (PORK) HONG SUE GAI....................10.70 GAI PAN.................................10.70 Peking Ravioli (6) (Meat Dumplings).................:......................................... 7.60 Tender chicken meat, dipped in batter, Beef....................................4.50 8.40 Pork&White Mushrooms.......:4.70 9.70 . 10.00 fried a olden brown, then expertly batter, (Choice of Moo Goo, Tow Goo or Bo Lo) Chicken................ .4.50 8.40 Pork&Bean Sprouts.................4.70 9.40 Teriyaki Beef (Marinated Beef on Bamboo Skewers).................................. g p y """"" .. Slices of white chicken meat sauteed with Till S eical Chow Mein ..........................9.90 Pork&Mixed Vegetables..........4.70 9.40 Teriyaki Chicken Marinated Chicken Meat on Bamboo Skewers................ 9.40 with selected Chinese vegetables, P y ( 1 selected Chinese vegetables in light sauce. 170 Pork&Peapods(in season) ......4.70 9.40 4.70 water chestnuts, and white mushrooms. Choice of: Fried Crispy ......:........ Spring Rolls:(2).................................................................................... ..... -EMPRESS CHICKEN..........11.70 Ah Moo Goo white mushrooms) Pork&Oyster Sauce.......:.........4.70 9 70 Crab Rangoon's (Crispy, Thinly wrapped crabmeat& cheese in noodle skin) 8.00 Tender chicken meat,dipped in batter, (B) Tow Goo (straw mushrooms) Pork&Black Bean Sauce ...:......4.70 9.40 Scallion Pancakes (Pan Fried Dough with Scallions and Seasoning)............. 5.90 fried to golden brown, sauteed with fresh. (C) Bo Lo (pineapple tidbits) VEGETABLE DISHES Roast Pork&Mixed Vegetables 4.70 9.40 Honey Spareribs (Short Ribs in Honey Sauce).............................................. 9.30 Chinese greens and white mushrooms!n GAI DING &BEAN CURD Pork or Roast Pork w Broccoli ...4.70 9.40 Imperial Wings (A Sweet, Spicy Garlic Version)........................................... 8.50 light brown sauce, nesting on top of soft. fried noodles. StirFriedMixedVegetables Sm. Reg. (CASHEW or ALMOND)......10.70 CHOP SUEY DIM SUMS, China Town style) (Chinese)............................4.10 . 7,80 Meatless Cho Sue 3.90 6.90 ( 0' HO YUE GAI P00................11.80 Fresh diced cut chicken meat p Y•••••••••-••••••• •••••........... 3.60 620............routs S Sue Mai (Meat in Thinly Wrapped Noodle Skin,.Steamed) (8)....................... 6.50 Chunks of tender chicken, fried in egg with diced cut vegetables, white .Bean •P Pork.,...................,...................4.00 7.20 F Har Gou (Shrimps /n Thinly Wrapped Noodle Skins, Steamed) (8)..........:.... 7.30 batter, and slices of ham,gamished with mushroom, snow peapods, tender Stir Fried Pea Pods .................... 720 Beef.........................................4.00 7.40 Water Dogs (Meat Wrapped in Wonton Noodle Skin, Steamed) (8)............... 6.60 Chinese vegetables, oyster sauce and water chestnuts and topped with choice Broccoli Cantonese Chicken....................................4.00 7.40 topped with crushed toasted almonds. of crispy(Almonds or cashew nuts). or Szechuan Style................ 3.90 6.70 S 420 8.10 SESAME CHICKEN.............11.40 �' hnmp .:................................... ' SOUPS White chicken meat, deep fried in Chinese Cabbage(Bok Toy)...... 3.60 6.40 Mushroom Pork .......................4.50 7.90 HOT AND SOUR SOUP ................................................................ BEEF (GNOW) Asparagus in season 6.20 Beef..........................:........4.50 820 ,,,,,,,,,,,, 4,30 water chestnuts flour and sesame p gus ( )•,••••••••••• The most popular spicy soup from Northern China-shredded meat, bean curd, HONG KONG STEAK..........13.80 in special Szechuan sauce. String Beans(Cantonese Chicken..............................4.50 820 and a variety of imported Chinese vegetables in a slightly thickened broth. Broiled tender beef steak to your or Szechuan) .......................4.00 6.10 Vegetable.................................420 7.80 WONTON SOUP WITH ROAST PORK OR CHICKEN....................... 4.10 specification, cut to strips nesting on top Hong Sue Bean Curd SubgumPork............................420 7.40 of thin cut onions, served with,the PORK (YOKE) 430 820 FRIED WONTON SOUP WITH ROAST PORK OR CHICKEN......... 4.10 Chefs special spicy sauce. CHAR SUE BOK TOY..........10.00 with Vegetable 4.60 8.40 Beef......................... Egg Blossom Soup with Mushroom...................................................... 4.10 STEAK KEW 16.00 Roast Pork with Chinese Cabbage. Bean Curds in Spicy Sauce........4.00 6.80 Chicken..............................4.50 8.20 ........................: Chicago Pork.................. ......4:50 7.90 Chinese Vegetable Soup (Add bean curd, 30¢extra)................................... 4.10 Filets of-sirloin steak sauteed with CHAR SUE DING.................10.00 . SWEETAND SOUR Yatka Mein Sou with Roast Pork or Chicken (Chinese Noodles) 4.10 Chinese greens, mushrooms and Diced roast pork sauteed with diced Beef...................................4.50 820 p )..... P Pork..:........................................,...........920 enhanced with an oyster sauce. vegetables topped with choice of Chicken......:.................::....4.50 820 Chicken Soup with Rice or Noodles ..................................................... 