Cinema Salem FEIR 1-31-2019 Food Establishment Inspection Form Page i of —
The Commonwealth of Massachusetts #Violations Date .1.__ ____
City of Salem Board of Health Priority- I, Priority foundation-7Core-• Time In
120 Washington Street,Salem MA 01970 `
(978)741-1800 Score(optional) Time Out 52. c ,
Establishment Name _ f Risk Category Type of Operation(s) T� a of Inspe6tian
s Cit1aMQ QfciodService VRoutine
Establishment Address/
} LAIL, st,,,,,-.c.... Retail ❑Reinspetion
Telephone ct>.k;>r l�7 4 q'0660 HACCP Y/N DResidential Kitchen Previous Inspection Date:
DMobile
Owner ! Permit*
�, et fVs r or r up��al y ❑Pre-Operation
Person-In-Charge(PIC)p[� I Food Safety Tnyning/Exp.Elate ['Caterer ['Suspect Illness
f.� �Dr'n� �N✓T 4vtu - ,. ❑Bed&Breakfast ❑General Complaint
Inspector D ❑Farmer's Market ❑HACCP
jçre yy Dc n;yy ['Other: ❑Other:
FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS
Circle designated compliance status(IN,OUT,WO,N/A)for each numbered item Mark 7C in appropriate box for COS and/or R
IN=in compliance OUT=not in compliance N/O=not observed N/A=not applicable COS=corrected on-site during inspection R=repeat violation
Compliance Status I cos R Corn li nce Status COS R
Supervision 17 IN OUT 1 Proper served,dreconditioned&unsafe food
previouslyisposition of returned,
1 /ir+youT PIC present demonstrates knowledge,and performs duties Thee I Temperature Control for Safety
vrr,i_
2 I IN/OU7 N/A Certified Food Protection Manager 18 IN OUT N/O Proper cooking time&temperatures
�iirr�JJ Employee Health 19 IN OUT /A N/O Proper reheating procedures for hot holding
,,��e�� Management,food employee and conditional
3 �IN]OUT I employee;knowledge,responsibilities and 20 l..UT N/A NiO Proper cooling time and temperature
"��' reporting
4 0•UT Proper use of restriction and exdusion 21 IN OUT&'N/O Proper hot holding temperature
5 Procedures for responding to vomiting and
�•lJT 22 IN UT WA WO Proper cold holding temperature
dtarheal events ,_
Good Hygienic Practices 23 I OUT N/A N/O Proper date marking and disposition
6 IN Ol1T Q
Prop eating,tasting,drinking,or tobacco use 24 IN OUT�s�N�lip.I NIO Time as a Public Health Control
7 IN No dischargeer from eyes,nose,and mouth I Consumer AOVFso
Preventing Contamination by Hands 25 l IN oU w. Consumer advisory provided for raw/
undercooked food
8 IN OUT cal Hands dean&properly washed Requirements
HI hly Susceptible Populations(HSP)
9 IN OUT N/A No bare hand contact with RTE food 26 IN OUT iA Pasteurized foods used;prohibited foods not
offered
10 &OUT Adequate sable string sinks property supplied
and accessible
Food I Color Additives and Toxic Substances
� Approved Source 27 IN OUT Food additives:approved&properly used
11 1.�OUT Food obtained from approved source 28 GOUT N/A Toxic sub.properly identified,stored&used
12 IN OUT NIA Food received at proper temperature Conformance with A.proved Procedures
13 IN OUT Food received in good condition,safe,& 29 IN 0 Compliance with variance/specialized process
unadulterated /HACCP Plan
14 IN OUT l/ WO Required records available:shellstodr tags,
L/ parasite destruction Risk Factors are important practices or procedures identified as the most
Protection from Contamination prevalent contributing factors of foodbome illness or injury. Public health
15 6,0T U N/A WO Food separated and protected interventions are control measures to prevent foodbome illness or injury.
16 IN 0 N/A Food-contact surfaces;cleaned&sanitized
GOOD RETAIL PRACTICES
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 not in compliance Mark IC in appropriate box for COS and/or R COS=corrected on-site during inspection R=repeat violation
Compliance Status I COS R Compliance Status I COS I R
Safe Food and Water Proper Use of Utensils
30 Pasteurized eggs used where required 43 In-use utensils properly 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/single-service articles:properly stored 8 used
Food Temperature Control 46 Gloves used properly
33 Proper cooling methods used;adequate equipment for Utensils,Equipment and Vending
_ temperature control
34 Plant food properly cooked for hot holding 47 Food&non-food contact surfaces cleanable,properly designed,
constructed&used
35 Approved thawing methods used 48 >I< Warewashing facilities:installed,maintained,&used;test strips
IL-
36 5, Thermometers provided&accurate 49 Non-food contact surfaces clean
Food Identification Physical Facilities
37 Food properly labeled;original container I 50 Hot&cold water available;adequate pressure
Prevention of Food Contamination 51 Plumbing installed;proper bacldlow devices
38 Insects,rodents,8 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:properly used&stored 55 Physical facilities installed,maintained,&dean
42 Washing fruits&vegetables 56 I Adequayt ventilation&lighting;designated areas us"(
57 SPECIAL REQUIREMENTS I OTHER I ❑Anti-choking(590.009(EJ) ['Tobacco(590.009[F]) BAllerven Awareness(590.009[G]) Woad 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 food establishment operations. If aggrieved by this order,you have a right to a hearing.Your request must be in writing and submitted to the Board of Health at the above address within
ten(10)calendar days of receipt of this order.
PIC's Signature: t, '-t-!-� ',-2i1/LC-- Print: F' f=( }-L;(i'l� I Date: J/ 3/ jc-]
Inspector's Signature:_/] .kr,,r Follow-up �13 NO (circle one) Follow-up Date,if applicable: )71.a
Food Establishment Inspection Form Paget of 3
The Commonwealth of Massachusetts
City of Salem Board of Health Establishment Name: .� `�'
120 Washington Street,Salem MA 01970 I . Date:.i 3 l�CIR
(978)741-1800 case" C/i2ei'►t[L.
TEMPERATURE OBSERVATIONS
Item I Location Temp CT) Item/Location Temp(SF) Item/Location Temp("F)
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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Discussion with PIC: Corrective Action Required [lido &4s
0Vntary Compliance 0 Employee Restriction/
Exclusion
Re-inspection Scheduled 0 Emergency Suspension
0 Embargo 0 Emergency Closure
0 Voluntary Disposal 0 Other
PIC's Signature: tit;k_eDate: 17
- /40
Inspector's Signature /f Date1/3 /�^ n
Rev.11/2016
/ �J�LEJ 7
Food Establishment Inspection Form Page 3 of 5
The Commonwealth of Massachusetts
City of Salem Board of Health Establishment Name:
Date:a/31/20/g
120 Washington Street,Salem MA 01970(978)741-1800 Llrfi,i CIA.'emc_
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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PIC's Signature: ��C/ - Date: 1 8//(7j
Inspector's Signature Date 51 1
Rev.11/2016