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IL BOCCA ITALIANA RESTAURANT INC - ESTABLISHMENTS IL BOCCA ITALIANA RESTAURANT INC. 140 WASHINGTON STREET u o u o f s �c .. _ _.. _... _..__, _.._.. _ _.. _ ...m .._ .. _ _ .__ __ .._ _. y 0140 Washington Street IL Bocca Italiana Rest. Inc. City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 978-744-7333 Physical Facility FAIL Non-Critical BLUE Owner Comment: There are many stained and damaged ceiling. Repair any leaks and replace all stained and damaged ceiling tiles. ':Patrice Desa0 PIC v Clean all ceiling vents. Patrice Desa The bottom of the wall near the plate area is chipping/peeling. Repaint wall and provide a molding at the bottom. Inspector David Greenbaum here is a hole in the wall near plate area. Repair the hole. Date Inspected: Correct By:' The back screen door has a gap at the side. Repair door to seal gap. 12/2/2005 The back stairs need to be repainted. Risk Level: GENERAL COMMENTS: Permit Number:, 391: BHP-2005-0236: •. Status: - SIGNED OFF' ' #of Critical Violations 0 :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®2005 Des Lauriers.Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Dec 05,2005 ) Page 1 oft Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) � D City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Dec 05,2005 ) Page 2 of arsxr,sHs +w:p.�'4.':ySM*X'T`sw5+ +pt..,...w. wY 'nttpie, � b�4 i� �a. '� QNawaw CITY OF SALEM9 MASSA-`..;�✓ !CHUSETTS. BOARD OF HEALTH ` 120 WASHINGTON STREET, 4TH FLOOR ' 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: IL Bocca Italiana Rest. Inc. Address of Establishment: 140 Washington Street Owner's Name: Patrice Desa Restrictions: Application Date: 12/3/2004 Permit for Food Establishment 163-05 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products These Permits Expire December 312005 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. AL GENT CITY OF SALEM9 MASSACHUSE l L I II BOARD OF HEALTH f • - c 120 WASHINGTONSALEM, MA 0197pTH FLOOR 01.� Z004 .� TEL. 978-741-1800 1. V FAX 978-745-0343 CITY OF SALEM STANLEY U. USOVICZ, UR. .JOANNE SCOTT, MPH, RS, CHO BOARD OF HEALTH MAYOR HEALTH AGENT 2005 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT � NAME OF ESTABLISH MENTOQO, 11(''t�� Cuf1C< TEL# "/,11Tt'Z44-13763 W ADDRESS OF ESTABLISHMENT WU if)I Ucno MAILING ADDRESS (if different) SafVI\Q C OWNER'S NAME �A1Jl2rrfCr, 11i\)A Xc u- �eJA TEL# 5( (4b2 �3c16 j6 ADDRESS 2I KJrli ibU 5T• CITY • STog . STATE tiJA zip_ azli2a CERTIFIED FOOD MANAGER'S NAME(S) _OEbN CERTIFICATE#(s) E130661S4669 (required in an establishment where potentially 1 hazardous food is prepared.) 1U EMERGENCY RESPONSE PERSON RT Wkt HOME TEL#'I'1I S3S ��OS gpA-pPM 11:38pµ- it.ao HOURS OF OPERATION: Mon. * Tue. Xiol!Ned. 1Thu. Ili Fri."' WSat.4_IQ4_,Sun. 2A-001 . TYPE OF ESTABLISHMENT 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 =$150 more than 99 seats 0 BED/BREAKFAST YES NO $100 ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES NO $5 TOBACCO VENDOR YES N $50 ALL NON-PROFIT(such as church kitchens) YES N_ $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. P�rsuan to M ter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my best knowle e elief, have filed all state tax returns and paid all state taxes required under the law. � l \ 1130.04 �r 03HOG-0595 Signature Date #ISocial Security or Federal Identification Number ---- - ------- el Revised 11/03/03 FOODAP2.adm Check#&Date y��� 114, pg_ j� L66 r� r. 0140 Washington Street IL Bocca Italiana Rest. Inc. City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE REINSPECTION Inspection HACCP: ❑ Telephone: Item Status Violation Critical Urgency Nature of problem or correction 978-744-7333 Non-compliance with: Done Owner: Anti-Choking PASS ❑ Patrice Desa Tobacco PASS ❑ PIC: ` FOOD PROTECTION MANAGEMENT Done Patrice PIC Assigned/Knowledgeable/Duties PASS ❑� RED Inspector: ;, David GreenbaumEMPLOYEE HEALTH Done Date Inspected: Correct-By: Reporting of Diseases by Food Employee and PIC PASS RED 5/5/2005 - Personnel with Infections Restricted/Excluded PASS ❑d RED Risk Level: FOOD FROM APPROVED SOURCE Done Permit Number: Food and Water from Approved Source PASS ❑d RED .BHP-2005-0236 Receiving/Condition PASS RED Status: Tags/Records/Accuracy of Ingredient Statements PASS RED SIGNED OFF Conformance with Approved Procedures/HACCP PASS ❑J RED # of Critical Violations:;__ plans x, PROTECTION FROM CONTAMINATION Done Time IN: Time OUT: Separation/Segregation/Protection PASS 0 RED Notes. , - = Food Contact Surfaces Cleaning and Sanitizing PASS RED 131: Proper Adequate Handwashing PASS 0 RED Urgency}Description(s): Good Hygienic Practices PASS ❑d RED BLUE: + - " Prevention of Contamination from Hands PASS RED Violations Related to Good Retail Practices (Critical ry Handwash Facilities PASS ❑d RED violations must be corrected immediately or within 10, k days)(Non-critical violations GeoTMSO 2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 06,2005 ) Page I of 0140 Washington Street IL Bocca Italiana Rest. Inc. must be corrected immediately PROTECTION FROM CHEMICALS Done or within 90 days) Approved Food or Color Additives PASS ❑Q RED RED: Violations Related to Toxic chemicals PASS RED Foodborne Illness Interventions TIMEITEMPERATURE CONTROLS(Potentially Haz Done and Risk Factors (Require Cooking Temperatures PASS ❑D RED immediate corrective action) Reheating PASS ❑d RED Cooling PASS RED Hot and Cold Holding PASS ❑d RED Time As a Public Health Control PASS ❑d RED REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO Done Food and Food Preparation for HSP PASS RED CONSUMER ADVISORY Done Posting of Consumer Advisories PASS 0 RED Violations Related to Good Retail Practices (Blue Done Management and Personnel PASS ❑ BLUE Food and Food Protection PASS ❑ BLUE Equipment and Utensils PASS ❑ BLUE 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 Owner must seal all openings around back screen door. Owner will fax the extermination contract with Freedom Pest Control to the Board of Health upon receipt. ' All other violations cited in 4/28/05 inspection report have been corrected. GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 06,2005 ) Page 2 of 0140 Washington Street IL Bocca Italiana Rest. Inc. GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. May 06,2005 ) Page 3 of 3 0140 Washington Street IL Bocca Italiana Rest. Inc. City of Salem FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection HACCP: ❑ Telephone:. Item Status Violation Critical Urgency Nature of problem or correction 978-744-7333 Non-compliance with: Not Done .Owner: - Anti-Choking PASS ❑ Patrice Desa` Tobacco PASS ❑ PIC: Patrice Desa FOOD PROTECTION MANAGEMENT Not Done Inspector'. PIC Assigned/Knowledgeable/Duties PASS ❑d RED David Greenbaum EMPLOYEE HEALTH Not Done Date Inspected: COrreCt By: Reporting of Diseases by Food Employee and PIC PASS ❑d RED 4/28/2005 Personnel with Infections Restricted/Excluded PASS ❑Q RED Risk Level:' FOOD FROM APPROVED SOURCE Not Done Permit Number: Food and Water from Approved Source PASS ❑Q RED Receiving/Condition/Condition PASS ❑Q RED BHP-2005-0236 g Status: '" Tags/Records/Accuracy of Ingredient Statements PASS ❑d RED VIOLATION Conformance with Approved Procedures/HACCP PASS ❑d RED #of Critical,Vlolations. Plans 3 - PROTECTION FROM CONTAMINATION Not Done Time IN: Time OUT n— Separation/Segregation/Protection PASS ❑d RED Notes: Food Contact Surfaces Cleaning and Sanitizing FAIL (Critical ❑d RED Diswasher di�reach the mandated .117:. - \ rinse ted�perature of'180°F. Repair '+ +� dishes er to to samhze with a final rinse err perature of 180'F Urgency Description(s): x 't Proper Adequate Handwashing PASS .I❑ RED BLUE. t Violations Related to Good t Good Hygienic Practices