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REYMIRAS MARKET - ESTABLISHMENTS 3 5 a Pe recd -Poa 7p-' 51— a-,�q 4 -� o.�us<-- of S�°P�•��,�os It �'• y' �� YeSc ted w,9 �-�1- �-cc/c�-1- yx L, - c%�-v � �o(C �-v�- �c est• _ e (-o1(( Gvl( ( C-� /4 Ar _ 9 :n _ ny y e R. rt x i 4 _ o 4 u ► Commonwealth of Massachusetts « r City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 05/19/2011 ESTABLISHMENT NAME: Reyniira's Market File Number:BHF-2004-000099 113 Lafayette Street Salem MA 01970 LOCATED AT: 0111 LAFAYETTE STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes RETAIL FOOD BHP-2011-0438 May 19,2011 Dec 31,2011 $70.00 TOBACCO VENDOR BHP-2011-0439 May 19,2011 Dec 31,2011 $135.00 Total Fees: $205.00 PERMIT EXPIRES December 31, 2011 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. Pagel . CITY OF SALEM, MASSACHUSETTS * BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGREENBAUM@SAJJ-,M.COM DAVID GREENBAum,RS ACTING HEALTH AGENT 2011 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT :RE`j W (V � / UkA.12 t<6+ TEL# gff' j y& 5ag� o[ ADDRESS OF ESTABLISHMENT �) " Ili IYII`I"(-E G- FAX# MAILING ADDRESS(if different) EMAIL- Business': Website: Q OWNER'S NAME QFJQA Qsch'&S sfE060U k)OUv4 TEL# 7 / o S5a 9'/O ,l ADDRESS 0 Ci>E�61 R A � SA 16 d-t t.i A L � `11 V STREET CITY // STATE ZIP �• CERTIFIED FOOD MANAGER'S NAME(S) FN & �G�,7ZL��ydVTIFICATE#(S) (Required in an establishment where potentially hazard us food is prepared) EMERGENCY RESPONSE PERSON HOME TEL# DAYS QF OPERATION Monday`• TuesdaK- 'vWednesday �Thursd "Fdd_ay, - SatuNay Sunda HOURS OF OPERATION / Please write in time of day. C� -�-- (For example llam-11 I TYPE OF ESTABLISHMENT FEE (check only) RETAIL STORE ES NO- less than 1000sq.fl. _$7 1000-10,000sq.ft. =$280 more than 1 0,000sq.ft. =$420 ------------------------------- --------------------------- -------------------------------------------------.-...------------------------------------- RESTAURANT YES 0 less than 25 seats =$140 (Outdoor Stationary Food Cart$210) 25-99 seats =$280 more than 99 seats =$420 - ----------------------------------------------------- --------------------------------- BED/BREAKFAST/ YES N0 $100 CHILDCARE SERVICES/NURSING HO ---------------------1y ff---------------------------------------------------------------------------------------------------------------------------------------------------------------- ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT/SOFT SERVE YE& dC $2 TOBACCO VENDOR (S'E,S/ NO 135 ALL NON-PROFIT(such as church kitchens) Y S NO *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 knowledge and belief,have filed all stale tax returns anp paid all state taxes required under the law. L /�I � /Z Si ure D to Social Security or Federal Identification Number Revised 10/7/11 FOODAP201 Ladm Check#&Date -------_------------- $ �yJ ___—__- ----- ,p Commonwealth of Massachusetts r �Lr City of Salem Board of Health IGmberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/12/2009 ESTABLISHMENT NAME: Reyntira's Market File Number:BHF-2004-000099 113 Lafayette Street Salem MA 01970 LOCATED AT: 0111 LAFAYETTE STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes RETAIL FOOD BHP-2009-0358 Jan 9,2009 Dec 31,2009 $70.00 TOBACCO VENDOR BHP-2009-0359 Jan 9,2009 Dec 31,2009 $135.00 Total Fees: $205.00 PERMIT EXPIRES December 31, 2009 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 1 P w E ? Commonwealth of Massachusetts • r City of Salem Board of Health 1Gmberiey Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/03/2008 ESTABLISHMENT NAME: Reymira's Market File Number:BHF-2004-000099 113 Lafayette Street Salem MA 01970 LOCATED AT: 0111 LAFAYETTE STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes RETAIL FOOD BHP-2008-0091 Jan 3,2008 Dec 31,2008 $70.00 TOBACCO VENDOR BHP-2008-0120 Jan 3,2008 Dec 31,2008 $50.00 Need additional$85 to fully pay Tobacco fee.Will send new permit when paid in full. Total Fees: $120.00 PERMIT EXPIRES IDecember3l,2008 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 12 of 15 i CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH =:..s '�ecrfiNg�F``r 120 WASHINGTON STREET,4art FLOOR TEL.(978) 741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 RECEIVEDtSCa MAYOR EM OOM JOANNE SOOTT, DEC 10 2001 14EALTHAGENT CITY OF SALEM BOARD OF HEALTH 2008 APP T,IION FOR PERMIT TJO� PERATjE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENTO!/ n��/I� ADDRESS OF ESTABLISHMENT) 1 / 3 s��t«�l�/ -/5e--FAX# ` 7 9— MAILING ADDRESS(if different) �5a EMAIL-Business': Website: OWNER'S NAME TEL# 7 ADDRESS �GIO 10-r11U, 0 �f f tP G/<y� lryz76 STREET CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) CERTIFICATE#(S) (Required in an establishment where potentially zardous food' prepared) / - - EMERGENCY RESPONSE PERSON 4 Ila `c e Z L r�� OME TEL# DAYS OF OPERATION Monday Tuesday Wednesday Thursday Fdda SaturdaySunda HOURS OF OPERATION D �U' '7,S-j "736 7- 30 `7_ . 3 L7 4. 3 f7 b Pj Please write in bine of day. 7 �,3 ??�� s 1l,, �D For example 11am-11 m x 10-m 7D• (9- IVB "D 9 6' QV ( - ` rr, 16) TYPE OF ESTABLISHMENTFEE (check only) RETAIL STORE YES NO less than 1000sq.ft. _$70 1000-10,000sq.ft. 80 more than 10,000sq.ft. =$420 r. - . ..............:..... ............................................ -RESTAURR.AANN T ,.. YES NO less than 25 seats =$140 _(Cutd�r St�tanPrv.E0od Cart$210) .- 25-99 seats,. . =$280. . Ica! _more thhaap,99 seats =$420 BED/BREAKFAST/ YES NO a $100 CHILDCARE SERVICES ADDITIONAL PERMITS MAKE (notjust serve) ICE CREAM, YOGURT/SOFT SERVE YES NO $25 TOBACCO VENDOR YES NO 5 ALL NON-PROFIT(such as church kitchens) YES 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 knowledge and belief,have filed all state tax retur nd paid all a taxes regwr under the law. tia au. .« c)5? - 70 Signature Date Social Security or Federal Identification Number � j - � � ------------------- Revised 4/24/07 FOODAP2008.adm Chccki!&Datc �/ 2 Z $ � w6az oy) --�o C& KA, � at YY1QZKt5 i� o ' n 1�eth -ckto at t { 1 �i I i ____--- , _�--- .-- ._--- :=;>� ___--- 1 I �, i _ � -" Ilas§achusetts Department of Public Health Salem Board of Health Division of Food and Drugs p 120 Washington Street,4'" Floor. g Salem, MA 01970-3523_ �7450343 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Name Date Type of ODeration(s) Tvpe of Inspection �s A/\:N n 1 e )P� I I' 1A ❑ Food Service ❑'Routine Address < e� Risk V Retail E Re-inspection T I t -gn Jo, ^ a A4 Level Residential Kitchen Previous Inspection Telephone () K O o „a m ❑ Mobile Date: Owner HACCP YM [ITemporary ElPre-operation - n n as 12,r� .i o r A-P-A ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) _ Time 3�_ ❑ Bed&Breakfast [I General Complaint v i In:;1(f(�1'C) ❑ HACCP Inspector ti1�` �( � 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) ❑Q 590.009(F) ❑Q action as determined by the Board of Health. mFOOD PROTECTION MANAGEMENTg.,. .„ .� trr`i e ❑ 12. Prevention of Contamination from Hands ❑ 1 PIC Assigned/Knowledgeable/Duties h EMPLOYEE HEALTH ''-" ❑ 13 Handwash Facilities .aL- 11 PROTECTIbNFROM CHEMICALS t a ; ❑ 2. Reporting of Diseases by Food Employee and PIC o e �_: -�� ���:�����-�:» �zr�.9e� ��6 ❑ 14.Approved Food or Color Additives ❑ 3 Personnel with Infections Restricted/Excluded wm m0 x�aix0ai acre 4i,.� A ❑ 15.TOXIC Chemicals 4 FOOD FROM AF?PRQVED SOURCE ii TIME7TENIPERATURE CONTRQLS F+otential HBardous Foods E) 4. Food and Water from Approved Source , �E yE µ (�� y h y ) E] 5. Receiving/Condition El 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 1 B. Cooling 9" ,-.' � ' m Mp El 19. Hot and Cold Holdin #"PROTECTION FROM CONTAMINATION, a a 9 ee L Yt '03+CI 4dtf u.diifiR�i.vpw.6 u El 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing - A REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS".(HSP)'.j El21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices i CONSUMERADVISORY, " a,� p YkI ❑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 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 (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 ssomuecFo�ia 000 Inspector's Signature: ,, a (� Print: PIC's Signature: �/ ti �� Print: �''7-t ;, „ e J�.�, Page- Page _of s Violations Related to Foodborne Illness Interventions and Risk Factors(Items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Cross-contamination 1 590.003(A) Assil tment of Responsibility* 3-3011](A)(]) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* Conked and RTE Foods* &103.11. Person in charge-duties Contamination from Raw Ingredients 3-302.11(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 3-302.11(A) Food Protection* applicants* 3-302.15 W'ashin Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.11. Foci Contact with Equipment and Applicant_To Report To The Person In Utensils* Charge* Contamination from the Consumer 590.003(G) Re orcin b Pern>n in Char=e* 3-306.14(A)(B) Returned Food and Reservice of Foci* 3 1 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(F.) Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501..11 t Manual Warewashing-Hot Water 3-201.1.2 Food in a Hermeticall•Sealed Container* Sanitization Temperatures, -- 3-20113 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 She11ER s* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-temp.,PH, concentration and hardness.* 3-202.16 Ice Made From Potable Drinkin-Water* 4-601.1[(A) Equipment Food Contact Surfaces and 5-101.1.1 DrinkingWater from an Approved System* Utensils Clean' 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0"' Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702.11 Frequency of Sanifization of Utensils and 3-201.14 Fish and Reerea tonally Caught Molluscan Food Contact Surfaces of Equipment*, 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 Regulatort,Authority 2-301.11 Clean Condition-Hands and Arms* 3-202.18 Shellstock Identification Present* 2-301.