The URL can be used to link to this page

GABLES GARDEN CAFE - ESTABLISHMENTS GABLES GARDEN CAFIE 54 TURNER STREET B I q 3 It l II Commonwealth of Massachusetts City of Salem s e Board of Health ' 4 120 Washington Street,4th Floor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/04/2006 WHO'S PLACE OF BUSINESS IS: House of Seven Gables -The Garden Cafe File Number:BHF-2004-0292 115 Derby Street Salem MA 01970 LOCATED AT: 0054 TURNER STREET SALEM,MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes FOOD SERVICE BHP-2006-0302 Jan 4,2006 Dec 31,2006 $25.00 ESTABLISHMENT Total Fees: $25.00 PERMIT EXPIRES December 31, 2006 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements, or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Page 6 of 20 e CITY OF SALEM, MASSACHUSETTS �,. BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. USOVICZ, JR. FAX 978-745-0343 MAYOR W W W.SALEM.COM JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT 2006 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENTTV% NbUS£of TttE S6VFV3E4PF FdSTEL# 478-744-o991 cnip'mev' 6- ADDRESS OF ESTABLISHMENT 115 D16"e/ ST, :5,4&eAf, 14A-- e/970 MAILING ADDRESS (if different) OWNER'S NAME TEL# ADDRESS CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) E-R/NE 00670 CERTIFICATE#(s) 2,!90( 9 (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON S7AN 1?zOP-C41171 ✓(D HOME TEL# 978-8ZI-5777 HOURS OF OPERATION: Mon.—Tue.—Wed.—Thu.—Fri.—Sat.—Sun.— TYPE on. Tue. Wed. Thu. Fri. Sat. Sun.TYPE OF ESTABLISHMENT FEE (check only) RETAIL STORE YES less than 1000sq.ft. =$ 50 1000-10,000sq.ft. =$100 more than 10,000sq.ft. =$250 - - ..................................... --- ---- -- --- --- ..... -- RESTAURANT YES less than 25 seats =$1 00 nn I „I/l 25-99 seats =$150- pl p V more than 99 seats -$200 - r�n................................................................................... ..$1 00 00--....-----.... BED/BREAKFAST YES �vyy - - .................... ------..............................----------..............----------................------------........................... ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES $5 TOBACCO VENDOR = 9 $50 ALL NON-PROFIT(such as church kitchens) =YES NO $25.z *Please pay total with one check payable to the City of Salem . This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my best knovAgdge an/ddpelliie�f, have filed all state tax returns and paid all state taxes required under the law. 12 11&105 042- I cA-32.u4 Signature Date Social Security or Federal Identification Number --------------------- --------------------------------------------------l�--------1,44 -/ `------------------------------------------ Revised 11/03105 FOODAP2.adm Check#&Date a77 ;',�/�/T- 0054 TURNER STREET The Garden Cafe City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone: ,. Item Status Violation Critical Urgency Nature of problem or correction 744-0991 X108 "` - Non-compliance with: Not Done Owner; : Anti-Choking PASS ❑ The House of the Seven Ga Tobacco PASS ❑ PIC' Jessica Destafano +: I FOOD PROTECTION MANAGEMENT Not Done 61r1SpeCtOr; = PIC Assigned/Knowledgeable/Duties PASS d❑ RED =David Greenbaum- I - EMPLOYEE HEALTH Not Done Date Inspected: Correct By "- Reporting of Diseases by Food Employee and PIC PASS ❑d RED 5/1912005 w Personnel with Infections Restricted/Excluded PASS ❑J RED Risk Level:' -" FOOD FROM APPROVED SOURCE Not Done Permit Number. Food and Water from Approved Source PASS ❑J RED BHP-2005-0341 `_ * Receiving/Condition PASS ❑d RED Status: "" a Tags/Records/Accuracy of Ingredient Statements PASS Q RED SIGNED OFFx " #of Critical Violations:- Conformance with Approved Procedures/HACCP PASS RED „. Plans 1 Time IN: Time OUT: Notes: 171: Urgency Description(s): SLUE: Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 19,2005 ) Page I of 0054 TURNER STREET The Garden Cafe must be Corrected immediately , PROTECTION FROM CONTAMINATION Not Done or within 90 days) Separation/Segregation/Protection PASSd❑ RED RED: : Violations Related to M Food Contact Surfaces Cleaning and Sanitizing PASS ❑ RED Foodborne Illness Interventions'. Proper Adequate Handwashing PASS ❑d RED and Risk