Amazing Pizza FEIR 1-31-2019 Food Establishment Inspection Form Page _of
The Commonwealth of Massachusetts #Violations Date 47
City of Salem Board of Health Priority- Priority foundation- Core- Time In
120 Washington Street,Salem MA 01970 r r
978 741-1800 Score(optional) Time Out �+
Establishment Name s , Risk Category T of Operation(s) Tvoe of Insce tion I
Establishment Address 11 JAI, P ®Food Service ❑��utine
[]RetailWReinspection
Telephone I�/►ccP Y/N ❑Residential Mtchen Prggv�i,ous Inspection(Date:
- []Mobile
Owner r } I Permit# LJIIw1polar)/ lJrrCvperauun
v
Person-In-Charg (Plc) Food Safety Training/ []
Caterer []Suspect Illness
'�.
[]Bed&Breakfast []General Complaint
Inspector [ Farmer's Market ❑HACCP
❑Other: ❑Other.
FOODBORAE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS
Circle designated compliance status(IN,OUT,WO,WA)for each numbered item Mark'r in appropriate box for COS and/or R
IN=in compliance OUT=not in compliance Nf0=not observed WA=not awlicable COS=corrected on-site during inspection R=repeat violation
Compliance Status I COs I R Com liance Status 2LR
Sup�silon 17 IN OUT Proper disposition of returned,previously
served,reconditioned&unsafe food
1 IN OUT PIC present,demonstrates knowledge,and Time!Temperature Control for Safety
performs duties
2 IN OUT N/A Certified Food Protection Manager 18 IN OUT WA WO Proper cooling time&temperatures
Employee Health 19 IN OUT N/A N/O Proper reheating procedures for hot holding
Management,food employee and conditional
3 IN OUT employee;knowledge,responsibilities and 20 IN OUT WA N/O Proper cooling time and temperature
rdn
4 IN OUT Proper use of restriction and exclusion 21 IN OUT WA N/O Proper hot holding temperature
5 IN OUT Procedures far responding to vomiting and diarrhea/events 22 IN OUT WA WO Proper cold holding temperature
Good Hygienic Practices 23 1 IN our WA WO Proper date marking and disposition
6 IN OUT WO Proper eating,tasting,drinking,or tobacco use 24 IN OUT WA WO Time as a Public Health Control
7 IN OUT WO L No discharge from eyes,nose,and mouth Consumer Advisory
Preventing Contanniriation by Hands 25 1 IN OUT WA andro�advisory provided for raw/
d
8 IN OUT WO Hands dean&properly washed Pectuirements for Hlohly Susceptible Populations HSP
9 IN OUT WA WO No bare hand contact with RTE food 26 1 IN OUT WA Pasteurized foods used;prohibited foods not
offered
10 IN OUT Adequate handwashing sinks properly supplied Food/Color Additives and Tonic Substances
and accessible
Approved Source 27 IN OUT WA Food additives:approved&properly used
11 IN OUT Food obtained from approved source 28 IN OUT WA Toidc sub.property identified,stored&used
12 IN OUT WA WO Food received at proper temperature Conformance with roved Procedures
13 IN OUTFood received in good condition,safe,& 29 IN OUT WA Compliance with variance/specialized process
unadulterated /HACCP Plan
14 IN OUT WA WO Required records available:shellstock tags,
arasite destruction Risk Factors are important practices or procedures identified as the most
Protection from Contamination prevalent contributing factors of foodborne illness or injury. Public health
15 IN OUT WA WO Food separated and protected interventions are control measures to prevent foodborne illness or injury.
16 IN OUT WA Food-contact surfaces;cleaned&sanitized
GOCID REI'AtL PMC710ES
Good Retail Practices are preventative measures to control the addition of pathogens,chemicals,and physical objects into foods.
Mark'X"in box if numbered item is riot in compliance Mark'r in appropriate box for COS and/or R COS=corrected on-site during inspection R=repeat violation
Compliance Status COS R Compliance Status cos R
Safe Food and Water Proper Use of tltenails
30 Pasteurized eggs used where required 43 In-use utensils property stored
31 Water&ice from approved source 44 Utensils,equipment&linens:properly stored,dried,&handled
32 Variance obtained for specialized processing methods 45 Single-use/singie-service articles:properly stored&used
Food Temperature ConbW 46 Gloves used property
33 Proper cooling methods used;adequate equipment for Utensils,Equipment and Vending
temperature control
34 Plant food property rooked for hot holding47 Food&non-food contact surfaces cleanable,properly designed,
constructed&used
35 Approved thawing methods used 48 Warawashing facilities:installed,maintained,&used;test strips
36 Thermometers provided&accurate 49 Non-food contact surfaces dean
Food ktentiiication Physical FaCilldes
37 Food property labeled;original container 50 Hot&cold water available;adequate pressure
Prevention of Food Contamination 51 Plumbing installed;proper backflow devices
38 Insects,rodents,&animals not present 52 Sewage&waste water properly disposed
39 Contamination prevented during food preparation,storage and 53 Toilet features:properly constructed,supplied,&cleaned
display
40 Personal cleanliness 54 Garbage&refuse properly disposed;facilities maintained
41 Wiping cloths:property used&stored 55 Physical facilities installed,maintained,&dean
42 Washing fruits&vegetables 56 i Adequate ventilation&fighting;designated areas used
57 SPECIAL REQIIIREMOM I OTHER I ❑Anti-choking(590.0091Ei) ❑Tobacco(590.00% ❑Allergen Awareness(590.009(G]] ❑Local law regulation []Other
Official Order for Correction:Based on an inspection today,the items checked indicate violations of the Board of Health Food Regulation/2013 Federal Food Code.This report,when signed below by
a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit
and cessation of fend establishment operations. lt grieved by this order,you have a right to a hearing. Your request must be in writing and submitted to the Bbard of Health at the above address within
ten f 10 calendar da .of 't of this order.
PIC'sSign ature: ' Print: ►� 1 Date:
Inspector's Signature _ Follow-u E NO (circle one Follow-up Date,if livable: f7/242J-157 I
I
Food Establishment Inspection Form Page_.�2 _of 2
TheCommonwealth of Massachusetts
City of Salem Board of Health Establishment Name: Date:
120 Washington Street,Salem MA 01970 r
t978)74.1-1800
TEMPERATURE TURE OBSERVATIONS
Item/Location "CernaF Item/Location Tem Item/Location Tem °l
OBSERVATIONS AND/OR CORRECTIVE ACTIONS
Violations cited in this report must be corrected within the time frames or as stated in Section 8-405.11 of the Food Code
Item Code Section P=Priority Item Description of Violation
Number PF=Priority Foundation Item
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SA
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11
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Discussion with PIC: C*rrecdw Action Required No es
❑Voluntary Compliance Employee Restriction/
Exclusion
❑Re-inspection Scheduled ❑Emergency Suspension
❑Embargo ❑Emergency Closure
❑Voluntary Disposal ❑Other
PIC's Signa re Date: '
Inspector's Signature Date:
Rev. 11/2016