-1.2 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201..17 Game Animals* 11 Good Hygienic Practices LS Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHEs Received at Proper Temperatures* 2401.12 Discharges From the Eyes,Nose and 3-202.'15 Package hate grit,* Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting" 6 Tags/Records:Shelistock 12 Prevention of Contamination from Hands 3-202.18 -Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.12 Shellstoek Identification Maintained* Em to•ees* Tags(Records:Fish Products 13 Handwash Facilities 3402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records.Creation and Retention* 5-203.11 Numbers and Capacities* Labeling of Ingredients* 5-204.1.1 Location and Placement* 5)0.004(1) g g Conformance with Approved Procedures 5-205.11 Accessibility.Operation and Maintenance 9 /HACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized Processing Methods* Devices 3-502.1.2 Reduced oxygen packalting,criteria* 6-301.11 Handwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures* b-301..1.2 HandDn*Provision Denotes critical item in the federal 1999 Frond Code or 105 CMR 590.000. x < BOARD OF HEALTH Establishment Name: n,.� /, �l y. A n ,PD Date: I Jo Page: Of Item Code C-Critical Item DESCRIPTION OF VIOLATION / PLAN OF CORRECTION ' Date No. Reference R—Red Item _ :_' ' PLEASE PRINT CLEARLY;' ' � � ` Verified /k r 1 Ab �•�n nne �� // -/ o V lX.: l - V oD x pn .nn/r v �Cb D�i :./ -- — v 11'� �91\na � - - duo r )l&A _ri jAn1 /n_i / (, /7d/� DVn A /1 �2,/ i •� — III Discussion With Person in Charge: Corrective Action Required: �lo L71 Yes ❑ Voluntary Compliance 4 ❑ Employee Restriction / Exclusion r ❑ Re-inspection Scheduled ❑ Emergency Suspension t I t t ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other i �. FORM 734B (REV. 7/2000) HOBBS &WARREN, - BOSTON This Form Approved by the Deportment of Public Health i Violations Related to Foodborne Illness Interventions and Risk 3-501.14(C) Received at Temperatures Acco Factors(Red Items 1.22) (Cont.) According to Law Cooled to 41°F/45°F Within 4 Hours.* PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives* 3-501.16(B) Cold PHFs Maintained at or below 3-202.14 Protection from Unapproved Additives* 590.004(F) 41°F/45°F* 15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 7-101.11 Identifying Information-Original 140°E* Containers* 3-501.16(A) Roasts Held at or above 130°F.* 7-102.11 Common Name-Working Containers* 20 Time as a Public Health Control 7-201.11 Separation-Storage* 3-501.19 Time as a Public Health 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) 7-204.11 Sanitizers,Criteria-Chemicals* 21 3-801.1I(A) Unpasteurized Pre-packaged Juices and 7-204.12 Chemicals for Washing Produce,Criteria* Beverages with Warning Labels* 7-204.14 Drying Agents,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(D) Raw or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides,Criteria* Raw Seed Sprouts Not Served.* 7-206.12 Rodent Bait Stations* 3-801.11(C) Unopened Food Package Not Re-served.* 7-206.13 Tracking Powders,Pest Control and Monitoring* CONSUMER ADVISORY 22 3-603.11 Consumer Advisory Posted for Consumption of TIME/TEMPERATURE CONTROLS Animal Foods that are Raw,Undercooked or 16 Proper Cooking Temperatures for not Otherwise Processed to Eliminate PHFs Pathogens.* Enecrve 11112001 3-401.1IA(l)(2) Eggs-155°F 15 Sec. 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell Eggs* Eggs-Immediate Service 145°F 15 Sec.* 3-401.11(A)(2) Comminuted Fish,Meats&Game SPECIAL REQUIREMENTS Animals- 155°F Sec.* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(B)(1)(2) Pork and Beef Roast- 130°F 121 Min.* catering,mobile food,temporary and 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 Sec.* residential kitchen operations should be 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs, debited under the appropriate sections Stuffing Containing Fish,Meat, above if related to foodborne illness Poultry or Ratites- 165°F 15 Sec.* interventions and risk factors. Other 3-401.1 l(C)(3) Whole-muscle,Intact Beef Steaks 590.009 violations relating to good retail 145°F* practices should be debited under#29- 3-401.12 Raw Animal Foods Cooked in a Special Requirements. Microwave 165°F* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 Sec.* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 17 Reheating for Hot Holding (Blue Items 23-30) 3-403.11(A)&(D) PHFs 165°F 15 Sec.* Critical and non-critical violations, which do not relate to the 3-403.11(B) Microwave- 165°F 2 Minute Standing foodborne illness interventions and risk factors listed above, can be Time* found in the following sections of the Food Code and 105 CMR 3-403.11(C) Commercially Processed RTE Food- 590.00. 140°F* Item Good Retail Practices FC 590.00 3-403.11(E) Remaining Unsliced Portions of Beef 23. Management and Personnel FC-2 .003 Roasts* 24. Food and Food Protection FC-3 .004 18 Proper Cooling of PHFs 25. Equipment and Utensils FC-4 .005 3-501.14(A) Cooling Cooked PHFs from 140°F to 26. Water, Plumbing and Waste 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 FC-7 .008 3-501.14(B) Cooling PHFs Made From Ambient 29. Special Requirements .009 Temperature Ingredients to 41°F/45°F 30. Other Within 4 Hours* *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. .ti'nt3H.r�.w}-1+.'i..".okF- t`nPN>.'+'.n.<.�✓'Rfe,ra.sfi'v�-..i.�mfti{y'p+e..rityy.""...�"'r�n!+.rrn ne•t.,. � * n r. +. -.d..,.m.:nA.<... Jpr,... ,..w"A4i�"wu�'A�`'Y.t. •"''�4..iMsf Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,4'" Floor 9 Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name Date` Tvoe of ODeration(s) .Type of Inspection /An t C\ 4A kzL Food Service Routine AddressI ➢ O Risks Retail Re-inspection Level II Residential Kitchen Previous Inspection TelephoneC ❑ Mobile Date: Owner ' HACCP YIN El Temporary E] Pre-operation I. Ann 0A h ❑ Caterer ❑ Suspect Illness Person in Chat&(PIC) Tie ❑ Bed&Breakfast El General Complaint Inspector p Permit No. ElOtherCP Each violation checked requires-an explanation on the narrative page( ) 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 ?` ElEMPLOYEE HEALTH - ' - F 13. Handwash Facilities PROTECTION FROM CHEMICALS°'q� e e I-i et �❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14. Approved Food or Color Additwes ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15.Toxic Chemicals a FOOD TIME/TEMPERATURELONTROLS Potentiall' Haardous Foods ❑ 4. Food and Water from Approved Source ( Y ) g x.. ❑ 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 - ti'.REQUIREMENTS FOR HIGHLY SUSGEPTISLEPOPULATIONS(HSP) _ El21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing CONSUMER ADVISORY ,� ;­LLi X0_4 El 11. Good Hygienic Practices -< ❑22. Posting of Consumer Advisories Violations Related to Good Retail Practices Number of Violated Provisions Related ❑v 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 by a Board of Health member or its agent constitutes an 23. Management and Personnel (Fo-2)(590.0 order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.0044))) 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 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:ssotrispecrFormsiaooc ,ink � ))�\C�✓N-�/Wj;�' r 1 1(�M�-. 7/(JJ�r Inspector's Signature: ,, Print: PIC's Signature: 40" Print: ^n. Page of -Pages Violations delated to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT S Gross-contamination 1 590.003(A) Assignment of Responsibility* 3-302.1IWO) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103.11. Person in charge--duties Contamination from Raw ingredients - 3-3021.1(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 repotting by food employee,and 3-302.11(A) Food Protection* applicants* 3-30215 Washing Fruits and Vegetables 590.003(F) Responsibility Of A 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(6) Re ortina b Person in Charge` 3-306.14(A)(B) Returned Food and Reservice of Food* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(F.) Removal of Exclusions and Res actions Food 3-701.1.1 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law`" 4-501.111 Manual Warewashing-Hot Water 3-201.12 Food in a Hermeticall •Sealed Container* Sanitization Tem eratures* 3-20113 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 E sand Milk Products.Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinking Water* concentration and hardness. 5-101.11 DrinkingWater from an Approved System* 4-60111{A) Equipment Food Contact Surfaces and Utensils Clean* 590.006(A) Bottled Drinking Water* 590.0(16(33) Water Meets Standards in 310 CMR 22.0* 4110211 Cleaning Frequency of Equipment Food- Contact Surfaces and Utensils'" Shellfish and Fish From an Approved Source 4-702.11. Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment* Shellfish" 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate Hand-washing Game and Wild Mushrooms Approved by Regulatory Author 2-301.11 Clean Condition-Hands and Arens* 3-202 IS Shellstock Identification Present* 2-301..1.2 Cleanin 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 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and 3-20115 Package Irate it y* Mouth* 3-101.11. Food Safe and Unadulterated* 3-301..12 Preventing Contamination When Tasting* h Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202,18 Shellstock Identification * 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Employees* Tags/Records:Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently located and Accessible 3-402.12 Records,Creation and Retention* 5-203.11 Numbers and Capacities* acities* 590.004(]) Labeling of Ingredients' 5-204.11 Location and Placement* 7 Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Plans - Supplied with Soap and Hand Drying 3-502.11 S ectialized Processin Methods* Devices 3-502.1.2 Reduced ps gen tteka"ng.criteria* 6-301.11 Handwashing Cleanser, Availability 8-103.12 Conformance with Approved Procedures^ 6-3(11.L2 Hand D 'ng Provision ° Denotes critical item in the federal 19991- xA Code or 105 CMR 590.000. E CITY OF SALEM /1 . BOARD OF HEALTH Establishment NameP AA,_nanJ l„A ,PV-r Date:1-- A(4- q Page: of Rem Ccde C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified PLEASE PRINT CLEARLY 1.0 n n n A”)nA :9"ff A. n _ n*, � /`vl��.