Factors (Require immediate corrective action)_ Good Hygienic Practices PASS 0 RED Prevention of Contamination from Hands PASS 0 RED Handwash Facilities FAIL Critical RED Kitchen handwash sink obstructed. Handwash sink must be clear and accessible at all times. The hot water in the restrooms is only warm. Restore hot water to maintain a temperature of 110°-130°F. PROTECTION FROM CHEMICALS Not Done Approved Food or Color Additives PASS ❑J RED Toxic Chemicals PASS ❑d RED TIMEITEMPERATURE CONTROLS(Potentially Haz Not Done Cooking Temperatures PASS ❑Q RED Reheating PASSd❑ RED Cooling PASS RED Hot and Cold Holding PASS ❑/ RED Time As a Public Health Control PASS ❑J RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Not Done Food and Food Preparation for HSP PASS RED CONSUMER ADVISORY Not Done Posting of Consumer Advisories PASS RED GeoTMSO 2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 19,2005 ) Page 2 of 0054 TURNER STREET The Garden Cafe Violations Related to Good Retail Practices (Blue Not Done Management and Personnel PASS ❑ BLUE Food and Food Protection PASS ❑ BLUE Equipment and Utensils FAIL Non-Critical ❑ BLUE The toaster oven needs a thorough cleaning. Water, Plumbing and Waste PASS ❑ BLUE Physical Facility PASS ❑ BLUE Poisonous or Toxic Materials PASS ❑ BLUE Special Requirements PASS ❑ BLUE Other-See Notes PASS ❑ BLUE GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 19,2005 ) Page 3 olf3 a,-r-- ' CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH SI 120 WASHINGTON STREET, 4TH FLOOR - e SALEM, MA 01970 .� TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Type of Establishment: FOOD SERVICE Name of Establishment: The Garden Cafe Address of Establishment: 54 Turner Street Owner's Name: The House of the Seven Gables Restrictions: Application Date: 12/13/2004 Permit for Food Establishment 230-05 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2005 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment, In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. HEALTH AGENT r CITY OF SALEM, MASSACHUS .� BOARD OF HEALTH o w o $� 120 WASHINGTON STREET, 4TH FLOOR r� p SALEM, MA 01970 CE,,rr 10 2064 .,8 TEL. 978-741-1800 Q' FAX 978-745-0343 CITY OF SALEM STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO BOARD OF HEALTH MAYOR HEALTH AGENT 2005 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT Tf TG +{0l-'EF 6F "T-H6 -seUEN 4-r?AgLIP'S NAME OF ESTABLISHMENT 6AMPt3 CAk-7e TEL# -17Q,-7yy-o:P1P13 ADDRESS OF ESTABLISHMENT 5// 'Turner s-1 LEH , 14tq 0/"370 _ MAILING ADDRESS (if different) OWNER'S NAME TEL# ADDRESS CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) CERTIFICATE#(s) -�725<m q (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON HOME TEL# HOURS OF OPERATION: Mon. V Tue.—ZiWed. ✓Thu. ,✓ Fri. ,/Sat. '/�Sun._i� TYPE OF ESTABLISHMENT FEE check only RETAIL STORE YES NO less than 1000sq.ft. =$ 50 1000-10,000sq.ft. =$100 Z more than 10,000sq.ft. =$250 RESTAURANT YES NO d�O less than 25 seats =$100 25-99 seats =$150 more than 99 seats =$200 BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES NO $5 TOBACCO VENDOR YES NO $50 ALL NON-PROFIT(such as church kitchens) YE NO $25 Please pay total with one check payable to the City of Salem This Permit is not transferable and must be reissued upon change of ownership. The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my be t owledge and belief, have filed all state tax returns and paid all state taxes required under the law. Signature Date Social Security or Federal Identification Number --------------------------------------------------------------------��-/----------------------------------------------------------------- Revised 11/03/03 FOODAP2.adm Check#&Date AV Y� �2� ay _. 