PASS ❑Q RED Retail Practices (Critical, Prevention of Contamination from Hands PASS ❑Q RED violations must be corrected immediately or within 10 Vr ° ° Handwash Facilities FAIL Critical RED ` Provide disposable paper at the kitchen days)(Non-critical violations andwash sink at all times. GeOTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Apr 28,2005 ) Paze 1 of 4 0140 Washington Street IL Bocca Italiana Rest. Inc. must be corrected immediately PROTECTION FROM CHEMICALS Not Done or within 90 days) Approved Food or Color Additives PASS RED RED: Violations Related to Toxic chemicals PASS ❑D RED Foodborne Illness Interventions TIMEITEMPERATURE CONTROLS(Potentially Haz Not Done and Risk Factors (Require Cooking Temperatures PASS ❑d RED immediate corrective action) Reheating PASS ❑J RED Cooling PASS RED Hot and Cold Holding FAIL Critical ❑d RED Super" cooling unit had a temperature of 50 Repair unit.to maintain a emperature of�F or below. Time As a Public Health Control PASSd❑ 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 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 Zaxyerator/freezer and the eed visible, accurate the meters. he microwave needs a thorough cleaning. Th snopener needs a thorough scouring. Water, Plumbing and Waste PASS ❑ BLUE Physical Facility FAIL Critical ❑ BLUE The back must have a tight fitting screen Ooor if the back door is to be left in the 10 pen position. Poisonous or Toxic Materials PASS [:1 BLUE Special Requirements FAIL Non-Critical ❑ BLUE Owner must employ the services of a licensed pest control operator and have monthly extermination performed in this establishment. Other-See Notes PASS ❑ BLUE GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Apr 28,2005 ) Page 2 of 0140 Washington Street IL Bocca Italiana Rest. Inc. GeoTMS®2005 Des Lauriers Municipal Solutions, Inc. ( Rev. Apr 28,2005 ) Page 3 of Antipasto Wsto Ov SP..nI N•u.W Awa F.al E,.y Dy.PA.i E..dlydd ••• '.�` " �...� j J ANTIPASTO SMALL $41.95 LARGE :9.95 MUSSELS CHABLIS $8.95 F..A N....1•S.p1J.i.l On...G..O.-1 CLyNI T u ..... Spy W/11.Wiw S.... L HOUSE GARLIC BREAD 15.75 , +, L..bu.7wa 0....•.OO..OO C11-1-w.1y u1 F...1 AJ +�� INSALATA CAPRESE 10.95 �D f''N.N -R=�tE.,N_U F.A M.,.ydl.Will SO..,T.uw..ArlAl.b..9...t.a N:,C.n.wy..all'.O.1 AJ F,..l b.,I ` SALMON CARPACCIO W..RAW WRL a....Fr...•.,...04..M.11.4 04.1 T"..N P!5 e! s.mJ will 0......Gq..•.n...n1 w......n..IdA.n.ou•M Mb.1 a..... CLA.• Of P.O. Will, ldd., S...• O, G.,J.. S,IJ PAN SEARED SCALLOPS 13.95 S.mIO...C...qui.u..s....Win Mo.l a.......1 a..ul Fm,• GOLDEN SNAPPER sis.95 P•. 5•161.41 R.4 Swq... WOL PIal.tuw Clot T...41 Witt FRIED CALAMARI AND ZUCCHINI $7.95 SL.II.t Lt«., WLlt. Wl.. B.tt., Sae. S...J W1tL MI..J S.nJ.itL Fill.l•DI R..J.,e Sae.. V.I.f.U.a CRAB CAKES 85.95 PAN SEARED SALMON FILLET 115.95 O•,H.uu4 F.A C.aL.A..A.S•wJ WIIL 1,116.4 T.PJ Wilt S..II SL11.1 1. A. A1tIdeL. L.«..S•e.. G,...•A.l A C4.1..Of C1•..9 0.,.•..•1.CL....S.... S....4 WRL MI.J Vyd.tiu O.F..L GAIIJ Pi...rrl.•M•.f•S...• SILVER GOAT CHEESE AL FORNO $7.95 PAN SEARED SEA BASS $IS.9s 3.6J Cly..G..Nt....S.-.J W.M H...,GIu.J T.P•J Wltl R.uNa T...feo. BI•.L A.J G.... 0111•.. F,ut F.1t FJ.3.1J AJ 5....LAI. C1yos WIIL Fr,A Ilut, 1. A WLlt• Wiw, Sao.. Zupp! Polio CHOICE. OF THE DAY CUP sass BOWL $3.95 CteJ•. Of GarJ., Sala) 01$U• Of Put• LOBSTER BISOUE CUP sass BOWL 19.94 CHICKEN PARMIGIANO sil.95 Pasta Suet Witt Ga,J.. 9.1.4 CHICKEN MARSALA $11.95 Brunt Of Ctl.l•. S.•f.•J Witt F..L M..&... AJ FETTUCINI VEGATALI 111.95 M.,..?. W4. T.,tJ Wltl M...ardl. CIO... S.st•J L.Aa. H.ntr..«.. 2e•.Li,i, FuL T..tsu, an..dt. DIN. Oil A.J G.J:. S....4 Or•,655 AJ S,4.4 i.u..twl CHICKEN VERDICCHIO $12.95 B...1... GL{.t.. S..bJ Iw Witt. Wt..Wttt Mobe.1. PHNNE WITH CHICKEN $12.95 Re.•tJ F..... •J Ani.lA• Murl• Aet.J CUA.,Witt 0.1....SlibL. Mulu•.1. L«at.0 0111, Oil. G•,R. Ty..J WIIL F.•.L SL..J P..«yt•..Clue. CHICKEN MARGHHRITA TORTELLINI AL FORNO $12.95 CLIA.. 5uut L47ltly D4PJ 1. Ell 6.111.. A.J Sut..J B.L•J T,fdli.i SldfJ Will P..i.i AJ SlOt.4i, Mntw..a Awa WitL A,u.L./.., M.•L,...a 1.A Wlit. Wi.. S,... T..•J Pr....ttw. TyJ WIA S..t.J G....a Vu1. 0.1....7.Jeu.la, Witt M•u..dl. CL..•. Pa.«tllu.CLuu Witt A T..I Of Ful T..Mu TIIJ Witt 6OCCA ITALIANA'S SPECIAL $13.95 M.uuJl. Rd.tiw. O/ GLb L.w Bnut Fi144 Will, Pru.•RL, Rwti.• SPAGHETTI WITH MEATBALLS $,9.95 CH.a. 8..•..U. P.1s4y AJ B.aO. Ty.J Will, L.....Cal., Sa.... S...44 Win MI.J VgdaLlu 6.4 Blatt Ftabu SPAGHETTI WITH MARINARA SAUCE 1 9.95 POLLO VEGETALE st1.95 RAVIOLI WITH MARINARA SAUCE $Io.9S SL.f..J M.JLIII... Of CLI.L.. WIIL P....... 0.1..., Z.-L1.1 B.....l B. Rut T•.•b•a . WUt. WI., AJ 01q..e LOBSTER AND, CRABMEAT RAVIOLI sn,75 T...•J WIn S.d..J SL,I., AJ S.01.,. I.Cru., L.L.t., S.... Carty! LINGUINE DEL GOLFO $12.95 CL.I..Of G•,J..SOW O. 10,01.RI Fl1.0.DI v...J...s•... U.ldu W1tl S..ta.a M.... 361.p S.allq..S..IR•.., Ful T.-&t...Witt Gall. A.J Oil CHICKEN PARMAGIANO PRIMAVERA 'TUTTO OI MARE" $11.95 VEAL PARMIGIANO $13.95 F..l stn...S-11... A./ C,.&-..t Win s..t. a.....It, i Z..AI.I. C.rr•t•.S.,J,I.a T.aOu Sort Oe..TLI. VEAL MARSALA $14.95 SplLdtl 1.A C..,., R...t.S.... S..IIglwi Of Vul S•.t.J WRL Fut M.A,...• A.J SHRIMP AND SCALLOPS $15.95 M..•.I.Wt.. T.".J Will M......11. Cl.... S..NJ St,l.l A.a S.all.n Witt Gall. Sealhe.. VEAL FRANCESE Issm C...0..JR...1.4 P..... 1. A FruL T...t.S..... V.al Lll Ltll DIII.J I. Ell Batt.. A.J S..b•J W11L S....a WitL fill Fitt-1.1 AJ T..I.J NO. 6,..a A.ta.Ld•a A.a Cal..a 1. A Lu.. 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I "OUSE GARLIC DREAD WITH CHEESE $1.96 S....4 Witt Rsl•t..1 F1611.m P-J... L«•bu,S.•.1 0.;....A.d.f.CR..t»,ON,.Oil A.J Fwal S•.J Tg9J Witt Maannlla C41". CHICKS" PARMIGIAHO 86.95 FRIED CALAMARI AND ZUCCHINI 1695 VERDICCHIO $7.95 C.LM FI.J GI•ua.i S..r•J WAIL F11d1.DI P.•J.e DI99ty Saw• 5..Ju.CLidr..Bua•t S•.1HJ Ful M•d....s,R..•t.J P•9fo A.J A.ttal.Lit 1.A V•rJ:••li.Wt.• Sa..•Witt A Lul Of Lt... PAN SEARED SCALLOPS $7.95 $vJ Oar A Cuarf Cilawtr.Saw•Witt MbJ Guos A.J MARSALA 51.95 R...t•J N"... a...1..•CU.&.. B....t S..f•.J Witt F...I Mw.l.r..• A.J M...•I• DOCCA ITALIANAS CRAB CAKES 14.11; WI..T.p44 Witt 14... ,.It,Chiu M..sa.44s Fust Gal Gin.Str 4 Will Mb44 Gnos a.J A Cl•iu if PiORENTINA t1.v5 Caa.f fegrwu6 C&....S....O.GAII.J Piw.alll•-M•y.S•... S..t•.J MJaUos Of CU.So Dnut Wit& M.d...r. A.J R.a•UJ I MUSSELS CHABLIS $7.95 L.N.0 Witt A S91.4 Of Witt.WI..Lff.J WIN Sfl.•ol.C•,... F",%Minds Sut.N Witt 0.1os.6a.li•A4 CMpfJ AJ F.H.a Clan• T•uf..•I.A Sit,W&O.Wt.r Se•. CLrnst Hoose ANTIPASTO VEGETALI $Gots B...a Ilap•wi•F..L Vy.bLl.AwHpd..P..p.d Day SAUSAGE TORE t1Jf If•U..4....L1'.... S•a..J 1.A F•rt T.ut.5....Witt N..l...�., I n s a l a t A 0.1..., P.9f... A.J W lit.W:.. S.-.J Witt P•.ta SOCCA ITALIANA SPECIALTY {1.95 pasta F•.,L P.bWa,G..da. A.tt.l.la, 61N., A.a.ir•. D.•...li, Mal...... Ca.lifbr•.,CL.•q b.•bu,Foo 14......If., 3....A Witt G. SaJ Ef711a.t. P.....IN.D• P.r.. O••r M1•.J G.••.s T..44 Witt PETTUCINI V966TALI 11.9f Wa•. $16.4 F110 Mll... Fral Sa.tuJ 0..a•It.Sfba•l.CL.rq Galas,Z... :.l. PASTA SALAD WITH GAMSERIh.fe b9a..ys.Sw.q•... G...b.S..J.I•J To.abu 1.A Galt. A.J 011 Pnil" P..b T...J Will Mi..J G....., M•Ilwat•J EfiflawL Sao. SouJ Witt Elf A.J S+laad Fdfv.1.1 L9+J Witt SbrsJ A,1114.to. Rras11J Pppu. M.d...w, A..J Pr.d•J$.all P••«tft...Cl.... SLA.,T.9f•J WIN Salsario Viwapat• A.J G.r9....1,CL.... PRIMAVERA TUTTO D' MARE $8.95 CRADMEAT SALAD 51.95 Ful SMi.p Swllga AJ C.a&..•t Will S..taJ Sa...It.Z.-M.1 Ritl t F..I S...Cr.L«ut Su.J Ow,Mud11.14t.L.a.• G.••... P•..• Car..is5 ..4 T«qm S•..44 r114 TU.SIJ.fldtl 4.Caa.f Pub. SI•.L 011.... Rr•.t•J Pq+•.• •.J C...t..•. GRILLED SCALLOPS B SALAD 1895 SHRIMP GIARDINERA WITH LINGUINE 18.95 Grlll•J A.J Ma.iw.NJ S.aMfa Sow44 Or.. Mb•J G..ana W;/& S..t,S&A.,Will Bondi,Cl orf L.at.u. Ode. 1.a G.46 Mariwat•J M..bo«•.G.III•J 0.4.1, Cyu.. P.01,S.1.4 A.J ..J Oil S•... Lq•J Witt SIu.4 PodfL.