� V' �n n _5�0,M, VEAL ) /� 6 T t7� AAA r nn i(r�P 16A-� J/Y '2,,A C�nn�� J dK.✓n/Yl, n, 3(� � 'NAV �( NA �—QISA t` U - ,- �-�S:D � ,, Ff�,�rl _ C i 47 ?A, " �k �11 U v } -fin lr� Aan "'aA z _ limn, )"", r�a� t o A _ �A A11 S )AJI ,A n q-6 o, 4 �1 Discussion With Person in Charge: Corrective Action Required: Li '_ if 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 noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: r i 51!1.14((`1 PRFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk According to LauCooled to - Factors((tetras 1-22) (Cont) 41'Fl45"P Within d PROTECTION FROM CHEMICALS 3-501.15 Cooling Medhods for PHFB --- 19 PHF Hot and Cold Holding 14 Food Color Additives_ 3-501.16B) Cold PHFB Maintained at or below 20.12 Add livves* 540.(XWF) 41°/45°F' 3-,'M2,14 PIoteC11oll III I jnapproeed Addnives t.j0 i 16i A) Ifar PFiF,c Maintained at or above 15 identifying or Toxic Substances -1 0 1 1 identifvtn r into:stat t o Ort m cl I4U F. " R -50 Held lot l) Ra +,ts Hild at or abou 130 F + I Connw r - - -- Time as a Public Health Control A j � 7 102.1 1 Common Naaw R ml<! Cut tur r, , I i U t m ss a Public,Haahti Conirot" -I 1 -(`f.11 Srnt Iticn Stria - --- - — �. - n{..1@I=H} �4 , an��:Yi nic.mznt 7-202.11 f Pat t6on -llws,Del, ui7l t- C_ _ �� •.�- - -------- 102- - -'02.12 C;tdnlon-oftise Toxic --- REQUIREMENTS FOR HIGHLY SUSCEPTIBLE -�7—( 11 1 Safifr trainer °rolllhz.._un ' POPULATION'S(HSP)_ 2t! k311 �Sani vets t'titerr Chrr rat ds -- �- 7 0-4.1° Cherioc'i,S for Ua,hl t cxl ui Cfitcra" { '1� ' Sill l t1,� .•nl lemic tl Pr l u ->;od ltncey aud� — { ?eaer i e, ilb Rat cue I,ah is _.770�Y.Ik �D.�ut�.tettte.(nreu;_;--- -' -,Rill 11(BI 1 oi Pa• emizedk I�, -- ti01 K:pe,or I'2_tistl (nun,d Animal f ix:d aa.i I °b6�!( nU t a t°Yr Pr n it1e�Cit ! r - -{--- A<r Svryc.l L 7-206.12 Rakn IS a S'ri on t._r I" eel 1I Xkd Prc tf', \o< R(,_SCJ 7-2,06 l? h:Cn.r,7, Yti ni tl'l 1 CONSUMER ADVISORY TIREITEMPERATURE CONTROLS 22 iI(_t 1 { a em r r s sore r'nct rf r m a n t�taon N 1-_ -._.�. ._ _ --! s { r i❑lie:! <w1 lhav tic K., tn<ae r,Lc.':r. j 16 ; proper Cool{cg Temperatures tor— 7 ! r}BA PHFB n I�� 1 rG,u , a I 1 ' 'D s.,tGl.i.: lc' . rte hS r— �_ ...r.------- t r 1 nn;<oc d ac `zc pica 2 tl ycw- ! i^_ 1 { } C ,rt + s,;. Sur, ! tur Km51ici[- I -- - t ! h lq � ,taotk � •.. __.--_ _>-_— _ -___- __( SPECIAL€SEQUiRE v1Et8s S 4 'i ,I rls!!I )i [>r r ! -. wu ,i 1 t ! 1 ! mill, t k)t r ilip, it I ind ! _! =�1.(il,t ltA) it � Pn(lir $-ild rnr �`tLif 2117�, � icSCi+n2 at Sl tCi7Ci1 Cr{ 3"t({ki= Iii t.icl ho = Ftsh% 'r_._. c.,,,,as d under clic ?,),a cYrriara _ori,; , I J L p, ! RIllllflatiPl tar I 01 I lr is€n- _ _ YaLt/.APON S, f E_?i*'ED r rJ ,00D RETAX RACT?.i"ES {hent 23_30 . 403.1;,Fsi tin s i+, i _'blew,! Sand.m� f Ul,r „ r.udr x• < rt +:. ii mf I! 'FP a r. I ; +i3.illri t..n,tsaeI'd h1'rc). ;?fl }<:xl- 1 _+ .n« O.0)1 ,. _ 403 i'(F! ? !2t I i tt rirnr*L + ei Puna +,r f ti,.e( tPe�r Uooa Ret-l Fr'tebce9 FC 590,000i . ! a !.ray m, t 2 d L-LY r i Proper Cooling of PHFB ' 24 f axl i Foxxi F rotrrnn 4C 3 I(' _ 501.LVA) C rmlin C'arn <j I}(t front 1 41 F is t WE;1'S[lra."Ston;:w;0 From IYI' r? Pais F._, its _ ' FC_- , (Xr. _f to + tt"5`F d tl tr : H u d I rns )t 2r c P re -!�s G 008 r --. - _._.-..�j 501 i4ili) � ('t)o1 PH M a om ' urltent { ,-- " cr!� r f cit„l ttr+t a irau:re I! ruS.u,ts it -1 f id5'F 3r aer -- S Iirindllkw * r "llur �.xriac:fl c .. +F'ari�t fee: iC" ii i!i i�Hl. i CITY OF SALEM BOARD OF HEALTH y Establishment Name: Date: Page: a of Item Codex, C-Cdticaittem � ? �� DESCRIPTION OF,VIOLATION OF,CORRECTION s �; Date. No. Reference' `R=Red Item " s ". t+ ,' r %, as;;i.<•. '• ,t Verified N s 1:41' 11 PLEASE PRINT CLEARLYVV� L1'� • .{.., (` .� 1�, nc w LAAO fiE 7 11�n.✓ —.}� d1 ,1 f _ U .pl`P no lrxcrlc�rC� v P �cA hI �� 1 0 l 1� / ,�� YlrnnP. IN !v IR (Ir� c, 4 ( a 1 Cl( {i v t i t J 1 f t x f 4 1 S }i - t3 v t ! ell � � Ccsi t_ r�r C Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes S " I have read this report, have had the to tions and agree to correct all Voluntary e opporo asquestions ❑ CI Employee Restriction/ i Exclusion 7 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 i( noncompliance may result in daily fines of twee y-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. I,= ❑ Voluntary Disposal ❑ Other: Win• � ✓ ,r . V i Violations Related!to Foodborne Illness Interventions and Risk Accordiag to Iain CMcd to Factors(items 1-22) (Cont) 4 I'Ftt45'F Within 4 Hews. PROTEC'nON FROM CHEMICALS C001ilh'Methods for PHFe 1=4 Food.or Color Additives 19 PHIF Hot and Cold Holding i-501 16(13) -6—)1d PH­F,'Maintained at or t,ednik 3-202 �2 Additive,' 590 004(F) 410/45°F* 3-30114 Protect an fron —1 tt"on Iran,Vila 50 1,1 fr(A) 11 nt PI-}1704aintained at or above Poisonous or Toxic Substances l4WF,-- Pwst��Hold at or 11,1111 110 colrtainer�' 4 Time as a Public Health Control k'uluruon Naw-- Workin"t,ontamor . 7-201.11 Sr .�01 !9 Time as a Public licalth Control, l� eiacwn-Slool e' vw rano Re Dco 7.202.12 Condition of Uwe REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203'.[I Toxic Conmmct� -Probillnionsit POPULATIONS(HSP 7-204.11 SaalUecBCatenathe-chetic nts' C, —; 8()T 1-1�'T� -1JnPNqtcuri/cd flrc-pacl�ailed Alices and 7-204.E——ficlla—cak Rev'raae��with Vvhruii! � 104 14 of,patoulized F'L-s* 21)5-31 IntomalF,xxJ(A ,N7,c s7 1 3-801.11 Q)? R.iworPadialliGx�IoAA ;inval Food and 7. Raw Sed Spn kn�Not Se,wd. 200 11 �,tnoed lot Pe,ticidee.Crihoo* 7-206.12 Roitent Bair Malone, r«s teed Rxxd Tif7)6 73 i lmckmg�P)wdcm P��l Control and CONSUMER ADVISORY 22 -60',I I Consumer Aeynsory Posted for Copwinption of TIMEITEMPERATURE CONTROLS for Aenre)l F'-�Xls'llca ajrc Raw, Undercooked u� 16 Proper Cooking Tearperetwes PHFs Not Oiherwisc flru=le w- � � dto F,Idnin,ae 3 ,-40 1,11 A(l)(2) Fgg.;- 155'F 15 See. i s }msrrctls rte Seniu 1450F]fisec, 3 PaWurrzcd Egg-Subsuarle for Raw Shelf 3-402.I1{A7("} Cormoninted Fish, Meats&Game --- -- - Amrvalq i -135'F SPECIAL REQUIREMENTS 401.11TI3)(1)TFPolkcw l3vd'Rmist 130F121 min- 155'F 15 Violate orr,of Section 590.009(A)-(f7) in oatermgmobil- food,temp oraivand � rc;deai kithe4 0 1,11(Ai 3opelalions 'Iioufd Ne Fish.Id at defined urider the appropriate sections Polldv'ow kavwsA65'1 t55 sec � above if relatod to fcWhornc illness 3-401,11(C)(3) Whole-rnusdc'tmao BeGf Slcaks interventions and risk factor,t 01her 145"F 590.009 vioiations relating to good retail I prauices hoold be debited U, 1 3-40IJ2 rider #29 - Spir,,cmt Reqvircrrlmts d11�he, 11W,- 145,17 1--5 sec.. 17 -iietreating For Hot Holding RELATED TO GOOD RETAIL PRACTICES 1-403,1 J(A)&,tf} 111-11-s 165'F l-')see (Iteno;23 -44) 9-401}(8; 11111,1waw- 165,F 2 Minwe Slanding, Cryo e'a"rIlld non-cl'ofcal Vi0kiliwl, n4och tie,leh relate to thr -I. " ./nodhorne illn"s wofvennomy can be 3-403.11(C) Crmlvl(Urcially paxtsiod kIH.Foxxl- fountl in thelollontom suefiona qf the Food Code and)0,5(,A4R ----------- 3-40 3 11(F) Rejnannng Unslwed Portio—m-Y T,"l—f Item I Good Retail Practices F F r K,-9 Ga 0--0R sari, 1 23, lAsnagempnt an-d-pei-Gnn-ef- 77E-72-7 —06i'--- ---�4, T-F;�-Aan---- ---1 -1--- sling of PHFs d Food Proledion 3 ; .004 Sg Proper 28 E -i-401,14(A) Cooling Cookzrd PHI's from 14fff to ------- 26, ater,oil 7ttof;withill"14ounq and From'101, .-27. physmat Fayfily FC-6 007 4 Rowt. 2F 7 to 4 PF!45-F Within Pmonws or Tom klatena�s ------+ � -M---- -------- — -501 IT(—B) Cooline PHR kladc From Ambient --219� 009 Tempe I i awre Ingredients 1(,4110F/45`17 f 3u other Within4 (tc[rotes critical item In s}x G h i+'i 944 Fess s{;,;dear 105('tett 590NA 7 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 744-5099 Equipment and Utensils FAIL Non-Critical BLUE Owner: Comment:A few lights in back room still missing covers.Provide covers on all lights. Reyna Ramirez Guerrero Physical Facility FAIL Non-Critical BLUE PIC: Steven Nova Comment: Faucet in bathroom runs when shut off.Repair faucet to ensure good working order and no leaking or running. Inspector: GENERAL COMMENTS: Elizabeth Salandrea All other violations from the 3/25/08 inspection report have been corrected. Date Inspected:!Correct By: 3/27/2008 Risk Level: Permit Number: BHP-2008-0091 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®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Apr 02,2008 ) Page I oft Item Status Violation Critical Urgency RED: Violations Related to t4 Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Apr 02,2008 ) Page 2 of 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-5099 Food Contact Surfaces Cleaning and Sanitizing FAIL Critical ❑v' RED Owner: 1.04 ment: One bottle of sanitizing solution available appeared to be water. Provide sanitizing solution of proper concentration and Reyna Ramirez Guerrero test strips at all times,and ensure sanitizer is available when meat is being packaged. PIC: �e knives stored in the knife rack dirty.Thoroughly clean and sanitize knives prior to storage. Reyna Ramirez - - --- - ---- Handwash Facilities FAIL Critical RED Inspector: Elizabeth Salandrea / Comment: Handwash sink missing soap in dispenser. Bottle of dishsoap available at time of inspection.Soap dispenser must be kept stocked at all times. Date Inspected:;Correct By: _ 3/25/2008 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) - - -- - - -- Risk Level: Hot and Cold Holding FAIL Critical ❑J RED 4 mment: Produce unit holding at approximately 55'F. Repair to maintain proper temperature of 417 or lower. Permit Number: alk-in fridge reading 51°F as taken with inspector's thermometer. Fridge must be immediately repaired or turned up to maintain BH_P-2008-0091 temperature of 417 or lower. '�� " Status:-- — -- - - 0,0 Un6bet 4/t)f1d. rrxetf�.. -PARTIAL COMPLY -ibI-C.. � 0-, #of Critical Violations: 4 h N�J� �DVO�nAI Time IN: Time OUT: Tt � PV._1�� Urgency Description(s): �S \'�Q -Slko A6 6, i_siej BLUE: -F 0mV W�b(Q,-FLt- t /vIPj- Violations Related to Good ll 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®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 27,2008 ) Page 1 oft Item Status Violation Critical Urgency RED: Violations Related to Good Retail Practices (Blue Items) Violations Related tq--.. Food and Food Protection FAIL Critical BLUE Foodborne Illness Interventions and Risk Factors (Require Comment:The following outdated items were found back on the shelves: immediate corrective action)- 1 kgs maria cookies e10nestle condensed milk grape fantas Owner must remove these items and closely monitor all expiration dates. OA " packages of meat in reach-in freezer have no labels or have incorrect dates on labels due to a problem with label machine. All meat not in its original package must have proper labelling. Equipment an Utensils FAIL Non-Critical BLUE mment: Reach-in cooler has accumulation of mold on floor under milk section;thoroughly clean this area. cream freezer needs defrosting and general cleaning. CFI/,,rs of both walk-in fridge and freezer have accumulation of spills and grime;thoroughly clean the floors. 