1 I� 0054 TURNER STREET House of Seven Gables -The Garden Cafe City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: FOOD PROTECTION MANAGEMENT 744-0991 x108 PIC Assigned/Knowledgeable/Duties PASS ❑d RED OWner = Non-compliance with: The House of the Seven Ga Anti-Choking PASS PIC: Catherine Costa Tobacco PASS Inspector: John Gehan r EMPLOYEE HEALTH Date Correct By:. Reporting of Diseases by Food Employee and PIC PASS ❑� RED B$ 066 Personnel with Infections Restricted/Excluded PASS RED Risk Level:, a FOOD FROM APPROVED SOURCE Permit Number: r Food and Water from Approved Source PASS ❑v RED BHP-2006-0302 - Receiving/Condition PASS RED Status: Open _ " Tags/Records/Accuracy of Ingredient Statements PASS ❑Q RED #of Critical Violations: Conformance with Approved Procedures/HACCP Plans PASS ❑d RED 1 Time IN: Time OUT: Urgency Description(s): BLUE: Violations Related to Good Retail Practices (Critical violations must be corrected immediately or within 10 days)(Non-critical violations must be corrected immediately or within 90 days) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeOTMS®2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. May 30,2006 ) Page I of Item Status Violation Critical Urgency RED: PROTECTION FROM CONTAMINATION - Violations Related to Separation/Segregation/Protection PASS ❑J RED Foodborne Illness Interventions and RISK Factors (Require - Food Contact Surfaces Cleaning and Sanitizing PASS ❑J RED immediate corrective action) Proper Adequate Handwashing PASS ❑J RED ' Good Hygienic Practices PASS ❑J RED Prevention of Contamination from Hands PASS ❑J RED Handwash Facilities FAIL ❑J RED Comments: handwash sink in back requires general cleaning. PROTECTION FROM CHEMICALS Approved Food or Color Additives PASS RED Toxic Chemicals PASS RED TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) Cooking Temperatures PASS RED Reheating PASS ❑J RED Cooling PASS ❑J RED Hot and Cold Holding PASS RED Time As a Public Health Control PASS ❑J RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food and Food Preparation for HSP PASS ❑J RED CONSUMER ADVISORY Posting of Consumer Advisories PASS ❑J RED City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeOTMS®2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. May 30,2006 ) Page 2 of 1` Item Status Violation Critical Urgency Violations Related to Good Retail Practices (Blue Items) Food and Food Protection PASS BLUE Equipment and Utensils FAIL BLUE Comments: Ice machine requires general cleaning. Small white freezer requires general cleaning. Water, Plumbing and Waste PASS BLUE Physical Facility PASS BLUE Management and Personnel PASS BLUE Poisonous or Toxic Materials PASS BLUE Special Requirements PASS BLUE Other-See Notes PASS BLUE GENERAL COMMENTS: 632: City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. May 30,2006 ) Page 3 oj3 ' qq, CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH' 120 WASHINGTON STREET, 4TH FLOOR r1f� SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT; MPH, RS, CHO MAYOR HEALTH AGENT COMMONWEALTH OF MASSACHUSETTS PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter III, Section 5 of the General Laws, to operate a Food Establishment in the City of Salem is hereby granted to: Type of Establishment: FOOD SERVICE Name of Establishment: The Garden Cafe Address of Establishment: 54 Turner Street Owner's Name: The House of the Seven Gables Restrictions: Application Date: 12/2/2003 Permit for Food Establishment 73-04 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 31, 2004 This permit is not transferable and must be reissued upon change of ownership or location. The permit must be posted in a prominent location in the Establishment, In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. AGE' NT _ R CITY OF SALEM, MASSACHUSETT��.{1�'n1'1\fn ig 2 U "' �n -0@ � BOARD OF HEALTH �J! ' 3.,• 120 \VASH!NGTON STREET, 4TH FLOOR, NOV n O 2003 SALEM, MA 01970 Y L ,pqG TEL. 978-741-1800 Ll� nL. {SALEM FAX 978-745-0343 +�4?ryt_C HEALTH STANLEY USOVICZ, JR. BOARD 1JI I H JOANNE SCOTT, MPH, R5, CHO MAYOR HEALTH AGENT 2004 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT IR6 A0046 of •1116 SEvtu GAWSTEL# qli'-7 fy'044! K tog ADDRESS OF ESTABLISHMENT st E t.vr VX-V-- St I 1 g s+- MAILING ADDRESS (if different) --MAILINGADDRESS (ifdifferent) 1��K�v St• + �ew.