•Ck.... Frul M•su.dla CL••s•. MUSSELS WITH SPAGHETTI CHICKEN PE3TO SALAD $7.95 C.IIt..t.J M....1. Sa.s..J 1.A F.at T....t.S...r O.4a.bJ 1. 0.11144 Qlstu B••ast 7Lsst,l Wilt to.a "ahawi.Snap P•str Ga•16.O".. Oil AJ P .. S....J 0...S9yld11 4.4 Po.. Pasta.SoaJ Oao MbsJ Go.s.s. Last.J AI...Js. POLLO PRIMAVERA WITH PENNE 11.95 Tuu1,.•.A.J R•atJ P ..tr. Sa.t.Curb.Witt 6...•.11.3... Pit..M a ..C....U A.J OUR SOUP Of TL. DAY C., $a.#$ B..1 $8.9s ClgptJ T..al... 1. A Ca•.f R.et.Su.•Lf9•J Will Sl•wJ Pa..ifi•..Clew P RAVIOLI DELLA CASA $6.95 P..I.. Sa+•J Wlll PaN Phil, IuJ . 0, C.f Of $•.f Foul M..•.J•Chis• 86•141 Sa.t.•J Witt Owl..•. Pits. DOCCA ITALIANA'S SPECIALTY 14.95 Mnbars Will B•Lpm Su.• Roast Port. Har. F•..tina CN•... R.a6144 Petra. Wit& BAKED PASTA licts $fl.f Maf•wwatst Pil.t•a P•.b B•L.J Witt Fi1.tt.Di P.«.J..•T.9f•J Witt SH..J THE GRILLED VEGETABLE $6,95 Mot&alls A.J MdH4 M..n.dla Chis. P....... 0.1.... M.al...r., T..at.u. Z...Lt.&. BAKED TORTOLLINI IN CREAM SAUCE $6.95 Efflla.t A.4 Pout M...a.dla T..nIU.t Pill•J WIN Ri..ih,Cl.... Ad SoJriJ T.uha Lffd OUR OTTIMO STEAK $1.9s Witt P:•.it Of Pos••itl•A.J G•.fo..14 Cl•it• Sa..• G.i11N F:IJ Mil... T.9t.J Will $.wf••J' 0.1..%, SPAGHETTI BOLOGNESE 1695 Pet fin. Mnt.ors.Cl•..f T•.afa. A.J • ... of Bdsa.I• VI..l., SL76tt1 Tq•J Witt O., N.uwaJ. Bdy.u. THE CLASSIC ITALIAN $7.95 BAKED EGGPLANT PARMIGIANA $1.95 M.•la J.l la, P.....fit. D• Par.•. R...tit Pg9o.. St.ff.J Witt P.....IR.. F.wtba C&..s. Pat.A.J R...td 9..... Litt.., $ala.i, T...t..s Aw4 F•wliw. CL.... T.ff•J Witt M......01. A.J R.ast J Moslaos IAI..A.a1.Ll. Mittlud. fa1.4 Witt $W 044•.Of 01,10-1 Witt Pil.1t.Di CHICKEN PESTO 16.15 P.r.J..o S.... G.nI.J CLI./.. Brut 14.11.2,11414 Witt Pill. A.J Rut Not• A.4 T.l+d Witt. T.ub. L.tt..• A.4 All Pal• ..... At Dal• G.III.J R.4 0.1... PLEASE ASK TO SEE OUR DESSERT AND CAFE MENU - MONEY MUSTARD CHICKEN 16.9s 0.III.4 toast Witt ......a. "..p M•.iaN Su.• T.fpJ Witt P....l... Cl.•.•,LraL it. Lift... A.J ,r •� ` , CRAB PARING WIT" SHRIMP SALAD 11.95 B U O N A F...L R..I Ga& Saint T.9+.4 Witt Sall Slri.9 A.4 Cj. ' O R N O MI.NJ G.0uu .s. S•..•J O. O.• Fol Bot. , ROAST TURKEY PANINO $6.95 t D.•.a Ibliawa'• R.ast4J T.ot•f. T...*4 Wit& t A.U•l.la, T.«•boa, BI..L 061.... Mb.J G.•.w. A.J D I V E R T I R S I ! ! ! M.1t.4 F..#1.. Clear ' CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH _ 120 WASHINGTON STREET, 4TH FLOOR )d SALEM, MA O 1970 _ 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: IL Bocca Italiana Rest. Inc. Address of Establishment: 140 Washington Street Owner's Name: Patrice Desa Restrictions: Application Date: 3/12/2004 Permit for Food Establishment 280-04 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, Sanitary Code before an renovations In accordance with the State S ry y , improvements, or equipment changes are made, all plans for such must be submitted to and approved by the Salem Board of Health. HEALTH AGENT s CITY OF SALEM, MASSACHUSETTS r"t BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 2004 APPLICATION FOR t�PERMIT TTOO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT IL yOCCC� ``1To�cnc��s1 IeK,TEL# NiA ADDRESS OF ESTABLISHMENT SA LC )'t VAIN- MAILING AIN-MAILING ADDRESS (if different) OWNER'S NAME 1hh�RICA b6SA TEL# 611 -S(o 1-023`7 ADDRESS CELttlS[�9,- f�2 301%0CITY EAS-T oi'J • STATEM ZIP 021 '28 CERTIFIED FOOD MANAGER'S NAME(S)�-1121CF 11 CSA_ERTIFICATE#(s) jk3 IS9609 (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON �AVd,f Oe JAV HOME TEL#()11 -X561- 0`LD i1= n' u:3o it=3c' Ito C6lL k�tl- 6"777 UUa HOURS OF OPERATION: Mon.0 Tue. Wed.�o Thu.�Fri. Sat."" oSun. 12� P^' TYPE OF ESTABLISHMENT FEE check only RETAIL STORE YES O less than 1000sq.ft. =$50 1000-10,000sq.ft. =$100 more than I0,000sq.ft. =$250 RESTAURANT NO 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 $50 ALL NON-PROFIT(such as church kitchens) YES . O $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 est o leddeaii-cl-be lief, have filed all state t tate taxes required under the law. J C, ` 10-y3b62 110 Signature Date Social Security or Federal Identification Number ---------------------------------------------------------------- ---------------------�--�,--/---------------------------------------- Revised 11/03/03 FOODAP2.adm Check#8 Date T8 3 3/:; �yL- Massachusetts Department of Public Health Salem Board of Health 120 Washington Street,41h Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name Date /� Typ of Operation(s) Tyne of Inspection IL e_ /a/ Food Service ❑ utine AddressRisk ❑ Retail Re-inspection ILId �'� �- Level ElResidential Kitchen Previous Inspection Telephone t S` 02.77 m ❑ Mobile Date: Owner HACCP YM ❑ Temporary ❑ Pre-operation P ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) 5 j_ Time ❑ Bed&Breakfast ❑ General Complaint In: El Inspector Out: Permit No. ElO herr- 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 And-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 PROTECTION FROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC 14.Approved Food or Color Additives El 3. Personnel with Infections Restricted/Excluded El FOOD FROM SOURCE ❑ 15.Toxic Chemicals ' "" - ' '"" ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE.CONTROLS(Potentially Hazardous Foods) - ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements [:117. 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 [_1 9. Food Contact Surfaces Cleaning and Sanitizing . REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) El 10. Proper Adequate Handwashing E]21. Food and Food Preparation for HSP ElCONSUMER:ADVISORY: 11. Good Hygienic Practices . . . ❑ 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 today, the items checked indicate violations of 105 CMR ofC Health. 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 4. Food and Food Protection (FC-3)(590.004) 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 26. Water, Plumbing and Waste (FC-5)(590.006) the food establishment permit and cessation of food 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,5M�,nFo„ 14dm� Inspector's Signature: Print: PIC's Signature: \}� Print: '-� l �A PageA 0f Pages Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT S Cross-contamination 1 590.003(A) Assignment of Responsibility* 3-302.11(A)(I) Raw Animal Foots Separated from 590A03(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103,11 r Person in charge-duties Contamination from Raw ingredients 3-302.1 1(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other` 2 590.003(C) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees and 3-30211(A) Food Protection' applicants' 3-30115 Washing Fruits and Vc,,etables 590.003(F) Responsibility Of AFood Employee Or An 3-304.11 Food Contact with Equipment and Applicant To Report To The Person Tn Utensils* Charge" , Contamination from the Consumer 590.003(G) Reporting by Person in Char e* 3-306.14(A)(1i) Redu and Fax]and Reservice of Food- 3 590.003(D) Exclusions and Restrictions'( Disposition of Adulterated or Contaminated 590.003(h) Removal of Exclusions and Restrictions Food 3-701.11 I Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Conteh mec with Food Law'" 4-501-111 Manual Warewashing-[lot Water 3-201.12 Food in a Hermetictll} Sealed Container' Sanitization Pen.crannies* 3-201.13 Fluid Milk and Milk Products* 4-501.1.12 Mechanical Warewashing-Hut Water 3-202.13 Shelf&»s* Sanitization Tem eramres* 3-202.14 E es and Milk Products.Pxstetuizeci* 4-501.114 Chemical Sanitization-temp.,PH, concentration and hardness 3-202.16 lee Made From Potable Drinking Water 5-1.01-11 Drinkin,, Water from an Approved System* 4-60tll(A) Equipment Food Contact Snrfaczs and 