6Wfiermometer in walk-in fridge broken; provide new accurate thermometer. � Many lights missing covers.Provide covers on all lights. Physical Facility FAIL Non-Critical BLUE bat kY� GS h when^- Comment: Faucet m bathroom runs when shu ff.Repair faucet to ensure good working order and no leaking or running. GENERAL COMMENTS: Final reinspection in one week, all outstanding violations must be corrected. City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 27,2008 ) Page 2 oft 0111 LAFAYETTE STREET Reymira's Market City of Salem t RETAIL FOOD - Food Establishment Inspection 5Z HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-5099 Separation/Segregation/Protection FAIL Critical ❑J RED Owner: EXOmment:Walk-in freezer had boxes of meat on top of ready to eat foods.Organize freezer so that potentially hazardous foods, Reyna Ramirez Guerrero such as meat,are below or separate from RTE foods to prevent cross contamination. }}PIC: Food Contact Surfaces Cleaning and Sanitizing FAIL Critical ❑J RED Reyna Ramirez _ cc��.If' �`V�� — Comment:One bottle of sanitizing solution available appeared`EA lSe water. rovide sanitizing solution of proper concentration and Inspector: test strips at all times,and ensure sanitizer is available when meat is being packaged. Elizabeth Salandrea r-Some knives stored in the knife rack dirty.Thoroughly clean and sanitize knives prior to storage. Date Inspected:Correct By: 1,3/18/2008 . L bay sink found obstructed and with dirty dishes in it.Owner has stated it is not currently being used.3 bay sink must be used Risk Level: properly to wash,rinse and sanitize dishes and utensils. Handwash Facilities FAIL Critical RED Permit Number: —Comment: Handwash sinmissing soap a d pape-Uowelsin dispensers.Keep soap and paper towel dispensers stocked at all BHP-2008-0091 times. 1jjR t--zrP dl.717 So�!4 iViOruu it d llS r ✓ ar Status: - TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) e„ VIOLATION Hot and Cold Holding FAIL Critical RED i#of Critical Violations: Comment: Produce unit holding at approximately 55°F. Repair to maintain proper temperature of 41"F or lower. tTime IN: .Time OUT: 'Urgency Description(s): 0, � tr5 BLUE: P Violations Related to Good O� � !Retail Practices (Critical' o ? violations must be corrected a immediately or within 10 days)(Non-critical violations t 1 must be corrected immediately or within 90 days) t City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMSO 2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 24,2008 ) Page 1 of l� Item Status Violation Critical Urgency 'RED: . Violations Related to Good Retail Practices (Blue Items) VIOIatIonSRelated t0 Food and Food Protection FAIL Critical BLUE ,Foodborne Illness Interventions and Risk Factors (Require Comment:Some items have price labels obscuring expiration dates. Do not cover expiration dates with price labels. immediate corrective action) _ The following items were found outdated: --13 pkgs maria cookies 12 tropicana apple juice WW1 pkgs nabisco saltines X11 nestle condensed milk —10 grape fantas 9 diet cokes 6 canada dry club soda 6 strawberry preserves 6 bumble bee tuna 4 gatorades 4 tropicana pink lemonade 2 betty crocker mashed potatos 1 souse salami 1 20oz coke 1 canada dry ginger ale 1 top pop grape soda 1 tropicana of Owner to closely monitor all expiration dates. —Many packages of meat in reach-in freezer have no labels or have incorrect dates on labels due to a problem with label machine. All meat not in its original package must have proper labelling. Equipment and Utensils FAIL Non-Critical BLUE Comment: Reach-in cooler has accumulation of mold on floor under milk section;thoroughly clean this area. VP/roduce unit needs general cleaning. ✓Small fish refrigeration unit at front needs general cleaning, including in door tracks. Ice cream freezer needs general cleaning. /-'- r ,,/ 1.4a/me unit needs a visible,accurate internal thermometer�b`T��l cd l/ ''Si bhe -T1 J�J ✓JV-e r— —Floors of both walk-in fridge and freezer have accumulation of spills and grime;thoroughly/clean the /floors �Y-- "Thermometer in walk-in fridge broken;provide new accurate thermometer. (A)a�/.--� J-ff - I� � .f. ' M/op stored in dirty water in mop bucket.Mop must be cleaned and hung to air dry not touching any surfaSces. L, eat wrapping table needs general cleaning, including shelf underneath. —Many lights missing covers.Provide covers on all lights. City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 24,2008 ) Page 2 of 3 4 . Item Status Violation Critical Urgency Physical Facility FAIL Non-Critical BLUE Comment: Faucet in bathroom runs when sh�ut'o7ffyZ p iLr faucet to ensure good working order and no leaking or running. Of %111 rL"til'inc- +aBathroom needs a general cleaning. GENERAL COMMENTS: Reinspection in one week, all violations to be corrected. Owner to provide extermination receipts upon reinspection. City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Mar 24,2008 ) Page 3 of 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: , TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) 744-5099 Hot and Cold Holding FAIL Critical RED Owner: Comment:The walk in had a temperature of 50°F. Repair unit to maintain a temperature of 41°F or below. Reyna Ramirez Guerrero PIC: The walk in freezer had a temperature of 26°F. Repair unit to maintain a temperature of 0°F or below. Provide visible,accurate thermometers in both units. Inspector: ' GENERAL COMMENTS: David Greenbaum All other violations cited in the 7/26/07 inspection report have been corrected. Date Inspected:Correct By: 8/2/2007 Risk Level: Permit Number: BHP-2007-0286 Status: SIGNED OFF #of Critical Violations: 1 Time IN: Time OUT: i Urgency Descriptiori 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®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Aug 02,2007 ) Page 1 oft f Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMSO 2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Aug 02,2007 ) Page 2 oft COURT DOCKET NO. CITATION NO. CITY OF SALEM �] VIOLATION NOTICEPD 6 NAME(LAST,FIRST,INITIAL) f2efna ,7`reZ 60.zr0 STREETADDRESS CITY/TOWN STATE ZIP LICENSE NO. LIC.EXP.DATE DATE OF BIRTH OWNERS NAME(LAST,FIRST,INITIAL) /'� I/e.'' y � i e'tL �.✓y l rGfO STREET#IJDRS. CITYFROWN STATE ZIP ,o>o alp Sit 141�7 A �i5�ix't1 REGISTRATION NO. STATE EXP.DATE M. EffYPE YEAR COLOR DATE OF VIOLATION TIME DATE CITATION WRITTEN PERSONAL ❑AM DYES PM I El NO LOCATION OF V�IIGL(A�TION f- � ')((r 15 tfq�:ENFORCING�ir/D�P 11 /4345/�p'aveX ' � 10:'14" OFFIENy EE- / CHAP. SEC(T}. FINES '. A / ?/ YJ 717 Fi .?p9 �..�It1� B C OFFICER I.D.NO, TOTAL FINE ' DUE F: ICER CERTIFIES COPY GIVEN TO VIOLATOR ❑ W HAND X �BY MAIL i DO NOT MAIL CASH-PAY ONLY BY POSTAL NOTE,MONEY ORDER OR BY CHECK MADE PAYABLE TO: CITY CLERK CITY HALL 93 WASHINGTON STREET SALEM,MA 01970 TEL.(508)745-9595 X 251 1 HEREBY ELECT TO EXERCISE THE FIRST OPTION AS STATED ON REVERSE, CONFESS TO THE OFFENSE CHARGED,AND ENCLOSE PAYMENT IN THE AMOUNT OF $ CASE# SIGNATURE SEE OTHER SIDE FOR FURTHER INFORMATION ENCLOSE PAYMENT IN THIS ENVELOPE,PEEL AND SEAL I `�'7P{9wc•.� `. ,_ ;r•A _-b '9 �.i�`YistcT `� . 'GITY'OFS`/�LT�EMj -�a ' � � I � �. � � � 1 5rs� '""'F��'"'� VIOLATION NOflCE•� x �'� �E,=,,' WN r A ' y§-p + :1 x * LICENSE N DATE 4* DATE OF SI y,y a y O R'3 NAME G (LAST.FIRST.INIyT7AL)- STREET DDRF.66 �IITYIMWN STATE LP , O1 REGISTRATION NO. STATE EXP.DATE M4kFjTYPE YEAR COLOR El- a:+^[[[BBB S '+» rbL «+ •O - } S r DATEOFVIOLATION TIME DATE CITATION WRITTEN Iu"iERs & ❑AM LJYES Q ❑PM (G$ S ❑NO _ LOCATION OF,VIO TION e�/7 FORCING E . I .-1 OFFENSE 11 CHAP. S Cn. FIRES Ell A /✓+� VU - Tit G OZ M rG/ rm C G-fR 596 a OFFICER I.Q.NO. TOTA FINE $� z Z 0 DUE O O O /( WICER CERTIF ES COPY GIVEN TO VIOLATOR aW1 JI1 ❑ IN HAND F 6t �y o JOY MAIL NLn o pgd - I DO NOT MAIL CASH- ONLY POSTAL NOTE,MONEY I- O�5; AC ORDER OR BY CHECK MADE PAYABLE T0: � U}c @NU cc CITY CITY CLERK 6 CITY FALL -+ 93 WASHINGTON STREET P4 SALEM,MA 01970 TEL.(E08)745-9595 X 251 I, I HEREBY ELECT TO EXERCISE THE FIRST OPTION AS STATED ON - REVERSE, CONFESS TO THE OFFENSE CHARGED,AND ENCLOSE PAYMENT IN THE AMOUNT OF ' S CASE SIGNATURE I SEE OTHER SIDE FOR FURTHER INFORMATION ENCLOSE PAYMENT INITHIS ENVELOPE,PEEL AND SEAL k. 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: TIMErrEMPERATURE CONTROLS(Potentially Hazardous Foods) 744-5099 Hot and Cold Holding FAIL Critical ❑d RED Owner: i— Comment:The walk in had a temperature of 50°F. Repair unit to maintain a temperature of 41°F or below. Reyna Ramirez Guerrero PIC: The walk In freezer had a temperature of 26°F. Repair unit to maintain a temperature of 0°F or below. j IN��S'�f vl!—:sible,accurate thermometers in both units. Inspector: Violations'Relat d to Good Retail Practices (Blue Items) David Greenbaum Food andFgod Protection FAIL Critical BLUE Date Inspected:Correct By: 7/26/2007 Ll There are price labels obscuring expiration/sell by dates. Do not obscure any expiration)sell by dates with price labels. Risk Level: V The fol owing items found outdated: gallon ofmilk 9-French's mustard Permit Number: 5-Tang BHP-2007-0286 1 -Parmesan cheese 4-Mashed potatoes Status: 13-Salad dressing. PARTIAL COMPLY Owner must closely monitor all expiration dates. #of Critical Violations: Some packaged meat in the front case has no label. All meat not in it's original package must have proper labeling. 