� Nk4 bt4io OWNER'SNAME ne- +f-0010- i1CVr—k Ca, 1 1aIc TEL# 9 (OS ADDRESS 1^-'r St ' CITY_ _ _ 5STATE PAA ZIP 014*0 CERTIFIED FOOD MANAGER'S NAME(S)GEoRG-1t4& FERMe4CERTIFICATE#(s)?191162 (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON Sk-%MtaY '5%3r C4(aldk HOME TEL#91$ i4y•3S Let\ `tom?it.5a7R HOURS OF OPERATION: Mon. Y- Tue. X Wed. x Thu. x Fri. n Sat. x Sun. x SN k� etser SJ -QLV(G►U) TYPE OF ESTABLISHMENT 11`'1 P*.I.y Sm»'5rn. FEE check only // RETAIL STORE YES NO less than 1000sq.ft. =$ 50 1000-10,000sq.ft. =$100 more than 10,000sq.ft. =$250 RESTAURANT ES NO less than 25 seats =$100 25-99 seats =$1500 more than 99 seats =$200 BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS MAKE (notjust serve) ICE CREAM, YOGURT, SOFT SERVE YES (11—D $5 TOBACCO VENDOR 'y// YES ®O $50 ALL NON-PROFIT(such as church kitchens) ,-) 3�n/ (:!ES:� NO $25 Please pay total with one check payable to the City of Salem This Permit is not transferable and must be reissued upon change of ownership.The Permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code, before any renovations, improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my best know) a and belief a filed all state tax returns and paid all state taxes required under the law. Signature Date / Social Security or Federal Identification Number ------- Il f -°5-------------------------� 2.=�Q ------------ ---- --- --- -------------- --- Revised 1 /03/03 FOODAP2. Check#&Date �%/ 0--3 Massachusetts Department of Public Health Salem Board of Health 120 Washington Street,4'" Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978) 745-0343 Name n Date T e of O eration s Tvpc of Inspection 7N� P ( 'a re- 3-//-D Food Service Q Routine Address Risk ❑ Retail ElRe-inspectiond R Level El Residential Kitchen Previous Inspection Telephone yqq_ I q 9l o ❑ Mobile Date: 9-9--0 8 ElTemporary ElPre-operationOwner HACCP YM El❑ Caterer ❑Suspect Illness Person in Charge(PIC) ( Time ❑ Bed&Breakfast ❑ General Complaint a T✓ c !i • In: [I HACCP Inspector (/N4 Out: Permit No. ❑ Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s)violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. t FOOD PROTECTION MANAGEMENT.,,;"�,""" ,a rr"" ❑ 12. Prevention of Contamination from Hands El 1. PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities k EMPLOYEE HEALTH - - - -_ --- -� .�•�-_-- . - ..� ,�.a..�.� P„ a PROTECTION FROM CHEMICALS �`�` 7 ' El 2. Reporting of Diseases by Food Employee and PIC. El3. Personnel with Infections Restricted/Excluded F-1 14. Approved Food or Color Additives El 15.Toxic Chemicals ❑ 4. Food and Water from Approved FOOD FROM APPROVED SOURCE '" „�;', "" ".r`""1 .vedS1 » ,,..m..0�.,, » - _ ved Source, TIMEREMPERATURE CONTROLS(Potentially Ha--[-rdzous Foods) , ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling I PROTECTION FROM CONTAMINATION' "" �� "'"" c ❑ 19. Hot and Cold Holding ❑8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing j.REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP),, ❑ 10. Proper Adequate Handwashing ❑21. Food and Food Preparation for HSP ❑ 11. Good Hygienic Practices CONSUMER ADVISORY;' ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board of Health. today, the items checked indicate violations of 105 CMR C N 590.000/federal Food Code. This report, when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. E ui merit and Utensils cited in this report may result in suspension or revocation of q p (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.006) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: 5:59JInspec(Fom514.0oc Inspector's Signature: /L _ �6111 .tA� Print: PIC's Signature: / ( / 1� Print: aig II i S 1'I Page-/ of_wPages Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT S Cross contamination 1 590.0o3(A) Assignment of Res arrmbility* 3-302.11(A)(1) Rau Animal Foods Separated from 540.003(E) Demonstration of Knowled e"` Cooked and RTE Foods* 2-103.11. Person in charge-duties Contamination from Raw ingredients TI02.1I(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other" 2 590.003(0) Responsibility of the person in charge to Contamination from the Environment require reporting by foal employees and 3-302.1 1(A) Food Protection` a tlicfmts* 3-302.15 Washing Fruits and Velgetableq 590.003(F) Responsibility Of A Forxi Employee Or An -3=304.11 Food Contact with Equipment and Applicant To Report To The Person In Utensils* Contamination from the Consumer 19Q003 