4.10 crispy Almonds or Cashew nuts Chicken...........................................:......9.50 TilaSpeicalChopSuey .9.70 TOW GOO GNOW.................12.90 py ( ) ...................... . Water Dogs in Chicken Broth (Cantonese Style)..................................... 6.50 Shrimps................................................1150 (Meat Wrapped in Wonton Noodle Skin) with Roast Pork or Chicken Slices of tender beef sauteed with small HONG SUE YOKE................10.50 juicy straw mushroom, peapods and Tenderloin pork in battersauteed with mixed Wontons................................................6.70 RICE NOODLES water chestnuts in brown exotic sauce. Chinese vegetables in light brown sauce. Scallops...............................................1150 POLYNESIAN CUISINE (China Town Style) TIKI WOR BAR 18.80 CHICKEN Rice Noodle..........:....................5.00 8.60 ........................................................................................ SEAFOOD (HOISIN) Fried Chicken with 7.90 Slices of beef, shrimps, lobster meat, roast pork and chicken meat cooked with (H� •••• JB ith..• Rice Noodle Singapore Style..... 5.00 9.00 HONG SUE SCALLOPS......12.90 CHOW HAR KEW&.............14.70 Fried Boneless Chicken(Half) .wn.8.80selected Chinese greens m an exotic sauce, served rn a s¢zling hot platter. •• r° Rice Noodle House Style .......... 5.00 9.00 TREASURE ISLAND..... ........ .............................................. 15.50 Scallops, deep fried in batter to golden SCALLOPS Mushroom Fried Chicken(Half) Grmy...8.80 Chow Foon .............................. 5.00 9.00 "or """ brown, sauteed with choice Chinese Slices of beef,jumbo shrimps, roast pork strips and golden chicken fingers superbly Fresh scallops and jumbo shrimps, Pineapple Fried Chicken(Half) ................8.80 Chow Foon House Style ........... 5.00 9.60 greens �n an exotic brown sauce. i sauteed with island spices and selected vegetables and topped with crispy Wontons. sauteed with selected Chinese greens, Chicken&Pea Pods..............................10.60 Pad Thai................................... 5.00 9.60 CURRIES FROM BOMBAY HONG SUE HAR..................12.90 mushrooms and water chestnuts in a O MFIN Choice Indian curry cooked with selected vegetables in spicy curry sauce. Jumbo shrimps deep fried in batter, light sauce. Chicken ...........ms...............10.80 L Beef................12.00 Shrimps .....:........13.00 Chicken..........11.60 sauteed with choice Chinese greens in HAR DING Chicken&White Mushrooms::::::::::::::.10.80 (Soft Noodles Dishes) exotic brown sauce. Chicken&Asparagus 10.60 Mein 520 9.60 HAWAIIAN WEDDING................................... ...................................... 14.70 (Cashew or Almond) ... Veg.Lo CHOW SCALLOP KEW.......12.90 Sm. Re Tender slices of beef and chicken meat in batter sauteed with pineapple chunks and Diced cut shrimps expertly cooked with SEAFOOD g• Tild Special Lo Mein ................. 5.90 10.90 Fresh scallops, sauteed with selected ......4.10 7.80 Roast Pork Lo Mein ..................530 .9.90 choice Chinese Vegetables nesting on a bed of soft noodles. diced Chinese vegetables and garnished Lobster Sauce(Meat Sauce) HAWAII STEAK 16.95 Chinese greens, mushrooms, and with choice of crispy(Almonds or S with Lobster Sauce .................................................................................... water chestnuts in a light sauce. Shrimp ........ 6.50 12.80 Beef......................................... 530 1030 "" cashew nuts). Tender sirloin steak cut in strips, sauteed with Chinese vegetables, CHOW HAR KEW.................12.90 Shrimp with Bean Sprouts......... 6.50 12.50 Chicken....................................530 1030 served on a hot, sizzling platter. Fresh jumbo shrimps sauteed with Shrimp with Green Peppers........ 6.50 1 1250 Shrimp .....................................5.90 11.00 HAWAII BEEF........................................................................................... 13.00 selected Chinese greens, mushrooms, All Items in Menu Subject 50/6 Mass Meal Tax Shrimp Mushroom Sauce.............. 1650 Soft Noodles .............................4.00 Tender slices of marinated beef, expertly cooked with pineapple chunks, white and water chestnuts in alight sauce. Not Responsible for Lost Articles. Lobster,Chinese Style ..........(Seasonal Price) Garlic Noodles ....................... mushrooms, pea pods and water chestnuts, enriched with oyster sauce. 7 ,C-)(IT It I I I , F -� ' 1 a Da Da D �v-7 D a Da D I I a D a I i i D L 00 r 4 �f: �. ' I& - r. LF Li �— - --- -- --- - - 1 CASHIERS S-AND & 4KE OUT � I I - I eg COG; (-' - ' LOU`�GE til"iv RGO"% I� KITCr L-N - --- --- I i 3 I f ��/)�Mj! 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