2 Eq4ment and Ut.nils FAIL Non-Critical BLUE Time IN: Time OUT: j / C ment:The back freezer has an accumulation of food spills and splatter. Thoroughly clean this freezer. Urgency Description(s): �i BLUE: Thefloors in both walk ins need a thorough cleaning. Violations Related to Good <e There are many light fixtures missing covers. Provide protective covers on all light fixtures. Retail Practices (Critical violations must be corrected GENERAL COMMENTS: immediately or within 10 Reinspection in one week, all violations to be corrected. 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®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jul 26,2007 ) Page 1 oft J Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jul 26,2007 ) Page 2 oft CITY OF SALEM BOARD OF HEALTH Reymira's Market Address: 113 Lafayette Street Owner(s): Reyna Remirez Guerrero Phone: 978-744-5099 September 13, 2006 The owner of this establishment was asked to present information regarding the handling of raw meat products. A review of this procedure was reviewed in accordance with the State Food Code. Pre-cut meats are purchased from Lawrence Produce. These products are delivered on Thursday morning and re-packaged at the time of delivery. The new packages are frozen and rotated out of the freezer into a cold refrigerator the night before sale. A scale, certified by the Sealer of Weights & Measures is used to weigh the meat. The owner is not cutting any meat. A bleach sanitizer, checked with test strips, is being used. The packages for sale to the public must have a label with the following information: type of meat, weight, price per pound, sell by date, name and address of the store. There must also be a Safe Food Handling label. _ 9-/3- D E� Winne Scott Date Health A ent i eyna Ramirez Guerrero- Date t Commonwealth of Massachusetts �t�^"t°i��'+. .�+' sr '`� ✓� .'¢r'A �.Fgi',w�r��3e�.,f,'#�.'�'.,.f� 4`_��5��, "�'7 'i u3`a ' r'4. b"`'4r � i. SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 01/04/2007 ESTABLISHMENT NAME: Reymira's Market File Number:BHF-2004-000099 113 Lafayette Street Salem MA 01970 LOCATED AT: 0111 LAFAYETTE STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes RETAIL FOOD BHP-2007-0286 ,Ian 4,2007 Dec 31,2007 $50.00 TOBACCO VENDOR BHP-2007-0290 ,tan 4,2007 Dec 31,2007 $50.00 Total Fees: $100.00 PERMIT EXPIRES December 31, 2007 Board of Health This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Page 4 of 12 CITY OF SALEM, MASSACHUSETTS BOARD HEALTH RECEIVED 120 WASHINGTON STREET,4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 JAN - 3 2007 FAx 978-745-0343 CITY OF SALEM Kimberley Driscoll www.SALEM.COM BOARD OF HEALTH Mayor JOANNE ScoTT, MPH, RS, CHO HEALTH AGENT 2007 APPLICATION FOR PERMIT TO PPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT �/.it/rGjS{{ ,, 74- TEL Q7 0 q1 ADDRESS OF ESTABLISHMENT///- // du FAX# 7 MAILING ADDRESS(if different) igr4!� EMAIL--Business': Owner's: / OWNER'S NAME TELL# 117r Zt:� --L7—Z� ADDRESS /&7 t[ °` j�- Ae jO 76 STREET CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) CERTIFICATE#(S) (Required in an establishment where potentially hazardous food is prepared) EMERGENCY RESPONSE PERSON l A?ef 4a OM TEL# 4 -7 OTOPERATION Monday ! Tuesday Wednesday Tharsday indaYSatnNay SnndayNOUNSOiOPEOAflON 7 6 T. b Ate? 7'3Uras 7 3bt-r�; -7,3b {any =? 6ttAt S (90, ,4PleasewdtelnnmeoftlaV[t!AIS fofexameleltam•11em1 !b'.. D°C� j (7 e va%�r`I': l�' O( 1 • QU tq•7", t b DD t��"4 /�7 TYPE OF ESTABLIS NT FEE (check only) RETAIL STORE �NO less than 1000sq.ft, =$ 50 1000-10,004sq.ft. =$100 more than 10,000sq.ft. =$250 -- ... - ... .............. .. ---- ..... ----- --... -...__ .. .. = RESTAURANT VES NO less than 25 seats $100 25-99 seats =$150 __...__ more than 99 seats =$200 BED -- /BR-EAK- - _ KFAS_...T Y......- -E'S'- _ -- ---NQ $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) YES 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 knowledge and belief, XSig�atium--c�', all stat tax returns anq paid all state taxes required under the law. _ Date Social Security or Federal Identification Number ---------------- - — - ------ ----- ----------- - ---- ---- ---------- - -- -- - - - 3 Revised 11/13106 FOODAP2007 adCheck#8 Date 9 2 /2 b O`_ $ �o�l.G+� / / r /26'1L 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-5099 Food Contact Sues Cleaning and Sanitizing FAIL Critical ❑ RED Owner: C me : There are dirty knives stored in the knife rack. All knives must me properly cleaned and sanitized prior to storage. Reyna Ramirez Guerrero PIC: T back ting board is stained and scored. Resurface or replace the cutting board. _ Di dishes in the 3 bay sink. The 3 bay sink must be used in a three part system to wash, rinse and sanitize all dishes and Inspector: ensils. David Greenbaum The sanitizer spray bottle does not work.Provide a new spary bottle for the sanitizer. Date Inspected:Correct By: 1/11/2007 Risk Level: Permit Number: BHP-2007-0286 Status: VIOLATION #of Critical Violations: 3 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®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 11,2007 ) Page I of Item Status Violation Critical Urgency [and ED: Violations Related to Good Retail Practices (Blue Items) olations Related to Food and Food Protection FAIL Critical BLUE oodborne Illness Interventions Risk Factors (Require mment:There is food stored directly on the floor of both walk ins. Store all food at least 6 8 inches off the floor. mediate corrective action) This food stored directly on the back room floor. All food must be stores at leas 6-8 inches off the floor. ,.,.There are many price labels covering expiration/sell by dates. Do not cover any expiration/sell by dates with price labels. The following outdated items removed from the shelf at the time of inspection: 4-Lunchables 1 -Margarine - 2-Salami 3-Taco dinner kit 3-Honey made grahams 1 -BBQ sauce 15-Goya fr t cocktail 8-Goy iced peaches 12- escavena 1 ancake mix -Berkley Jensen Evaporated milk 8-Ranch dressing 4-French dressing 6-1.5 oz parmesan cheese 7-3 oz parmesan cheese 14-Jiffy corn muffin mix 2-Dinty Moore beef stew 3-Turkey gravy 14-Beech nut baby juice 4-Gerber baby beans Owner must closely monitor all expiration dates. Equipment and Utensils FAIL Non-Critical BLUE Comment:The back freezer needs a general cleaning. —. Label the back hand wash sink"Hand Washing Only" T walk in freezer floor has an accumulation of food spills. Thoroughly clean the floor. wrapping machine needs athorough cleaning. Mop stored in mop bucket. Clean mop and store upside down not touching any surfavpce to air dry. The ice cream freezer needs a visible accurate thermometer. Physical Facility FAIL Non-Critical BLUE Comment:There are many water stained ceiling tiles throughout the establishment. Investigate the source of the leak and repair. Replace all stained ceiling tiles. City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 11,2007 ) Page 2 of • Item Status Violation Critical Urgency r The floor of the walk in has broken tiles. Replace all broken tiles. ilr There are light fixtures that have no covers. Provide protective covers on all light fixtures. The b oom needs a general cleaning. Other-S Notes FAIL Critical BLUE Comment: There is a litter box,old cat food cans and a cat in this store. Pets are prohibited from food stores. Owner must remove the cat and litter box immediately. GENERAL COMMENTS: Reinspection in one week, all violations to be corrected. City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 11,2007 ) Page 3 of 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: Violations Related to Good Retail Practices (Blue Items) 744-5099 Equipment and Utensils FAIL Non-Critical BLUE Owner: Comment: Label the back hand wash sink"Hand Washing Only" Reyna Ramirez Guerrero PIC: Signs have been ordered. Physical Facility FAIL Non-Critical BLUE Inspector: David Greenbaum Comment:There are many water stained ceiling tiles throughout the establishment. Investigate the source of the leak and repair. Date Inspected:Correct By Replace all stained ceiling tiles. 1/26/2007 There are light fixtures that have no covers. Provide protective covers on all light fixtures. Risk Level: I' GENERAL COMMENTS: Permit Number: All other violations cited in the 1/11/07 inspection report have been corrected. BHP-2007-0286 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®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 26,2007 ) Page 1 oft ,! Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Require immediate corrective action) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741.1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 26,2007 ) Page 2 oft 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-5099 Food Contact S aces Cleaning and Sanitizing FAIL Critical ❑ RED Owner: LComment:The sanitizer spray bottle does not work. Provide a new spary bottle for the sanitizer. Reyna Ramirez Guerrero PIC: Inspector: David Greenbaum Date Inspected:Correct By: 1/18/2007 Risk Level: Permit Number: BHP-2007-0286 Status: VIOLATION #of Critical Violations: 3 y 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®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 18,2007 ) Page 1 oft Item Status Violation Critical Urgency RED: Violations Related to Good Retail Practices (Blue Items) Violations Related to Food and Food Protection FAIL Critical BLUE Foodborne Illness Interventions and Risk Factors (Require Com There are many price labels covering expiration/sell by dates. Do not cover any expiration/sell by dates with price immediate corrective action) -I labels. Equipment and Utensils FAIL Non-Critical BLUE '- Co ent:The back freezer needs a general cleaning. Label the back hand wash sink"Hand Washing Only" t,�hewa it In freezer floor has an accumulation of food spills. Thoroughly clean the floor. -tMyp stored in mop bucket. Clean mop and store upside down not touching any surtavpce to air dry. T,heie cream freezer needs a visible accurate thermometer. Physical Facility Facility FAIL Non-Critical BLUE Comment:There are many water stained ceiling tiles throughout the establishment. Investigate the source of the leak and repair. Replace all stained ceiling tiles. T e floor of the walk in has broken tiles. Replace all broken tiles. ryt& /tea{wi y 1 y-. There are light fixtures that have no covers. Provide protective covers on all light fixtures. Other-See;2n�t: FAIL Critical BLUE Co There is at least two cats in this store,one in the back room and one roaming the store. Pets are prohibited from food , stores. Owner must remove all cats from this establishment immediately. 