590.006(A) Bottled Drinking Water* Utensils Clean* 54 4-602.11 Cleaning Frequency of Equipment Foad- 0.006(B) Water hands Standards in CMR 220` Contact Surfaces and Utensils* Shellfish and Fish From an Approved oved Source 4-70211 frequency of Sanitization of Uten0s and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equi men(* Shellfish* 4-703.11 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 Re Mato Author' 2-301.11. Clean Condition-Hands and Anes" 3-202.18 Shellstock Identification Present" 2-301.12 Cleaning Procedure* 590 004(C) Wild Mushrooms* 2-301-14 When to Wash" 3-201-17 Game Animals' 11 Good Hygienic Practices S Receiving/Condition 2-401.11 F..atina,Drinking or Using,Tobacco* 3-20211. PHFs Received at Pro ter Tent eraau.es* 2-401.12 Discharges'From the Eyes.Nose and 3-202-15 Packaee Into nit " Month* 3-101.11 Food Safe and Unadulterated* 3-301.12 PreventineContamination When Tastin=* 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.13 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained' Ent(]ovens* Tags/Records:Fish Products 13 Handwash Facilities 3=102.11 Parasite Destruction, Conveniently Located and Accessible 3-402.12 Records.Creation and Retention* 5-303.1.1 Numbers and Ca acities* 590-004(1) Labeling of Ingredients' 1 5-204.11 Location and Placement* 7 Conformance with Approved Procedures 5-205-11 Accessibility,O ration and Maintenance IHACCP PlansSupplied mth Soap and Nand Drying 3-50211 Specialized Processing Methods* Devices 3-50212 Reduced oxvaen packaging,criteria'' 6-301.11 Ilandwashing,Cleanser.Avarlab8ity 8-103.12 Conformance with Approved Pnxxdores*. 6-301.12 Hand Drvin,.Prorision "Dcnoter critical reran in the tellers] 1999 Food Code or 105 CMR 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name: �G CG/� /rifu Ar/4 d /'3 d"r Page: Z of Z Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Vete ;f No. Reference R—Red item Verifietl --PLEASE PRINT CLEARLY X11 C (�Qc,�r Sca.csbY.r mea .�s/' rSs ,tc,i-off PU c.�r d' .aro smF ht,. K.� r &n t /uz0+001 i s eiP�fJ N vi c e ��SPdC3"re/✓ !�II�7N /hf'J2f N /t�C.e�iCl2� 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 twg ty�fi..ve dollars'o pen, sion/revocation of ❑ Embargo ❑ Emergency Closure your food permit. Ll Disposal L3Other: 3-561.14(C) PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk According to Law Cooled to Factors(items 1-22) (Cont.) 41°F/45T Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-501.16(21) Cold Plus Mairatened at or below 3-202.]2 Additives* 590.004(F) 41"/45"'F* 3-302.14 Protection from Unapproved Additives* 't-501.16(A) Hot PHFs Maintained at or above I$ Poisonous or Toxic Substances - 40"F 7-101.1 I Identifying Information-Original 3-501.1.6(A) Roasts Held at or above 1300F. G>ntainers* Control 7-102.11 Common Nat -Working*Containers* 20 Time as a Public Health 7-20t.11 Separation-Storages` 3-507.19 Time as a Public Health Contrnt* 7-202.11 Restriction-Presence and Use* 590,004(H) Variance Re nirement 7-202.12 Conditions of Use* 7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 7-204.1 l Sarntizers,Criteria-Chemicals'" 7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.1 1(A) Unpasteurized Pre-packaged Juices and Beverages with Warning Labeds� 7-204.74 Drina Agents.Criteria* 3-801.11(B) Use of Pasteurized Egos* 7-205.11 Incidental Food Contact. .Criteria* 3-801.11(D) Raw or Partially Cooked Arinnal Ford and 7-206.11 Restricted Use Pesticides.Criteria* Raw Seed Sprouts Not Served. * n Rodent Bait Stations"` 3-go1.11(C) Ra toned Faxi Packs=e Not Rn-served. " Tracking Powders,Pest Control and Mmutorin�* CONSUMER ADVISORY TIMEfrEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods'Phat are Raw. Undercooked or PHFs Not Otherwise Processed to Eliminate 3-401.L1A(ll(2) Eggs- 1.55°F 15 Sec. Pathonens,*e'hxooa rrosom Ergs-Immediate Service 145",Fl 5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3-401.11.(A)(2) Comminuted Fish, Meals&Game E gs* Animals- 155°F 15 sec. ,r' 3-401.11(11)(1)(2) Pork and Beef Roast- 13WF Ll min* SPECIAL REQUIREMENTS 3-401.11(,A)(2) Ratites, Injected Meats- 155°F 15 590.009(A){D) Violations of Section 590.009(A)-(D)in sec, * catering, mobile fool, temporary and 3-40t.11(.A)(3) Poultry, Wild Came,Stuffed PHPs, residential kitchen operations should be Staffing Containing Fish,Meat, debited under the appropriate sections Foultr or Ratites-165`1 15 sec. * above if related to foodborne illness 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks interventions and tisk factors. Other 145°F* 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. 3-401.11(A)(1)(b) All Other PHFs- 145°F 15 sec. f7 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, which do not relate to the Time" foodborne illness interventions and risk}'actors listed above, can be 3-403.11(C) Commercially Processed RTE Fond- found in the following sections of the Food Code and 105 CMI? _ 140"F* 590.000. 3-403.11((3) Remaining Unsliced Portions of Beef Item Good Retail Practices. FC 580000 Roasts" ( 23. Mang ement and Personnel___..._ FCC IS Proper Cooling of PHFs 24. Food and Food Protection FC- 3 .004 25 Equipment and utensils __FC 4 _ A05 3-501.14(A) Cooling Cooked PHFs from 140°F to _____ _M. _ Water, Plumbing and Waste FC-5 .006_____ 70"F Within 2 Hours grid From 70°F 27. Ph sisal Facility_ FC-6 .007 to 41°F/45"F Within 4 Hours. * 28. Poisonous or Toxic Materials FC-7 .008 3-501.'14(B) Cooling PFIFs Made From Ambient 29. S ecial Rs uirements _ _ .009 Temperature Ingredients to 411V45°F 30,__ Other _-� Within 4 Hours'" ssunmantt+.e zm„ Denotes critical item in the federal 1999 poral Code or 105 CMP 590.000. Massachusetts Department of Public Health Salem Board SHealth 120 Washington Street,0 Floor Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax(978)745-0343 Name Date � // TYpe of Ooeretion(s) T�ytg�", f tnsaection L 4/ A 1; 610th a'FgO Service ('Routine Address Risk ❑ Retail ❑ Re-inspection Level ❑ Residential Kitchen Previous Inspection Telephone7- L - 3 (+!� ❑ Mobile Date: Owner HACCP Y!N ❑ Temporary ❑ Pre-operation {j�� E El Caterer El Suspect Illness Person in Charge(PIC) x+ Time ❑ Bed& Breakfast ❑General Complaint 7� In: ❑HACCP Inspector / out: Permit No. ❑Other_._ A-VoEach 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 590.005(E) ❑ 590.009(F) ❑ action as determined by the Board of Health. 47,.FOOD PROTECTION MANAGEMENT o-"`, , ❑ 13/Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties 13. Handwash Facilities ❑ 2.OReportinLof Diseases b Food Employee a PROTECTION FROM CHEMICALS Reporting y „andPlC ..w. [114,Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals FOOD FROM APPROVED SOURCE ...a , . 1--- ...- fTIMEnEMPERATURE CONTROLS(Potannaily Hazar-dous Foods} E] 4. Food and Water from Approved Source -_, A ❑ S. 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 tREQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)'„ -=. ❑21, Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices a 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 today,the items checked indicate violations of 105 CMR of Health. 590.000/federal Food Code. This report,when signed below C- Y' by a Board of Health member or its agent constitutes an 23. Management and Personnel (FC-2)(590A03) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 25. Equipment and Utensils (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 26. 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: fO Sa9pinscecrForms-id0oc l l Inspector's Signature: Print: PIC'sSignature: Print:,,N r1 (� �RLe.