G) Re ortina b Person in Charge* 3-306.14(A)(13) Returned Food and Reservice of Food* 3 590.003(D) Exclusionsand Resniclions* Disposition of Adulterated or Contaminated 590.003(E) Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCEFood' 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.1.11 Manual W�washing-Hot Water 3-201.12 Faxi in a Hermetically Sealed Container* MecSaidhanical Tem eashin s" 3-201.13 Fluid Milk and Milk Products* d-501.112 Mocha+ucalWarewashine Hot Water 3-202.13 Shell E��s* Sanitization Tem eratnres* 3-202.14 Eo..s and Milk Products.Pasteurized* 4-501.114 Chemical Sanitisation-temp.,pH, concentration and hardness. 3-202.16 Ice Made From Potable Drinkinn Water` 4-601.1 l(A) Equipment Food Contact Surfaces and 5-1.0111 Drinkito Water from an A roved S stem" Utensils Clean" 590.006(A) Bo led Drinkin Water* 4-602.11 Cleaning Frequency of EquipmentFood- 590.o06(B) Water Meets Standards in 310 CMR 22.04' Contact Surfaces and Utensils'ti Shetllish and Fish From an Approved Source F4 )3 1 1 Frequency of Sanitization of Utensils.tad 3-201.14 Fish and Recreationally Caught Molluscan Fund Contact Surfaces of Equipment* Shellfish* .'11 Methods of Sanitization-HotWaterand 3-201.15 Molluscan Shellfish from NSSP Listed ChemlcaP, Sources* 1 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by 2-301.11 Clean Condition-Hands and Arens* Re utafo Author' 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedoue* 590.004(0) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* 11 Good Hygienic Practices ReceivingfCondition 2-401.11 Eating,Drinnn kior Usin,g Tobacco* 3-202.11. P13 Fs Received at Pro ser Tem eratures* '--401.12 Discharges From the Eyes,Nose and 3-202.15 Package Lute it * Mouth* 3-101.11. Food Safe and Unadulterated* 3-301.12 Pre�amination When Tustin " h Tags/Records:Shellstock 72 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Em lovers* TagslRecords:Fish Products 13 Handwash Facilities Conveniently Located and Accessible 3-402.1 l Parasite Destruction* 3-402.12 Records.Creation and Retention* 5-203.1 i - Numbers and Ca *cities* 590.0040) Labeling of Ingredients' 5-20411 Location and Placement* 7 Conformance with Approved Procedures 5-205.11 Accessibility.Operation and Maintenance lHACCP Plans Supplied with Soap and Hand Drying 3-502.11 S ecialized Processing Metltals* Devices 3-50212 Reduced ox �eu tack*(ina.criteria* 6-301.11 Handwashin Cleanser,Availability 8-103.1.2 Conformance with Approved Procedures" 6-303.12 Hand Drvin,Provision - 5 *Denotes critical(tem in t6�Etidvr,J 1999 F`a)l Code a�LOS CMR.,30.(300. 1 � CITY OF SALEM ' nn BOARD OF HEALTH Establishment Name: Yw 4' /'G! e Date: 3-i/- O t�l Page: of ;I— Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date f, No. Reference R—Red Item Verified �r -...PLEASE PRINT CLEARLY 4>' ' 0f. i101,' die ��G/o+uitiP F v rr /ivr, /ri v av r 0,&P1,60,1 0 71 rrGG r7/h f ;t ¢ �i;cJr7c YFJY.1 C v Sp.4 K t?u J, f �f c -G bh r/ uP Li /7SSuv 7/ Lr 7/SP� i x .A 12V �'bn/ar f ir7i/iN Cd,;(-VS ICe e 4PZ76114N9 Of 1y87A? Of Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all L3 voluntary Compliance Ll Employee Restriction r violations before the next inspection, to observe all conditions as described, and to Exclusion V� p L] Re-inspection Scheduled El Emergency Suspension T comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. //yy � // n ( _'lam/ El Voluntary Disposal ❑ Other: ciAr. - q4 4 ' 3-501.14(0) PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk Accordin- to Law e'oatcd to.,. Factors(items 1-22) (Cont.) 41'F/45'F Within 4 Hours. * �` PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs l4 -- r Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 �Addttives's r3-501.16(8) Cold PIIRMaintainedatorbelow 590.004(F) 41"145'F 3-30214 Protection from LJnappioved Aclditives" 3-501.16(A) Hot Pf1f?s Maintained at or abut-e IS Poisonous or Toxic Substances 140°P. 7-101.11 Identifying lnfbrnnation-Original 3-501.16(A) Roasts Held atarabove l3(I'F. * Containers* 20 Time as a Public Health Contra) 1-102.11 ComrnonN'atne-Working,Containers* 3-501.14 Time as a Public Health Control* 7-:01.1.1 Separation-Stortae"' 7-202.11 Restriction-Presence and Use" 590.004(H> Variance,Rec❑irement 7-202.12 Conditions of Use, 7-203.11 Toxic Containers-Prohibitions" REOUIREMENTSFORHIGHLYSUSCEPTIBLE POPULATIONS 7-204.11 Samtizers.Criteria Chemtca ..lSHSP 7-204_'(2 Chemicals for Washin Produce, Criteria*` 21 3-801.11(A) Unpasteurized Pre packaged.Juices and Beverages with Warning Labels* 7-204.14 Daring Agents.Ctltetta" ;-801.11(B) Use of Pasteurized E.