11//Future repeat violations of this nature will result in monetary citations being issued. GENERAL COMMENTS: Final reinspection on Monday, January 22, 2007, all violations to be corrected. - 3Z�ko 16/ City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 18,2007 ) Page 2 oft Mass rhlsetts Department of Public Health Salem Board of Health t. ! I 4. 3 + 120 Washington Street,4' Floor Division ol Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name t') Date Type of 0 eration(s) Tyne of Inspection G'�u ju# ❑ Food Service ❑ Routine Address Risk ®Retail 0 Re-inspection _ , /4 _ _ a Level El Residential Kitchen Previous Inspection Telephone ❑ Mobile Date: ation Owner r HACCP YM El Temporary ❑ SuspePre-opct Illness l�fi a i ,�p/�, , ❑ Caterer ❑ Suspect Illness Person in'ChaFge(PIC)` Time ❑ Bed&Breakfast ❑ General Complaint In: t ( .j) ❑ HACCP Inspector j l �� Out:11, 2 Z Permit No. ❑Other Each violation checkedlrequires 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 EMPLOYEE HEALTH" El7, r„�- a " $L i`y t y iF�m, 13. Handwash Facilities !v..-, €fi :>;,F {"PROTECTtONFROMCHEMICALS '" "'r, ""'• r • '" „3 �.. ❑ 2. Reporting of Diseases by Food Employee and PICS •_ a:-a - ' .a3 Im �.1 ,(amm,� �_._� ' ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded .a ❑ 16.Toxic Chemicals FOOD I=ROM APPROVED SOURCE`_.,,> �� ; W�1 ,� �,��- .,ama 4 TIMEITEMPERATUAEcONTROLS PoteMlall Ha aidous Footls ❑ 4. Food and Water from Approved Source ( Y ) ❑ 5. Receiving/Condition Eli 6. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling PROTECTION FROM CONTAMINATION "' ` i�j r'�"'s 19. Hot and Cold Holding ❑m8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing [REQUIRE146itS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)L El21. Food and Food Preparation for HSP El 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices fdONSUOERADVISORYy n, i � 7 ,", ❑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 Cil �el 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 5. Equipment and Utensils (FC-4)(990.009) cited in this report may result in suspension or revocation of 25. Water, Plumbing and Waste (FC-4)(590.005) 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 PR28. 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:5X?ns tFom 14.E r1 \1 Inspector's Signature: Print: PIC's Signature: �� ! % Print: r ' �y Pagel o Pages Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT F 8 Cross-contamination 1 590.003(A) Assignment of Respimsibility_- 3-302.11(A)(1) Raw Animal Foods Separated from - 590.003(B) Demonstration of Knowledge" Cooked and RTE Foods* 2-103.1.1. Person in charge-.duties Contamination from Raw Ingredients 3-302.11(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 fund employees and 3-302.11(A) Food Protection* applicants*_ _ 3-302.15 'Washing Fruits and Vegetables 590.003('F) Responsibility Of A 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 5%003(G) Reporting by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(E) Removal of Exclusions and Restrictions - Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE Foci* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004('A-B) Compliance with Food law* 4-501..111 Manual Warewashing-Hot Water 3-201.1.2 Food ins Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chetnical.Sanitization-temp.,pH, concentration and hardness. 3-202.16 Ice Made From Potable Drinking Water* 5-101..1.1 DrinkingWater from an Approved System* 4-601.11(A) Equipment Find Contact Surfaces and Utensils Clean' 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Nood- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* Shellfish and Fish From an Approved Source 4-702-11 Frequenev of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment* 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 RegutalotyLuthont 2-301.11 Clean Condition-Hands and Arens* 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 Receiving/Condition 2401.11 Eating,Drinking or Using Tobacco* 3-202.11 PHFs Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and 3-20215 Package Inte it * - Mouth* 3-101.11 Food Safe and Unadulterated* 3-30112 Preventing Contamination When Tasting* 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification * 590.004(E) Preventing Contamination from 3-203.12 Shellstock Identification Maintained* Ent to ees* Tags/Records:Fish Products 13 Handwash Facilities 3402.11 Parasite Destracdon' Conveniently Located and Accessible 3-402.12 Records,Creation and Retention" 5-203.11 Numbers and Capacifies* 590.004(7) Labeling of Ingredients` 5-204.1.1 Location and Placement* 7 Conformance with Approved Procedures 5-205.11 Accessibility.Operation and Maintenance tHACCP Plans Supplied with Soap and Rand Drying Devices 3-502.11 Specialized Proce sin Methods* 6-301.11 undwashin Cleanser,Availability 3-502.12 Reduced ox en acka 'na,criteria* 8-103.12 Conformance with Approved Procedures* 6-301..12 Hand Dr 'ng Provision 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. - L r- CITY OF SALEM BOARD OF HEALTH Establishment Name: 1 r Date: aG Pager of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified :PLEASE PRINT CLEARLY - 'Y O 1 .�;� d - I D r 'r 4 f f f LJ Discussion With Person in Charge: Corrective Action Required: ❑ No Yes * I hove 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 El Re-inspection Scheduled ❑ Emergency Suspension E coNply with all mandates of the Mass/Federal Food Code. I understand that anoncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo LiEmergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: 3-50 L 14(C) _L IIR Rec,ei�ed at Temperatures Violations Related to Foodborne Illness Interventions and Risk Ac cordon to taw Cooled to Factors(items 1-22) (Cont.) 4PF145 F Within 4 Hums. PROTECTION FROM CHEMICALS 3-501.'15 Coolim,Methods for PHFs 19 PHF Hot and Cold Holding lA Food or Color Additives 3-501.16(B) Cold P1IN Maintained at or below 3-202.12 Addntnces'r 590.004(F) 41'145°F* 3-302.14 Protection from lhnan roved Additives* 15 Poisonous or Toxic Substances 3-501.16(A) Hot PHFs Maintained at or above 140'F * 7-101..11 Identifying Information-Original 3-501.16(A) Roasts Held at or above I30'B." Containers' 7-1.0211 Common Name-Warkims Containers* 20 Time as a Public Health Control 7-201.1 l Se arstion-Sfbra ex 3-501.19 Time as a Pub1Co Health Connni* 7-202.1 t Restriction-Presence and Uae'" 590.004(H} Variance Re ulremenc 7-202.12 Conditions of Use REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-303.11 Toxic Containers-P ohibitions* POPULATIONS(HSP) 7-204.11. Satnozers,Criteria Chemicals* 7-204.12 Chemicals for V. tshune Produce,Criteriai` 21 3-801.71{A) Unpasteurized Pre-packaged Juices and Bee t u;es with Witt rant,1 ebels* _T20414 Dcid,c eats.t ontau* 3-801,11(B) Use,of Pasteurized F s* 7-205.11 Incidental Food Contact.Lubricants* 3-801 11(U) Raw or Partially Cooked Animal Foal and 7-206.'11 Restricted Use Pesticides.Criteria* Raw Seed S gout's hot Served. 7-206.12 Rodent Bait Stations" 3-801.11(C) 11no erred Food Parka�e Not Re-served. 7-206.13 Tracking Powders,Pest Control and Monitoring*" CONSUMER ADVISORY TIMEfIEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Anhnal Foals That are Raw.Undercooked or PHFs Not'Otherwise Processed to Eliminate erecavd z�or 3-40L1IA(1)(2) Eggs- 155F 15 Sac. Pride "cn5 E es-Imm�edratc Service 145'F15sec* 3-302.13 Pasteurize,Eggs Substitute for Raw Shell r as * 3-401.1'1(A)(2) Comminuted Fish,Meats.&Game Animals- 155'F 15 sec. a SPECIAL REQUIREMENTS 3-401.11.(3)(1)(2) Pork.and Beet Roast - 1,0 F 121 min* - 590.009(A)-(D) Violations of Section 590.009(A)-(ll)in 3-401.11(A)(2) Ratites,Injected Meats 155'F 15 sec. * catering.. mobile food,temporary and 3-401.1,1(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,htmct Beef Steaks interventions and risk factors. Other 1450F* 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under N'29- Microwave 165'F* Special Requirements. 3-401.1 I(A)(1)(b) All Other PHFs- 145'F 15 sec. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES ,-403.11(A)&([)) PEBss 165'F 15 sea. #g (Items 23-30) 3-403.11(B) Microwave- 165'F 2 Minute Standing Critical and non-critical violations, which do not i elate in the Time* ,foodborne,illness internenhons and risk factors listed obove. can be, 3-40,.l l(C) Commercially Processed RTE Food- ,found In the fallowing sections of the Food Code and 105 CMR '140°F* 590.000. ----------- 3-403.11(^) Remaining linsliced Portions of Beef Item Good Retail Practices FC 590.0[!0 - - Roasts': 23. Mana ement and Personnel _F0_2 .003 18 Proper Cooling of PHFs 24. Food and Food Protection FC-3 .004 25 Equipment and Utensils _ FC -,4 ..._005 3-501.14(A) Coaling Cooked PHFs from 140'F to 26 Water,Plumhin and W aste FC 5 .006 70°F Within 2[fours and From 70'F 27. Physical Facilit FC-6 .007 to 41'F/45'F Within 4 Hours. * 26. Poisonous or Toxic Materials FC-7 .008 3-501.14([3) Cooling Pl-IFs Made From Ambient 29. S euial R uirements __ _ .009 Temperature Ingredients I 41°F145`F 3q,_ Other _ �- Within 4 flours't sswm,nro.K�sa.ax *Denotes critical item in the Gsicotl 1999 Food Code or 105 CMR 590900. rv..Y F.w♦ ':Y r. rt.d..w`�7n4!s.'r�AiNsek%s�°'r"7r'T'.... � .. ,.yryn.