�lp �M1 FPPagee�offl Pages f ' S Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 '', Cross-contamination 1 x90A03f.k) Assignment of Responsibility* 3-302.ll(A1 Raw Animalm Foods Separated fro 590 003(B,_ Demonsh.ation of Knowledge* Cooked and RTP Foods* 2-103.11 Person in charge --(little s Contamination from Raw Ingredients 3-302.1I(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* 590,003(C) Responsibility of the person in charge to Contamination from the Environment L21 require reporting by foot employees and 3-302.11(A) Food Protection* a �licants" _ 3:302.15 FY ashin-Fcults and Vegetables 590.003(1-) Responsibility Of food Employee Or An 3-304.11 Food Contact with Equipment and Applicant To Report To The Person In Utensils* Charge' Contamination from the Consumer 590.003(0) 3-306.14(A)(B) Returned Food and Rescrvicc of Food" 3 590.OWiD) Exclusions and Restrictions" Disposition of Adulterated or Contaminated 590.003(,1-) Remooat of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Viater From Regulated Sources 9 Food Contact Surfaces 590.004(A-Bl Comphan e wifh Foal law* 4-501_111 Manual Warewashing- Hot Water 3-201.12 Foots in a Hermetically Scaled Container* S uunzation tem teratures* 3-201_t3 Fluid Milk and Milk Products* 4-501.112 Mechanical WarewashinHot Water 3-202.13 Shalt Eggs* Sanitization Tem eratures* 3-202.14 ER is and Milk Products.Pasteurized` 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made Froin Potable Drinking Water" concentration and hardness.* 5-101.1.1 Drinkin Water front an A roved System* 4-601.J I(A) Equipment Food Contact Surfaces and Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency ofHquipment Food- 590,006(B) Water Meets Standards in 310 CMR 22.0" Contact'Surfaces and Utensils* Sneilllsh and Fish From an Approved Source4_702.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces_oPE Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-207.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 1p Proper,Adequate Handwashing Game and Wild Mushrooms Approved by 2-301.11 Clean Condition-Hands and Arms* Re u(ato Authorit 3-202.18 Shellstock Identification Presents' 2-301.12 Cleaning Procedure* 590.004(0) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 _ Game Animals* ll Good Hygienic Practices 5 Receiving/Condition 2-401.I I Eating,Drinkin or Using Tobacco* 3-202.11 PHFs Received at Pto er Temperatures* 2�OL i 2 Discharges From the Eyes,Nose and 3-202.1.5 Package Ince rit * Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting* L6 TagsiRecords:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from Ell3-203.12 Shellstock Identification Maintained* Ha tondwash Facilities Tags/Records:Fish Products 13 Conveniently Located and Accesslbte 3-402.11 ParasiteDcntnuaion* 3-402.12 Records.Creation and Retention* 5-203.11 Numbers and Ca gonias* 590.004('1) Labeling of ingredients' 5-204.11. Location and Placement* 7 Conformance with Approved Procedures 5-205.11 Accessibility.O aeration and Maintenance /HACCP Plans Supplied with Soap and Hand Drying 3-502.11 S ecializxd Proeessine Methafs* Devices 6-301.11 Handwashin 3-502.12 Reduced os gen tackang,criteria" Cteansec,Avaitabilit- 8-103.12 Conformance with Ai rt,xed I o edures* 6-301.12 Hand Drng Provision "Denotes critical item in the Cameral 1990 food Code or 105 Ch1R 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name: IL rge /f AclM1A Date:��-/ Page: Z of Item Code C-critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified PLEASE PRINT CLEARLY ?A1 Aj, 05A-Coo(! aCl,[ DaCS' 6F Y 4c. 1<errAkP4 Frt6A# o&n^. Ali_ "I d-s 4s>: [£dr` o Murf F Sb, rJ CA_d5' t . tJ C P AS UNItlNlS mitiotr mtnr ,gz A" rHPkEVijdr f'� C Qu+�s►t TiNR D s'r A& 10Ati9K P"orufcs. eVr ,t' Ar Pew�t� ►tF£R6ttot�ts a t,6A riotte Ar Att_ yimirr. r'3 e t criarN H 1t- 0d9 WE uMsri r/NR 6'31' & Cas r (/iLay1W A-LL- N63_ G b LA41r 1 C0 vo If./ AaAfor •r M�s>r f.6'�it268 ST7 N e elnl 0&f- 61 rnr"M !' /eA N Mr o Ole r LV10 +_f ?moikie t aeL Ccs IPI6 x- r7f, N C S r s .eec r+mtAilart o f ae 0 GK brei T 0 Mef! .ra4 Awa rmdrn m ower Mit t 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. p ❑ VoluntaryDisposal ❑ Other: I 3-501.14(0:) PRFs Received at Temperatures Violations Related to Foodborne fitness Interventions and Risk According:to Iaw Cooled to Factors(items 1.22) (Cont.) 4I°F/45".E WiChrn 4 Hours. * PROTECTION FROM CHEMICALS 3-501.15 Coolina Methods for PHFs 14 Footl or Color Additives 19 PHF Hot and Cold Holding 3-50 L I6(B) Cold PI11's Mammined at or below 3-202.12 Additives" 590.004(F) 41 V45°F* 3-302.14 Protection from.Una> roved Additives* 3-501.16(A) Hot PHFs Afaintained at or above 1=515 Poisonous or Toxic Substances 140"F " 7-101.11 identifying Information-Original 3-501.16(A) Roasts Held at or above 130°F. Containers* 7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control 7-201.11 Separation-Storage" 3-501.19 Timc as a Public Hcawh Control* 7-202.11 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions" pOPULATIONS(HSp 7-204.1'1. Sanitizers,Criteria-Chemicals* 7-204.1.2 Chemicals for Washiq Produce,Criterias21 3-80'1.1l(A) Unpasteurized Pre-packaged Juices and Beverages with Warning i abels* 7-204.14 Drvin tuts,Criteria" 3-801.11(B) Use of Pasteurized Ecga* 7-205.11 Incidental Food Contact.Lubricants' 3-801.11(D) Rau or Partially Cooked Amma7 Food and 7-206.1 t Restricted Use Pesticides.Criteria* Raw Seed S xouts Not Served.'t 7-206.12 Rodent Bart Stations* 3-g01.11(C1 Uno aped Fcwd Parka>e NotRe-served. 7-206.13 Tracking Powders.Pest Control and Monitoring* CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw.Undercooked or PHFs Not Otherwise Processed to Eliatinate Pathe ens 3-401.I1A(1)(2) Eggs- 1.55 T 1.5 Sec. �r Te.-E,rxooi E w,s-immedi ate Service 145°F15sec- 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish,Meats Xz Game E gs* Animals- 155`•"F 15 sec. " 3-401.1 l(B)(1)(2) Pork and Beef Roast - 130`''F 121 rain* SPECIAL REQUIREMENTS 3-401.11.(A)(2) Ratites,Injected Meats-155`F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in sea * catering,mobile food, temporary and 3-401.1.1(,)(3) Poultry,Wild Game,Stuffed PHFs, residential kitchen operations should be Sniffing Containing Fish,Meat, debited wider the appropriate sections Poaltr or Ratites-165°.F IS sec. ,, above if related to foodborne illness 3-401.1 l(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145°P* _ 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked irr a practices should be debited under #29 - Microwave 165F* Special Requirements. 3-401.11(A)(I)(b) All Other PHFs-145°F 15 sec. * - /7 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(A)&(D) PHFs 1650F 15 sec. " (Items 23-30) 3-403.11(H) Microwave-165°F 2 Minute Standing Critired and non-critical violations. which do not relate to the Time" foodborne illness once ventions and risk factors listed above, can be 3-403.11(C) Commercially Processed RTE Food- found in a the following,sections of the Food Code and 105 CtYIR 140"F* .590.0.06. q . Good Retail Practices F 590.000--- Item_ 403.11(E)� Remautina„tinsliced Portions of Beef Roasts` 23. Mana in ent and Personnel _ FC-2 .003 1g Proper Cooling of PHFs 24 Foodand Food Protection _.__ FC-3 .004 25. __ Equipment and Utensils FC -4 __ 005 3-501.14(A) Cooling Cooked PHFs from 140°F to 26. Water,Plu_mbinq and Waste FG 5 006 70"F Within 2 Hour and From 70°F 27. Physicai Facility FC-6 I .OD7 _o_______ FC-7 .008 to 41'F145 F Within 4 Hours. 28. Poisonous or Toxic Materials „__--_--_ 3-501.14(B) Cooling PHFs Made From Ambient 29. 5 e iiaq Ra uirements 1 .009 Temperature ingredients to 41TF/450F 30. Other Within 4 Hours'# Is'-)R­e.