*s* 7-205.11 Incidental Food Contact,Lubricants* 3-801.)l(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria'" Raw Seed S xoats Not Served. '= 7-206-12 Rodent Bait Stations* 3-801.11((,) Uno.enedFoodPackageNotRe-served - " 7-206.13 Tracking Powders, Pest Control and bvtonitorine- CONSUMER ADVISORY TIMEfTEMPERATURE CONTROLS 22 3-G03.1 t Pall) Advisory Posted for Consumption of' 16 Proper Cooing Temperatures for Animal Fouls That are Raw. Undercooked F6 Proper Cooking Temperatures for or PHFs Not Otherwise Processed to Eliminate no ears 3 rr e,ar-tem 3-401.UA(1}(2) Eggs 155°F15Scc. Ems-s-Immedi ate Service 1 l5'N-Ssec* -11, Past'euw seed Eggs Substitute for Raw Shell 3401.11(A)(2) Comminuted Fish.Meats &Game Etr gs* Animals- 155'F 15 sea* SPECIAL REQUIREMENTS 3-401..11.(13)(1)(2) Perkand Beef Roast- 130-F121min- 3-401-11(A)(2) Ratites, Injected Meats-155°F i S 590.009(A)-(U) Violations of Section 590.009(A)-' in Sea *- catering, mobile food, temporary and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFi,, residential kitchen operations should be Stuffing Containing Fish,Meat. debited under the appropriate sections Poultry or Ratites-165°F 15 sec. ` above if related to'foodborne illness 3401.11(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Othcr 145'F* 590.009 violations relating to'good retail 3-40L.12 Raw Anunal Foods Cooked in a practices should he debited under#29- Microwave 165'F* Special Requirements. 3-401.11(A)(1)(b) At Other PHFs - 145'F 15 sea " 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(A)&(D) PHFs 165'F 15 sec. * (Items 23-30) 3-403.11(B) Microwave-165'F 2 Minute Standing Critical and non-critical violations, achich do riot relate to tyre Time* foodborne illness interventions and risk facto=s listed above, can be 3-40311(C) Commercially Povessed RTE Fond- fount in the folloe inn; sections of the Food Code and 105 C AIR 140°1"* 590.000. 3-403.11(E) Remaining Unsliced Portions of Beef Item 1 Good Retail Practices ° FC 590.000 Roasts" 123. Management and Personnel FC-2 .003 --- - IS Proper Cooling of PHFs 24 Food and Food Protection _ FC_3 .004 g 25-i E ui ment and Utensils iFC 4 .005 3-501.14(A) Cooling Cooked YRFs from 140"F to �26 ! W� Plumbing and W aste FC-5 006 70'F Within 2 Hours and From 70'F 27, Physical Facility FC-6 .007 to 41'F/45°F Within 4 Hours. * 28. Poisonous or Toxic Materials I FC-7 .008 on 8l Cooling PHFs Made Hum Ambient 29 Special Requirements 009 Temperature Ingredients to 41-F/,15'F ! 30. 1 Other _ _ - --. Within 4 Hours* *Pennies critical item in the federal 1949 Ftwd Code of 105 CD11t 590.000. Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street, 0 Floor Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name Date T "f O eration s T e of-inspection Inf A GW 4 ff of CAO-'d 6 /e st/ kr Food Service outine AddressRisk LJRetail ❑ Re-inspection , Y rUl �lt SF' Level ❑ Residential Kitchen Previous Inspection Telephone 711Yf0199/ M El Mobile Date: OwnerPN[E IVOUI` OF SN�LrJ HACCP Y/N ❑❑ Catereary ElPre-operation El Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast El General Complaint In: ❑ HACCP Inspector QA-Af IQ G takwRA Out: Permit No. ❑Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Non-compliance with: Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. FOOD PROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties 13. Handwash Facilities EMPLOYEE HEALTH - ❑ 2. Reporting of Diseases by Food Employee and PIC PROTECTION FROM CHEMICALS El3. Personnel with Infections Restricted/Excluded E] 14. Approved Food or Color Additives FOOD FROM APPROVED SOURCE - ❑ 15.Toxic Chemicals ❑ 4. Food and Water from Approved Source - TIMENEMPERATURE CONTROLS(Potentially Hazardod§Foods) ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) [:110. Proper Adequate Handwashing El21. Food and Food Preparation for HSP ❑ 11. Good Hygienic Practices CONSUMER ADVISORY, ' "" [:122. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22): of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR ofC, Nth. 590.000/federal Food Code. This report, when signed below 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590.004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils cited in this report may result in suspension or revocation of (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-6)(590.007) have a right to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FC-7)(590.008) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: S ia.nm Inspector's Signature: ' -Print: PIC's Signature: cPrint: a, /� -� iOS /� Page of ages Violations Related to Foodborne Illness Interventions and Risk Factors(items 9-22) PROTECTION FROM CONTAMINATION. FOOD PROTECTION MANAGEMENT >d Cross-contamination 1 -590.003(A) Assignment of Responsibility"` 3-3O2.11(A}(1) Ra% . runa oods Separa ed from 590.003(B) Demonstration of Knowledge" Cooked and RIE Foods* 2-1031,11 Person in charge--duties Contamination from Raw Ingredients 3-30111(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Othar" 2 590.003(C) Responsibility of the person in charge to Contamination from the Environment require reporting by food employers and 3-302.11(A) Foul protection* apfmcanls* 3-302.15 Washing InAuts and Ve«etables 590.003(F) Responsibility Of AFood Employee Or An 3-304.11 Food Contact with Equipment and Applicant To Repoli To The Person In Utensils* Char e* Contamination from the Consumer 590.003(G} Re o ting by Person in Charge* 3-306.14(A)(B) Returned Food and Resen-ice of Food' 3 590.003(D) Exclusions and Restrictions* - Disposition of Adulterated or Contaminated 590.003(E) Removal of Exclusions and Restrictions Food 3701.11 Discarding or Reconditioninglinsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A B) Compliance with Food Law* 4501-111. Manual Warewashing-Hot Water 3-201.12 Food in a Hennetical,ly Sealed Container" Sanitize on 9'em eramres* 3-201.13 Fluid Milk and Milk Products* 4-501.1.12 Mechanical Warewashing-Hot Water 3-202.13 Shelf E s* Sanitization Temperatures* 3-202.14 E is and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.;pH, concentration and hardness. * 3-202.16 Ice Made From Potable DrinkingIN 4-001.11(A) Equipment Food Contact Surfaces and 5-101.11 Drinking Water from an Approved Svstern" Utensils Clean* 590.006(A) Bottled Drinking Water* 4602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* Shellfish and Fish Froman Approved Source 4-?02A I Frequency of Sanitization of(Utensils and :-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces afE+quiltment* Shellfish* 4_903.11 Methods of Sanitization-Hot Water and 3 201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by Regulatory Authorit 2-301.11 Clean ConditionHandsand Anus" 3-202.18 Shellstock Identification Present* 2-301.12 Cieaninv Procedure* 590 (cl(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* it Good Hygienic Practices g Receiving(Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PRFs Received at Proper Temperatures 2-401.12 Discharges From the Eyes,;Bose and 3-202.15 Package Into it•* Mouth*` 3-,101.1 I Fiwd Safe and Unadulterated * 3-301.12 Preventing Contamination When Tasting" g TagslRecords:Shellstock 12 Prevention of Contamination from Hands 3-202.1.8 Shellstock Identification' 590.004(E) Preventing Contamination from 3-203.12 Shellsrock Identification Maintained* 3-002.1Parasite Destruction* Conveniently ]Duces* TagslRecords:Fish Products 13 Handwash Facilities Conveniently Located and Accessible 1 3-402.12 Records.Creation and Retention* 5-203.11 Numbers s and la gums* 590.0(4(]) Labeling of ingredients` 5-204.11. Location and Placement* 9 Conformance with Approved Procedures 5-205.11 Accessib lite, O eration and Maintenance IHACCP Plans Supplied with Soap and Hand Drying 3-502.11 S eciali7ed Processing Methods,` Devices 3-502.12 ,Reduced oxygen packagin ,criteria* 6-301.1.1 Hartdwashing Cleanser.Availabilit 8-103.12 Confovnance with Approved Procedures* 