� -�,..M..,....dd '+'!n-i^a.f0.d r� :r -.. . . ... .. .. «.. . 11 :._w. �-v y♦,rn... Massachusetts Department of(Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,4'"Floor 9 Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name '/ Date Tyne of OperatigoW Type of Inspection wcz( !rn S G fM T / l !o El Food Service © Routine Address ( ( � I o t A/ RIF ©, Retail El Re-inspection Level ❑ Residential Kitchen Previous Insp ction Telephone ¢ . �� ❑ Mobile Date: �f 4�0 ElTemporary ❑ Pre-operation / HACCP YM U ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) r-�' Time El Bed&Breakfast El General Complaint - 1 ) In: la."t. ❑ HACCP Inspector J O 9 Out: Q� 10 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 MANAdEMEN7,a„ rere ;.�` °�Y�`m � ❑ 12. Prevention of Contamination from Hands ❑ 1 PIC Assigned/Knowledgeable/Duties ❑ 13 Handwash Facilities EMPLOYEE HEALTH a r' p � ti rte, 7. rtx�..-.._ : , PROTECTIONFROM CHEMICALS [1 2. Reporting of Diseases by Food Employee and PIC ,=ems' •��, � _ Flo El 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded i,riQ im s i etg{wsxis ❑ 15.Toxic Chemicals r„ n 4. FROM APPROVED SOURCE ov mare ?<IMEITEMPERATURE CONTROLS(Potemially Hdzardous Fo©ds) ❑ 4. Food and Water from Approved Source r �y 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 CONTAMINATIONf;-. 19. Hot and Cold Holding d�x W+-rvcinv-^mv Ynre d... zt .m- � e�+1 r+q�¢�l -m r116.Poe ,I tl n-��� ❑ 8. Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizingt REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)�gL ❑21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices ,°CONSUMER ❑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 N 23. Management and Personnel (FC-2)(550.003) by a Board of Health member or its agent constitutes an r 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 X 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, 28. Poisonous or Toxic Materials (FC-7)(590.ow) 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:),,�. 'r_ D`CJCJIO^ _/ S:5 01nsp edam 14,o `f� �. Inspector's Signature: � N- Print: PIC's Signature: ( Print: ;76 6-� Page of_A-Pages I 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* 3-302.1.1(A)(]) Raw Animal Foods Separated from 590.003(B)- Demonstration of Knowledge" Cooked and RTE Foods* 2-103.11 Person in charge-duties Contamination from Raw ingredients 3302.11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other* 2 540:003(C) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees and 3-302.1.1(A) Food Protection* applicants* 3-30115 'Washing Fruits and Vegetables 590.003(F) Responsibility Of A Food Employee Or An 3-304.21 Food Contact with Equipment and - Applicant To Report To The Person In Utensils* Charge's Contamination from the Consumer 590.003(0) Reporting by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* 3 1 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(E) Removalof Exclusions and Restrict ons Food 3-707,11 Discarding or Reconditioning Un safe ale FROM APPROVED SOURCE Food* 4 _ Food and Water From Regulated Sources 9 Food Contact Surfaces 590A04(A-B) Compliance with Food Law* 4-501.1.11 Manual Warewashing-Hot Water 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 3-201.13 Fluid Milk and Milk Products* 4-501.1 12 Mechanical Warewashing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eg>s and Milk Products.Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, 3-202.16 Iee Made From Potable Drinking Water* concentration and hardness.* 5-101..11 DrinkingWater from an Approved System* 4-601.11(A) Equipment Food Contact Surfaces and Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and Utensils* ShelNish and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-HotWaterand -- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved by 2-301.11 Clean Condition-Hands and Arms* Regulatory Authodt 3-20118 Shellstock Identification Present* 2-30112 Cleaning Procedure* 590.004(0) Wild Mushrooms* 2-301.14 When to Wash* 3-201..17 Came Animals* 11 Good Hygienic Practices 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-202.11 - PHFs Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and 3-202.15 Pack,a e Integrity* Mouth* 3-101.11. Food Safe and Unadulterated* 3-301..12 Preventing Contamination When Tasting* 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(E) Preventing Contamination from 3-203.1.2 Shellstock Identification Maintained* Em to ees* Tags/Records:Fish Products 13 Handwash Facilities 3402.11 Parasite Destruction* Conveniently Located and Accessible 5-203.11 Numbers and Capacities* - 3-402. Records,Creation and Retention` 5-204.11 Location and Placement* 540.004(4(1) Labeling of Ingredients' 7 Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Plans Supplied with Soap and Hand Drying Devices 3-502.11 S ecislized ProcessingMethods* 6-301.11. Handwashin Cleanser,Availabilit 3-502.1.2 Reduced oxygen packaging,criteria* 8-103.12 1 Conformance with Approved Procedures'" 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Food Code or 105 CNIR 592000. n k a CITY OF SALEM BOARD`OF HEALTH _ Establishment Name: 2 (G� S / Date: �i Page: of Nem Code C-Critical Item I DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item Verified '. PLEASE PRINT CLEARLY r J— G ��leiJCe.�T ` G G s iei ail Y^t � �1 f G _ I O ice (?CAA t,)D 17)�111_c in D, C or s c ( tvn.P O/� 7 DcXA(o� �q M o I G ) •7� r Jf t7r c . O Dov AIR 101 5 / Q er ideiZC.0. r h10 S �� Mt(i n /lam v t -FC 17_ 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-fi doll rs or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal ❑ Other: F„s . ,-501.14(C) PHFs Received at Tentperatdres Y Violations Related to Foodborne Inness Interventions and Risk According to Saw Cooled to Factors(Items 1-22) (Cont.) _ =41 T/45`.F Within 4'Hour x. PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs Food or Color Additives 1y PHF Hot and Cold Holding 14 4 3-501.16(3) Cold PIIFs Maintained at or below x3-202.12 Alchtives' 590904(0) 4P/45°F* 3-302.14 Protection from Cna> roved Additives* 3-501.16(A) Hof PHl's Maintained at or above 15 Poisonous or Toxic Substances 40'1•. 7-101.11 Identifying Information-Chigntai 3-501.16(A) Roasts Held at or above 130°F. Containers* 7-102.11 Common Name-Working Containers" ZO Time as a Public Health Control 7-201.17 Separation-Storage„ 3-SU7.19 Time as a Public Health Control* 7-202.11 Restriction-Presence mud Use* 590.004(11) VarianceRt uiremen[ 7-202.12 Conditions of Use* 7-203.11 Toxic Containers-Prohibitions" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sauttizers,Crites is-Chemicals* POPULATIONS(HSP) 7-204.12 Chemicals for Washing,Produce,Criteria* Zk 3-801.11(A) Unpasteurized Pre-packaged Juices and 7-204.14 Drvin-Agents,Criteria` Beverages with Warning Labels* 3-801.118) Use of Pasteurized E+ s* 7-205.11 incidental Food Contact.Lubricants* 3-$01.11(D) Raw or Partially Calked Animal Fax/and 7-206.1 t Restricted Use Pesticides.Criteria* 7-206.12 Rodent Bait Stations" Raw Seed Sprouts Not Served.,x 3-801.11(C) Uno cued Food Package hot Re-served. 7-?06.13 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 Foads'Fhat are Raw, Undercooked or PHFs Not Otherwise Processed to Eliminate 3-401.11A(1)(2) Eggs- 155'F 1.5 Sec. Pathe cis ea•cov..r ieuoi E*gs-Lmnedtate Service 145°F15sec* 3-302.13 1 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish,Meats&Came E ^s* Animals- 155°F 15 sec. '" 3-401.11(13)(1)(2) Pork and Beef Roast- 130"F 121 min* SPECIAL REQUIREMENTS _ 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.11(A)(2) &nitas, Tnjeaen{Meafs-l55`F15 - see * catering, mobile food,temporary and 3-401.11(A)(3) Poultry, Wild Game,Stuffed KIN, residential kitchen operations should be Scoffing Containing Fish,Meat, debited under the appropriate sections Pouhr or Ratites-165°F 15 sec.;. above if related to foodborne illness 3-401.11(0)(3) Whole-muscle,Intact Beef Steaks interventions and tisk factors. Other 14YT* 590.009 violations relating to good retail 3 401.12 Raw Animal Foods Cooked in a practices should be debited under 1129- Miciowave 165°F* Special Requirements. 3-401_Il(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)&(D) PHFs 165°F 15 sec. "= (Items 23-30) 3-403.11(6) Microwave- 165"F 2 Minute Standing Critical and non-critical violations, which do notaelate to fire Time* foodborne illness iter venrions and risk factors listed above, can be 3-403.11(0) Commercially Processed RTL' Food- ,found in rhe following sections of the Fond Code and 105 CMR 140°F* 590.000. _ 3-403.11(E) Reinaram',UnslieedPortions ofBeef Item Good Retail Practices_ FC 5900.00 Roasts* 23. Mani ement and Personnel_ FC -2 .003 -1 18 Proper Cooling of PHFs 24. Food and 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,-- lumbin and Waste FC 5 .006 _ - P 70`F Within 2 Hour and From 70°F 27. Ph s-isal Facility.._., FO-6 . .007 _ to 41°F/45°F Within 4 Hours. * 28. Poisonous or Toxic Materials FC-7 f .008 3-501.14(3) Cooling PRFs Made From Ambient 29. S ectal Re uiremanis _ _ .009 Temper attire lmgredientsto41TV45`F 30. Other Within 4 Hours't + oam n<kcz ao, "Denotes uTaical item in the federal 1999 Foal Code or 105 CMR 590900. l CITY OF SALEM BOARD OF HEALTH ° fit✓ Date: la �� Page: of Establishment Name: e�-(. IruS fild- Item Code C=Critical Item -"'DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date t No. Reference R—Red Item - Verified .+. PLEASE PRINT CLEARLY n oto (;!c � e -,Cl a q1ii D S it _ Al q.; r tif'G5G j rG Ji_ CKc�: I w Sho( cGn s � -l.rd i. 1 240(Lef c - I,f acl -(off. n D S c-[_C r L= id ck 0 r�Cr. l n ! I Wr4I - to v re J , I nal o w r Discussion With Person in Charge: Corrective Action Required: ❑ No Yes 1 have read this report, have had the opportunity to ask questions and agree to correct all :3 voluntary Compliance 13 Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Emersion d E P i 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 F• your food permit. � 1������` Voluntary Disposal 0 Other. 3-503.14(C) . 