*xe ami "Denotes caitical item in thx taleral 1999 Pood Cade or 105 CMR 590.000. l i CITY OF SALEM BOARD OF HEALTH Establishment Name: IL PnecA (TALfA-NiA Date: /dAb+/ Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Data No. Reference R-Red Item J - Verified PLEASE PRINT CLEARLY S eAlf r,R. ps t*- opt+r c1OsAA40MS rUit._ 0-6 liff 0d A 0CT i S ii%l7tNi - SoLvftdlM NVr a tmoage r D S . XA14 i rit_t S7atrnel� ,tit v sr 114, .awl to Al- &-jo A k s A-V_ 4. i drfel�Aurt 1111FAITAIf- cs�r- N wA9/ i X ,tMi o®a I & Roo S i I I I I Discussion With Person in Charge: Corrective Action Required:- El No Ll Yes have read this report, have had the opportunity to ask questions and agree to correct all c3P Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion P Ll Re-inspection Scheduled LI 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. ❑ Voluntary Disposal ❑ Other: i 3-501,14(0) PHFs;Received at"Tenrincratures Violations Related to Foodborne fitness Interventions and Risk According to Law Cooled to Factors(items 1-22) (Cont) 4 I'F/45'F Within 4 Hours. 3-501.15 Cooling Methods for I1HFs PROTECTION FROM CHEMICALS 11 r_.. - �,__9 PHF Hot and Cold Holding L_L4 Food or Color Additives 3-501,16(E) Cold PRFs Maintained at or below 3-202.12 Additives* 590.004(F) 41'45" F' 3-302.14 Protection fromLInall2rn1,A Additives, 3-501 16(A) Hot PlIFs Maintained at or above Poisonous or Toxic Substances 140'17. * 7-101.11 identifying Infiannation-Original 3-501,16(A) flexists Held at or above 130'F, containers- 7-102,11 Common Name-Working Containers' LN - Time as a Public Health Control 7-201.11 1 Separation-Stora_ 3-501.19 Tinic ass Public,Health Control*, 590.004(Fi) Variance Requirement 7-202.11 Restriction-Presence and Use" 7-202.12 Conditions of Use* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203-11 Toxic Containers-Prohibitions" 7-204.11. Sarfitjzers.Criteria-Chemicals* POPULATIONS(HSP) 21 3-80 1.11(X) Unpasteurized Pre-packaged Juice�and 7-20-1.12 Chemicals for Washing Produce,Criteria, -7-204_14 -prVinig I Bever ages%vifb Warning.1-abbelv 3-90I11(B). ol'Pasteurized Egp* 4 7-205.11 Incidental Food Contact, Labricannc' ( 3-$0,1.1.1 k�17- or Partially Cooked Animal Food and 7-206 1 Restricted Use Pesticides.Criteria* Raw Seed Stwouts Not Served. 7-206.12 1 Rodent Bail Stations" 3-801.11(C) Unopened Food Package Not Re-served, 7-200 13Tracking, Powders,Pest Control and 'Morritoripo CONSUMER ADVISORY TIMEITEMPERATUPE CONTROLS 22 3-603 " Coroanner Advisory Posted for Consumption Of 16 Proper Cooking Temperatures for Annual Foals That are Raw.1-Tradlacooked(it PHFs Not Otherwise Processed to E'liminate 'at 1-401.1 LI A(1)(2) Eggs- 155`0 15 See. ___1_ _ hO ins r,ecs,cr jai 11gs-hancedrale Service l4_50FI_5sec* 302 J3 Pasteurised Eggs Substitute'for saw Shell 40 E I I(A)(2) Comminuted Fish,Meats&Game Eggs' Animals- 155°F 15 sec. 3 Pork and Beef Roast- 1'0+ 121 590-t)09(,k)-(D) Violations of Section 590.009(A)-(D) in 3401 1 l(B)l,)(2) SPECIAL REQUIREMENTS 3-401.11(A)(2) Raritts, Injected Means-155F 15 se'. - entering, mobile food,temporary and 3-401.11(A)(3) Poultry,Wild Game, Stuffed PHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, dchircd under the appropriate sections Poultry(a�Ratitcs_J()VF 15 sec above if related to foodborne illness 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 145°F* 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. 3-401,11(A)(1)(1)) All Wier PHFs 145'F 1.5 sec. * LE7 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(A)8(I)) PHFs 165°F 15 sec. "I (Items 23-30) 3-403.11(B) Microwave- 1650 F", Minnie Standing Critical and non-critical violations, which ds)we relate to the Time" foodborne illness interventions and risk factors listed above, can be 3-403.11(C) Commercially Processed RTE Food firlo'd in.the fallowing sections of the Food Code and 10.5 CMR 14WF- 590.000. 3-403.11(E) Remaining Unsl!ced portions of Beef Item T Good Retail Practices FC b80 000 Roasts* 23. Maralperrent and Personnel FC-2 .003 Cooling of PHFs Protection --- FC-3 F.004 - Proper Cc 24. -Food and Food tection mbin and Waste FC 5 25. Equipment and Utensils FC-4 .005 3-501,14(A) Cooling Cooked PI IFs from 1,10'F to 26. �Alaler Pill 60 10"FWithin 2 Hours and Fron170'1� ZTP�,sialFacll� FC-6 007 to 4 PF1451-T Within 4 Hours. 28, Poisonous or foxic MaterialsFC FC-7 .008 ---- ------- -- 3-501.14(13) Cooling PHFs Made From Ambient .009 Temperature Ingredients to 41'17145"F _30 ... Other Within 41 lours* "Denotes c7aical item in the loderal 1999 Food Code or 105 C[,Ili 590.000. CITY OF SALEM BOARD OF HEALTH Establishment Name: /L prrsl I, r ,,4,*4 Date: 3�� ��..r Page: r of 4 Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date 3 No. Reference R—Red Item Verified PLEASE PRINT CLEARLY r feqr > d 5 r � v x 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 t comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars r suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. Com- _ ❑ Voluntary Disposal ❑ Other: 3-501.14(C) PHFS Received at Temperatures Violations Related to Foodborne illness Interventions and Risk According to Law('00led to Factors(items 1-22) (Cont.) 41"F745'F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.75 Cmfl ..A eMethodsforPHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-501.16(13) Cold PIMs Maintained at or below 3-202.12 Additives" 590,004(F) 41.'i45'F" 3-302.14 Protection from Unm.roved Additives'a 3-507.16017 Hot FHFs Maintained at or above 15 Poisonous or Toxic Substances 4 'F._v 7-107.11 Identifying fofonnafion-Or,ignal 3-501.16(A) Roasts Heid at or aboae 130-F. Containers* 7-102.11 Corrnnon Name-'Working Containers* 20 Time as a Public Health Control 7.301.11 Se.oration-Stara e" 3-501.19 Time as a Public Health ControP` 7-2021t Restriction-Presence and Use" 590.004(1-1) Variance Recuiretnent 7-102.12 Conditions of Use" 7-203.11 Toxic Container%-Prohibitions" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7?04.11 Saoidzeis.Criteria-Chemicals* POPULATIONSH( SP) 7-204.13 Chemicals for W"ashur>Produce.Criteria" 21 3-801.11(A) Unpastcurized Pre-packaged.Juices and Beverages with Warning Labels' 7-204.14 Dmiag Agents. Criteria* 3-801.11(B) Use of Pasteurized Eggs* 7?05.11 Incidental Food Contact,Lubricants* 3-301 11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria' Raw Seed Sprouts Not Served.,x 7-206.12 1 Rodent Bait Stations" 3-801.t 1(C) LJno xned Pocxt Pucka re Not'Re-served. 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw, Undercooked or 16 Proper Cooking Temperatures for Not Otherwise Processed to Eliminate PHFS PatlioaenS e' ^" izoor 3-401.11 A(1)(2) 6erz 155°F 15 Sec. 1-302.1 Pasteurized Ffge Substitute for Raw Shell F gs- Immediate Service 115 1 15sec*_ 3-401.11(A)(2) Comminuted Fish.Meats&Came Animals- 155'F 15 sec. " 3-401.1l(B)(1)(2) Pork and Beef Roast-'130T 121 tubi, SPECIAL REQUIREMENTS 3401.11(A)(2) Ratites,Injected Meats- 155F 1.5 590 009(1_%)_(U} Violations of Section 590.009(A)-(D)in sec. * catering,mobile food, temporary and 3-401.11(A)(3) Poultry,Wild Came.Stuffed PHF+, residential kitchen operations should be Stuffing,Containing Fish,Meat, debited under the appropriate sections POltltry or Ratites-165'F 15 sec. * above if related to foodborne illness 3-401.1 1(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other - 145-F" 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, 3-401.11(A)(1)(b) All Other PRFs- '145'F 15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-40111(A)&(D) PEIFs 165'F 15 sec. * (Items 23-30) 3-403.11(13) Microwave-165'F 2 Minute Standing Criticed and non-critical riolatione, which do not relate to the Time* foodborne illness interventions and risk factors listed abate, cart be 3-103.'1l(C) Commercially Processed RTE Foat- fauna in the following ve(th o of the Food Code and 105 CMR 140'F' 590.000. _ 3403.11(E) Retraining Unsliced Portions of Beef Item I Good Retail Practices FC 590.000 i Roasts"` F23_ 1j danagement and Personnel FC-2 ,om Ig Proper Cooling of PHFS 24 Food and Foo Protection FC 3 .004 __-_ _ _n tt . . .005 3-501.14(A) Cooling Cooked PHFS from 140'F to 25 Equipment and Utensils FC-4 _ _ 26. Water.Plum _ bin and Waste FC 5 .006 70'F Within 2 Hours arc(Front 70'F L28,_: Ph s1cal FacilityFG-6 .007 to 41'F145'F Within 4 Hours. * Poisonous or Toxic MaterialsFC-7 .008 3-501.14(13) Cooling PHFs Made From Ambient S eP eial Requirements009 Temperature Ingredients to 41'Fl45'F Othsr (__ ............ .. Within 4 Hotu's- s.o xo.nasx:.z o�� *Denotes critical item in thetederat 1999 Food Code or 105 CMR 590.006, CITY OF SALEM BOARD OF HEALTH Establishment Name: LL A(/r/ /,r to Li ANIS Date: 3 -/n- 0 Page: / of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date i No. Reference R—Red Item Verified - PLEASE PRINT CLEARLY S;. t LYS it Z / 2 /f /J ii e ✓ l Poi/C �t i �� di s m 19A,1L / ) q i � s l"�s i� � c� � � Ps lid" ✓/ /�Ge- .f!C9/,.¢. 's 42� n u� Zfe "rPGL" n e 4221-cl 4IZ� S P ) tis �r ';�� 4_A1 �,es v-ash � 1e Fd-�-P 14e, N .v 117 (�4ldles / 4c rn /eke ywrsh e cL NeeC15G° P�'QI tiP Peri ✓ f 9z /GUO Pc f C'A , v ,,O vC /d& cd✓e,k J Jff�S ry C P P L1 9- PCG of L/ �I S 7n L/ 4 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/ inspection, to observe all conditions as described, and to Exclusion violations before the next ins p ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that i noncompliance may result in daily fines of twenty--f+ve dollars-osuspensl n/revocation of Li Embargo Ll Emergency Closure your food permit. �i > �� \ "-"-��-- 0 Voluntary Disposal ❑ Other: 3-501.14((') PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk According to l.aw Cooled to Factors(items 1-22) (Cont.) _ 4VF/45"F Within 4 Hours.=" PROTECTION FROM CHEMICALS 3-501.15 Ca lhtglle8rods for PHFs Food or Color Additives 19 PHF Hot and Cold Holtling . 3-501.16(6) Cold PHFs Maintained at or below 1- 20212 Additives" 590.004(F) 41"145°F- 3-30114 Protection froth Unaplrrtn•ed .lddrtives` 3-501,16(A) Ihrt PHFs Maintained A or above Lis Poisonous or Toxic Substances 140"F''. =" 7-101.11 Identifying Information-Original 3-501.16(A) Roasts Held at or above 130'F. Containers 7-102.11 Common Name I-Working Conatiners* 20 Time as a Public Health Control 7?01.11 Se arttion-SEorage"' 3-501.19 Time as a Public Health Control's 7-20211 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use* _ 7-203.11Toxic Containers REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitturs.Criteria-Chemicals* POPULATIONS(HSP) 7-204.12 Chemicals forWashin*Produce, Criteria 2'l. 3-80 L 11(A) Unpasteurized Prep Aaged.Juices and Beverages with WarnmglatbeWl 7-204.14 Drying Agents.Cuteric" 3-801.11(B) Use of Pasteurized Epp- 7-'?05.11 Incidental;Food Cont let,Lubricants* 7-206.11 Restricted Use Pesticides,Criteria 3-801.1.1(D) Raw or Partially Cooked Animal Food and Rau Sccd S trouts Not Served 7-206.1.2 Rodent Bait StationO 3-801.11(C) Unopened Food Package Not Re-served. 7-206.13 Tracking Powders, Pest Control and Monitorine' CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer.Advisory Posted for Consumption of Animal Fools native Raw. Undercooked or 1G Proper Cooking Temperatures for PHFs Not Otherwise Processed to Eliminate r nvcr 2oar 3=101.I1A(1)(2) Eggs- 155'F h Sec. Patho,cre Lugs-immediate Service 145`1715sec' 3-302 13 Pasteurized Eggs Substitute for Raw Shell 3401.11{A)(2) Comminuted Fish.Meats&Game Egg'* Animals- 155'F 15 sec. SPECIAL REQUIREMENTS _ 3-401.11(6)(1)(2) Pork and Beed Roast- 130'F 12'1 nun" ;90.00 Violations of Section 590,009(A) (D)in 3-401.11(A)(2) Rattles,Ljected Meats- 155'F 15 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 ander 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 risk factors. Other 145°F r` 590.009 violations relating to`fiord retail 3-401.12 Raw Animal Foals Cooked in a practices should be debited under #29- Microwave 163'F* Special Requircmenis. 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.1.1(A)&(D) PHFs 165'F 15 sec. # (Items 23-30) 3 403.11(B) Microwave-165'F 2 Minute Standinze Critical'and non-critical violations, which do not relate to the Tine* foodhorne illness iarervcruians and tisk factors listed above, can he 3-403.11(C) Commercially Processed RTE Food- found in the following sections of the Food Code and 105 CAIR 140'F'" 590.000. _ 3403,11(E) Remaining Unslieed Portions of Beef Item Good Retail Practices FC 590.000 Roasts' i 23 Management and Personnel FC-2 .003 1g Proper Cooling of PHFs P4. Food and Food Protection__ FC-3 .004 -- 25. E m ns meet and Uteils _FC 4 005 _ 3-501.14(A) Cooling Cooked P1IFs from 140'F to 26. Water.Plu_mbinp and Waste FC 5 .006 70`F Within 21tours and From 70'F _ al i 27. Ph sical Facility FC_6 .007 35()114(6 Icmicriil�ur�lnMr gdicntsourt * _28 iPoesia Regrrerne Matenals ` FC 7 008 to41'F/4i°F Within4H ) € m Ambient 29 $Qecial Requirements 009 1 b to 41"F1450F 30 . Other Within 4 Hours* s.^,oionnn,a„az ao� Denotes critical item in the federal 1999 Food Code or 105 C94R 590-000. IMPORTANT MESSAGE 9 FOR DATE TIME ,//,�?P.M. M //s' ,2 OF e 3h444!7 PHONE6?'�flL��U—X1.3 0'3 AR CODE NUMBER EXTENSION D FAX D MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU [RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE 4 oaee SIGNED V� FORM 4009 YYYY���O MAOE IN UJ S.A. NOTES oci6) CITY OF SALEM, MASSACHUSETTS LICENSING BOARD 120 WASHINGTON STREET 978-745-9595 ext.421 NOTIFICATION FORM IF YOUR APPLICATION INCLUDES THE SERVING OF FOOD YOU MUST HAVE THIS FORM SIGNED BY THE HEALTH DEPARTMENT PRIOR TO SUBMITTING YOUR APPLICATION TO THE LICENSING BOARD. (this form MUST be signed and returned with your application). NAME OF BUSINESS Corporate name: Il Bucca Italiana Restaurant, Inc. d/b/a: LOCATION: 140 Washington Street, Salem, MA 01970 TELE. # 978-745-9100 TYPE OF LICENSE Restaurant APPLICANTS INFORMATION Name: Patrice M. DeSa Home address: 21 Whitby Street Cit,; E. Boston State: MA Zip: 02128 Home tele. # 617-567-0237 HEALTH AGENT/INSPECTOR'S COMMENTS: Hqgh Agent notification fam r: CITY OF SALEM BOARD OF HEALTH Establishment Name: -r/ 13OCC a ria / a n a Date: /A - a - O 3 Page: of ;Z_ Rem Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTIONDate No.. Reference R-Red Item Verified " .. .PLEASE PRINT CLEARLY A. 04 o t 4 Vohder esr~ horJ.P /se,f lPd / %'/oz.s and w AMU rye ew o > n e t v 4F 4 S4,14 e 0 d axle . - -rhzeo, w Nl kae, Sl/ bi tR � Ik J l� � /P� r.Xtq �/IL Q,KGJ dllSLrWGS�d� GU/ �i Q tavOSI��, GU//I 5caw 4tu, he, ,a- e..94/--Aod. Puse time /HW eer/y U eQv Iced d ✓o d d ,til &V;7 /o 34P +-tc4e 4r 4 Wdt nol be, IJP %t tLv rlitw /Jpr c� o-/ Aeo l/ C H A u es /u ro u P aaE�T ST.�v�7U/C� /6,06rv 5 a° e v/ ..od eke. /ISD aF /-�E9-cTl �,uD f.�� �o✓E/� ale /ar u/fi�eJ• f�twel� �o��s r 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/ violations before the next inspection, to observe all conditions as described, and to Exclusion � p ❑ 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. - ❑ Voluntary Disposal ❑ Other: 1 t 3-501.14(C) PHFs Received at Temperalures Violations Related to Foodborne fitness Interventions and Risk According to Law Cooled to Factors(items 1-22) (Cont) 41°F145°F Within 4 Hours. 19 CooPHF Hot . PROTECTION FROM CHEMICALS �-501.10 Cooling Methods for PHFs 14 Food or Color Additives and Cold Holding _ 3-501.16(13) Co1dPAFs Maintained at or below3-202.12 Additives* 590.004(F) 41^/45°F* 3-30214 Protection from lTnat.Waved Aglditives't 3-SOl.tfi(A) Her PHFs n4aintained at or above 15 Poisonous or Toxic Substances 140°F. * 7-101.11 Identifyiatglnformation-Original 3_501.16(A) Roasts Held at or above 130'F. Containers" 1-102.11 Conunon9anre-Workin Containers'' 20 Time as a Public Health Control 7-201.1.1 Se.aranon-Stot 7gc"' 3-501 19 Ttr_ne as a Public Health Control* 7-20211 Restriction-Presence and Use* 590.004(H) Variance Req uh-ement 7-202.12 Conditions of Use* 7-203.11 TOXie Containers-Prohibi ons* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers.Criteria-Chemicals* POPULATIONS HSP) 7-204.12 Chemicals for Washing Produce,Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged.luices and 7-204.14 Drying A eats.Criteria* Beverages with Wanare Labels* 7-205.11 Lrcidental Fwd Contact,Lubricants* 3-801.11(B) Use of Pasteurized F,,-s* 3-801.11(D) Raw or Pao ally Cooked Animal Food and 7-206.12 Restricted Use Stations* C6teria* Raw Seed S)routs Not Served."' 