6-301.12 Fland Drying Protnsian °Denote€critical item in the federal Nro)Food Code or 105 CNil2 590-0po. CITY OF SALEM BOARD OF HEALTH / Establishment Name: ITAfif G)tf1D,6r4 CAFAC Date: /��/B/o�/ Page: of 2 Item Code C—Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item - Verified ._.. .,,.PLEASE PRINT CLEARLY / 3 I a,tsrtrrN/� ,rri r,6- P,4Prrre— cawtf4 s-. AS&L✓a 4esa I d o rt2tSiL Ctf�at t/r 4 , I I i i Wit"i C 00rKa�t r rMn P Za NU /ro I �o fv '14Jl� Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ Exclusion violations before the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. /� — i��_ 0 Voluntary Disposal ❑ Other: 3-SOL1�1(C} PHFs Received a`c IImpervtures Violations Related to Foodborne fitness Interventions and Risk According to Iaw Cooled to • Factors(items 1-22) (Cont.) 41"F74S°F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Conlin*Me hods for PHFs 14 PHF Hot and Cold Holding LX-14 Food ar Color Additives 15 Cold PHFs Maintained at or belou- 3-202.12 Additives* 590.004(F) 41 V45°F* 3-302.14 Protection from Unapproved Additives" 3-501.16(.0) 7itrt PHFs Maintained at or above 15 Poisonous or Toxic Substances 140°F.* 7-11)Y.11 Identifyinglnti,>rmatit�m-t)riginal Containers* 3-501.16(A) Roasts Held at or above 130°F. 20 7-10211 Common Nante-Workinn Containers* Time as a Public Health Control 7-201.11 Se aration-Sim�age" 3-501.19 Time as a Public Health Control* 7-20,2.11 Restriction-Presence and Use)" 590.004(H) Variance Re uiretneut 7-202.12 Conditions of Use* 7.203.11 Toxic Containers-Prohibitiunst` REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sterilizers,Criteria-Chemicals* POPULATIONS(HSP) _ 7-204.12 Chemicals for Washine Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and _ Beverages watt Warning 1.ibel, 7-204.14 Drying Agents.Criteria* - 7-205.11 Incidental Food Contact-Lubricants* 3-801.11(B) Use of Pasteurized Ewes* 7-206.1 2 Restricted Use Pesticides-Criteria'" 3-801.11(1)) Raw or Partially Cooked Animal Food and Raw Seed Sprouts Not Served. ' 7-206.12 Rodent Bait'SEtttions* 3-801.11(C) Unopened Food Package Not Re-served. 7-206.13 Tracking Powders,Pest Control and Matitorin CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods`chat are Raw,Undercooked or PHFs Not Otherwise Processed to Eliminate ' 3-40'LL1A(ll(2) Eggs- 15i`F ].SSec. Patho�uns* Eggs-hmnedi ate Service 145°Fl5sec* 3-302.13 Pasteurized Eggs Substitute for flaw Shell 3401.11(.0)(2) Comminuted Fish,Meats&Game Eggs* Animals-155°F 15 sec. * 3-401.11(B)(1)(2) Pork and Beef Roast- 13WF 121 mina` SPECIAL REQUIREMENTS 3-401.11(A)(2) Ratites, injected Meat's-155°F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in Sec * catering, mobile food,temporary and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-165"F 15 sec. * above if related to foodborne illness 3-401.11(C)(3) Whole-muscle,Intact'Beef Steaks Interventions and tisk factors. Other 1450F,'; 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165°F* Special Requirements. - 3401.11(A)(1)(b) All Other PHFs-145°F 15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICEs 3-403.11(A)&(I)) PHFs 165°F 15 sec. * (Items 23-30) 3-403.11(B) Microwave- 165°F 2 Minute-Standing Critical and non-critical violations, which do trot relate to the Time* foodborne ilhress interventions and i isk Jacraors listed above, can be 3-403.11(C) Commercially Processed RTE Food- fomrd in the fellonrntg sections o.1 the Food Code and 105 CMR 140°Ft 590.000, ta - 3-403.11(P.) Remaining Unsliced Portions of Beef Item Good Retati Practioes FC- 590.001) a ana ement and Personnel Roasts* ____---- FC-2 .003 ___--- 18 Proper Cooling of PHFs 24. Food and Food Protection FC-3 .004 _ _ . 3-501.14(.0) Cooling Cooked PHFs front 140°F fa 25 Equipment and Utensils FC 00526. _ W ater,Plumbing and Waste FC 5 006 70°F Within 2 Hours and From 70'F 27. Physical Facility_ FC-6 1 .007 to 417/45°F Within 4 Hours. * 28. Poisonous or Toric Materials FC-7 .008 - ---------- 3-501 A,I(B) Cooling PHFs MadeFrom Ambient 29. Special Re uiremems _ .009 Temperature Ingredients to 41°F/45°F 30 Other Within 4 Hours'' Denotes critical item in tha federal 1999 Food Code or 105 CNIR 590.000.