7-206.1.2 Rodent Halt Stations* 3-801.11(C) Unopened Food Package Not Rc-served. 7-206.13 Trading Powders,Pest Control and Monitoring" CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Fo ods`fhat are Raw, Undercooked or 16 Proper Cooking Temperatures for Not Otherwise Processed to'Eliminate PHFs moon""014 3-4(}1.11 A(1}(2) Eggs- 155'7 15 Sec. Patbotc.ns f t;Rs-Immediate Service.1450FISsec:* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish.Meats&Game Eggs* Animals- l55°F 15 sec. 3-401.11B)(1)(2) Porl and Beet Roast- 130°F 121.milO SPECIAL REQUIREMENTS _ 590.009(A)- 3-401.11(A)(2) Ratites, Injected Meats--155°F 15 @I Violations of Section 590009(A}(D)in Se,, * catering, mobile food, temporary and 3-401.11(A)(3) Poultry,Wild Game.Started PHFs- residential kitchen operations should be Stuffing Containing Fish,Meat. debited tinder 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 risk factors. Other 145°F* 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under ll29- Microwave 165`F* Special Requirements. 3-401.11(A)(1)(b) All Other PHFs- 145°F15 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(13) Microwave-165'F 2_Minute Standing Critical and non-critical violations, which do not relate to the Time" jitodborne tiluess interventions and risk factars tested abave, can he 3-40311(C) Commercially Processed RTE Food- ,found in the follrmzng sections of the Food Code and 105 CMR 14017* .590.000. 3-403.1i(E) Remaining Unsliced Portions of Beef ` Item Good Retail Practices k FC 590.000 Rr,a7sts* 23 Management and Personnel FC-2 .003 1 24 Fd d Food Protection FC-3 .004 Ig Proper Cooling of PHFs Food an ----- +- 25. E uiment and UtensilsFC 4 005 _ 3-501.14(A) Cooling Cooked PHFs from 140'F to 126. Water.Plumbin and Waste FC-5 .006 70'F Within 2 Hours and Front 70'T 27. Ph sisal Facilli -QFC-6 .007 to 41°F(45°F Within 4 Hours. * L 28 Poisonous or Toxic Materials FC-7 .008 3-501.,14(B) Gmliug PHFs Made F'ronn Ambient 1 29. S ecial Regglrements _ _009 Temperature Ingredients to 4P'F/45`F 30. Other _._ _._ ---- --� 'Denotes critical item in t 6e federal 4999 Food Code or 105 CMR 590.000. CITY OF SALEM 't BOARD OF HEALTH i{ r� Establishment Name: Date: / y �l - 63 Page: of Rem Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION pate No. Reference. R—Red Item Verified y PLEASE PRINT CLEARLY 'T C, S✓ a ca t n fm _ l • a ledl06 0 _/'Z2 l i U k_J � - - e - _ wc k 11 (+ Sr �< E g7titvdorJs .�/d7 In PP, Zg u w f �8 - t U--1 av At ,,. 1 tqaaz. t P y 1. elll n Discussion With Person in Charge: Corrective Action equired: Lf 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 3 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. / / A I 4 ❑ Voluntary Disposal ❑ Other: s � 3-501.14(C) PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk Aceoidint;to Law Cooled to Factors(Items 1-22) (Cont,) 41.°1-/45°F Within 4 Hours. PROTECTION_FROM CHEMICALS 3-501.15 Cooling Methods for PHFs Food or Color Additives 19 PHF Hot and Cold Holding 14 3-501.16(B) Cold PIIF,s Maintained at or below 3-202.12 _Addnncs'r 590.004(F) 41°145°F* 3-302.14 protection from Unapproved AddfGve 'w 3.50[ 16(A) Hot PHFs Maintained at or above 15 1 Poisonous or Toxic Substances 140°F.* 7-101.11 Identifying Information-Original 3-501.16(A) Roasts Held at or above 130`"F. Contarners t59�0(.�004(H) Time as a Public Health Control 7-102.11 C parati 'Vatne-Workitt*Containers* Time as a Public Health Control7-261.11 Se.oration-Storage"7-202.11 Restnction-Presence and Cine" VarianceRe'cuiretnent 7-202.12 Conditions of Use REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibitions' POPULATIONS(HSP) 7-204.11 Sanitizers.Criteria-Chemicals* ---- 7-204.12 Chemicals for Washing Produce.Criteria* 21 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.14 Drira, Agents.Cotena* Beverages with Warning Labels* '7-265.11 Incidental Food Cont tet,Lztbrieants" 3-801.11(B) Use of P isteurired Hens` 7-206.11 Restricted Use Pesticides,Criteria* 3-501 1 I(D) Raw at Partially(,calked Animal Food and Raw Seed Souls Not Seised. 7-206.12 Rodent Bait Stations* 3-801.1.1(C) Unopened Food Parka�e Not Re-served. 7-206.13 Tracking Powders, Pest Control and �`" -- Monitorine' CONSUMER ADVISORY TIME/TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods 9'hat are Raw, Undercooked or 16 Proper Cooking Temperatures for Not Otherwise Processed to Eliminate PHFs Ee.omx r �wi 3-401.11 A 1O(2) Elms- Pathogens 155'F 15 Sec. Lc s-Immediate Service 145°FL5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell T467.11(A)(2) Comminuted Fish.Meats&Game Eggs' Animals- USF U see. 4' SPECIAL REQUIREMENTS 3-401.11.(A)(2) Ratiics, Injected Meats'- t55°F 15 3-401.11(B)(1)(2) Polk and Beef Roast- 1.30°F 121 min* 590.009590.009(A)-(D)(A)-(D) Violations of Section nn aU - 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 risk factors. Other 145-T 4` 590.009 violations relating to good retail 3-401.12 Raw Aminal Foods Cooked in a practices should be debited under#29 - Miciowave 165°F* Special Requirements. 3-40 1.11(A)(1)(b) All Other PHFs-145°F'15 sec. * 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 103.'11(A)&(D) PI IFs 165°F 15 sea * (Items 23-30) 3-46311(13) Microwave- 165'F 2 Minute Standing, Critical and non-critical violations, which do not relate to the Time* foodborne illness inten,entions and risk factors listed above can be 3-403.1.l(C) Commercially Processed RTE Food- lutrnd in the following sections of the Food Code and 105 CMR 146°F` 590.000. 31103.1.1(B) Remaining Unsliced Portions of,Beef ? It Good Retail Practices i FC 590,000 Roasts'` 23. Management and PersonnelFC-2 .003 _ 24 Food and Food Pra2ection FC-3 .004 1g Proper Cooling of PHFs - ---- -- -, 25. EgwpmPnt and utensiis FC 4 .005 3-501.14(A) Cooling Calked PHFs from 14W to -_-" - --" --" -"- '0 -- a 26. Water.Plumbing and Waste FC 5 .006 76 F Within 2 Hours and From 70"F 27. Physical Facile �FC-6 .067 to 41°Ft4s"F Within 4 Hours.* j_28 Poisonous or Toxic_Materials FC-7 .008 3-5(11.14(B) Cooling PHFs Made From Ambient 20 Special Requirements 009 Temperature Ingredients to 41°FI45"F 30. Other _ ----- _ Within 4 Hours* s-'Y:,f n11C..4 *D noir,critical!rem in the federal 1999 Foal Cale of 105 Chin 590.000. New Italian restaurant set to open early next year SALEM—A new Italianrestau- holic Beverages Control Commis- rant may open in the downtown sion for approval. where Troisi's is now located. The new owners,Vander and On Monday night,the Licensing Patrice DeSa of East Boston,said Board approved the transfer of a they hope to start the new restau- seasonal beer and wine license from rant early neat year. Troisi's Italian Cuisine, 140 Wash- Troisi's,which remains open for to Il Bucca Italiana.The business,opened in 2002. the state Alco- –Tom Dalton r R � 7 ernment yesterday raised the na- tional threat level to orange,indi- i eating a high risk of terrorist at- e . 'A,- tack,and said threat indicators are *&P, 'perhaps greater now than at any point"since Sept, 11,2001,with ?,I strikes possible during the holi- days. Americans were promised"ex- tensive and considerable protec-tions"around the country and told s to stick to their travel plans de- spite intelligence indicating the al- Qaida terrorist network is seeking KIRA HORVATH/Staff photo again to use planes a— an ders dealt with a lagging econo- and exploit susr' U.S.aviatio Som e .