'PHFs Received at Temperatzftes . Violations Related to Foodborne Illness Interventions and Risk According to Iaw Cooled to Factors(items 1-22) (Cont) 41'F/45^F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Coolinn Methods for PHFs 14 Food or Color Additives 19 PHF Hot and Cold Holding --- ------- 3-501.16B) Cold PRFs Maintained at or below 3-202.12 A590.009(F) 41'/45'F` 3-302.14 Protection from Unapproved Additives* 3-501.16(A) Ifor PRFs Maintained at or above 1g Poisonous or Toxic.Substances 140'F. * 7-IOi.11 :Identifying Information-Original 3-501.16(A) Roasts Held at or above 130'F. Contaiuers" 7-102 1 11 Common Name-Working Containers" 20 Time as a Public Health Control 7-201.11 Separation-Storage" 3-501.19 Time as a Public Health Control* 004(hq VarianceRa u 7-202'11 Restriction-Pres�enceaudUse* 590. g-trenieat 7-202.12 Condifirms of Use- 7-203.1.1 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11. Sairitizeis,Criteria-Chemicals* POPULATIONS(HSP) - 7-204.12 Chemicals for Washing Produce,Criteria" 21 3-801..11(A) Unpasteurized Pre-packaged Juices and 7-204.14 Dryicg Agents.Criteria* Beverages with RarningLabels* 3-801.11(B) Use of Pasteurized Eggs* 7-205.11 Incidental Food Contact.,Lubricants* 7-206.7 1 Restricted Use Pesticides,Criteria' 3-801.11(D) Raw or Ri tially Conked Animal Ford and Raw Seed S gouts Not Served. '" 7-206.12 Rodent Bait Stations* '3-801.11(C) Unopened Food Package Not Re-served. 4` 7-206.13 Tracking Powders,Pest Control and Nlonitonn­ CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foo s'That are Raw,Undercooked or PHFs Not Otherwise Processed to Eliminate ' 3-401.11A(1)(2) Fabs 155'F 15 Sec. Pathogens.* ` "`"I" E gs hnmedi its Scrvicc 145'FlSsec* 3-302.13 Pasteurized Eggs Substitute.for Raw Shell 3-401.1 I(A)(2) Comminuted Fish,Meals Sc Game Eggs* Animals- 155'F 15 sec. m )( )( SPECIAL REQUIREMENTS 3-401.I1(B 12) Pork and Beef Roast- 13D°F 121ndn* --- 3-401.1 1(A)(2) Ratites,Injected Meats- 155'F 1.5 590.009(A)-(D) Violations of Section 590.009(A)-(D)in sec.* catering, mobile food,temporary and 3-40 Ll I(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) K'0ole-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 Regairemenis. 3-401-11(A)(1)(b) kit Other PHFs-145'F'15 sec. * 37 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(.4)&(D) PHFs 165°F 15 sec. * (ttetm 23-30) 3-403.11(B) Microwave-165'F 2 Minute Standing Critical card non-critical violations, which do not relate to the Time* foielborne illness interventions arid risk factors listed above, can be 3-403.11(C) Commercially Processed RTE Food- ,found at the following sections of the Food Code and 10.5 CMR 140°F* 590.000. 3-403.11(E) Remaining Unsliced Portions of Beef, Item Good Retail Practices FC Fjgaoov Roasts"` 23. Marra ement Personnel ____ 1g Proper Cooling of PHFs 24. Food and Food Protection _ _ FC-3 .004 25._ E ui merit and Utensils FC-4 .005 3-501.14(A) CaoIlngCooked PHFs from 140'Fto -28. Water. Plumbin and Waste FC-5 006 70"F Within 2 Hours and From WE ZT Physical Facilit _ _ FC-6 .007 to 41'F/45'F Within 4 Hours. * 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHR Made From Ambient 29. Special Requirements - ' .009 'Temperature Ingredients to 41°F/45"F i 30-------- Other _ __--_.- Within 4 Flours' swor,,:m.,<ro-x ao< *Denotes critical item In the IOIcral 1999 Fwd Code or 105 CNIR 590-000. ` t A CITY OF SALEM BOARD OF HEALTH `. Establishment Name: C15.�Gr Date: U6 Page: of _ Item Code C-critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R–Red Item: - Verified PLEASE PRINT CLEARLY 4 . .2 _ u c .an rra C2, 1i42 n 1� � r dice- 4 t CClQ A A� g fi Discussion With Person in Charge: Corrective Action Required: ❑ No Yes 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 r comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-f've dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. ��� 11 Voluntary Disposal ❑ Other: 3-5(11.14(0 PHFs Received at Temperatures Violations Related to Foodborne Illness Interventions and Risk According to taw Cooled to Factors(items 1-22) (Cont) 41'F/45'F Within 4 Howl. PROTECTION FROM CHEMICALS 3-501-15 Cool n<=Methods for l'HFs i' Food or Color Additives 19 PHF Not and Cold Holding 14 ---- 3-501.16(B) Cold PHFs,Maintained at or below 3-202.12 Additives'i�. 590.004(F) 41')45° F^ 3-302.14 Protection from Unapproved Additives'1=5 Poisonous or Toxic Substances 3-501.16(A) IIoI' PHFs Maintained at or above 140°F. * 7-101.11 Identifying Information-Original 3-501.1.6(.A) Roasts Held at or above 130'F. Containers, 20 Time as a Public Health Control 7-102]I Common Name -Working Containers* ',201.11 Separation.-$forage" 3-501-'t9 Time as a Public Health Control* 7-20211 1 Restriction-Presence and Use's 590.004(H) varianceRc uirement 7-202.12 Conditions of Use REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7- 7.203.11 Toxic Containers Chehibitiaas* POPULATIONS(HSP) _ '204.11 Satfrtizers.Criteria-Cnucals* 7-204.12 Chemicals for Washia Prodm:e, Criteria* 21 3-80'L11(A) Beverages wit Pre-packaged Juices and Beverages with Warm mi L abels'^ 7-204.14 Drting Agents,Criteria* 3-801,11(B) Lee of Pasteurized Eg gs` 7-205.11 Incidental Food Contact,Lubricants* -� 7-206.11 Restricted Use Pestrcides, Cnteria's 3-801 11(0) Raw or Partially Cee+ked Animal Food and Raw Seed S Trouts Not Served.'s 7-206.12 Rodent Bait Stations* 3-801.I 1(C) Uno cued food Parka se Not Re-served. * 7-206.13 Tracking Powders,Pest Control and Monitormg" CONSUMER ADVISORY TIME7TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Anent Faxis'lliat are Raw.Undercooked or PHFs Not Otherwise Processed to Eliminate PathCi�Cns*erecba.r uawi 3-401.11A(1)(2) Eggs 155 F 15 Sec. Eggs-Immediate Service 145'Fl5sec* 3-302.13 Pasteurized Eggs Subsriune for Raw Shell 3-401.11.(A)(2) Comminuted Fish, Meats&Game Eggs" Animals- 155'F 15 sec. s 3-401.13 B(A)(t 2) Pork Beet Roast -13WF 121 man* SPECIAL REQUIREMENTS )( 590.009(A)-(D) Violations of Section 590.009(A)-(D)in 3-401.71(0)(2) Ratites,Injected Meats-155'F 15 _ sec. ` catering, mobile food, temporary and 3-401.11(A)(3) Poultry, Wild Game,StuffedPHFs, residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultiv or Ratites-165°.17 15 sec. * above if related to foodborne illness 3.401.11.(C)(3) Whole-muscle,Intact Beef Steaks interventions and risk factors. Other 1450F* 590.009 violations relating to good retail ; 3401.12 Raw Animal Foods Cooked in a practices should be debited under it29- Microwave 165`F* Special.Requirements. 3401..11(A)(1)(b) All Other PHFs--145'F 15 sec * I7 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(A)&-(D) PRFs 165'F 15 see. * (Items 23-30) 3-403.11(B) Microwave-Ib5°F 2 Minute Stwdine Critical and non-critical violations, which do out relate to the Time* foodborne illness interventions and risk factors listed above, can be 3-403.11(C) Commercial ly Processed RTE Foal- 'found in the following sections of the Food Cede and 105 CMR 1400F* 590.000. _ 3-403.11(E) Remaining Unshced Portions ofBeefItom Good Retail Practices FC 590.000_1 Roasts's 23. Management and Personnel ____ F_C--2 .003 Ig Proper Cooling of PRFs 24. Food and Food Protection FC-3 .004 25 _Equipment and Utensils FC 4 _.005 3-501.14(A) Cooling Cooked PHFs from 140'Ft'o 26. Water,PlumbintiandWaste FC 5 .006___ 70'F Within 2 Hours acid From 70°F 27. Physical Facility. __ FC-6 .007 to 4 t'Ff45-F Within 4 Hours. "` 26. Poisonous or Toxic Materials FC-7 .008 9-501.14(8) Cooling PHFs Made From Ambient 29. _ Special Requirements Temperature Ingredients to 41'F145'9 30Other _ _L Within 4(lours" ssvnr n,m -z.un: Denotes critical itun In the choral 1999 Food Code or 105 CMR 590.000. 4M y. Y MassaMhusetts Department of Public Health Salem Board of Health 120 Washington Street,4t"Floor Divisbn of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 NameDate Type of Operation(s) Type of Inspection Q\ I/G 'Ic ❑ Food Service ❑ Routine Address Risk © Retail PRe-inspection I I - Level El Residential Kitchen Previous Inspection Telephone " ❑ Mobile Date: (WQ1QC Owner HACCP YM El Temporary ElPre-operation Q( trrL ❑ Caterer ❑ Suspect Illness Person in Charg ( IC) Time ❑ Bed&Breakfast ❑ General Complaint In:�� K) Permit ElHACCP Inspector r Ou : n-� Permit No. ❑ Other Each violation checked requires an explanation on the narrative pages) 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() ❑ 590.009(F) ❑ action as determined by the Board of Health. ''FOOD PROTEGTON MANAdEMENT ❑ 12. Prevention of Contamination from Hands +, ❑ 1 PIC Assigned/Knowledgeable/Duties ❑ 13. Handwash Facilities §EMPLOYEE HEALTHKfl­v.ea " ruM`H" aad N_o--?s ��tt F,i c3k PROTECTION FROM ❑2. Reporting of Diseases by Food Employee and PIC ,� ao. :�» r•�m«� �•�_ ' _. .- � ' ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15 Toxic Chemicals mFOOD FROM APPROVED SOURCES„„„ i ❑ 4. Food and Water from Approved Source SIMEIrEMPERATURE CONTROLS(Potentially Hazardous Iends)"" ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7 Conformance with Approved Procedures/HACCP Plans 1❑ 18.Cooling PROTECTION FM ROCONTA'M-INAT40N�" o-' 19. Hot and Cold Holding i ❑ 8.Separation/Segregation/Protection ❑20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing ,REbUIREMENT$FOR HIGHLY SUSCEPTIBLE PQPULA7ION&(MSP) E-121. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices p",,:CONSUMER.ADVISORY; �"c ❑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 1a by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(59 23. Management and Personnel (FC-2)(590.0 4)) order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of 25. Equipment and Utensils (Fc-4)(5900.00.00 )5) 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 yZ 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:590MVe lForm&14. a-JJL Inspector's Signature: \ Print: - Oc>setC PIC's Signature: Page f 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)(1) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* - - Cooked and RTE F<wds* 2-7.03.11. 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(0) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees and 3-302.11(A) Food Protection* applicants* 3-302.15 Washing Fruits and Vegetables 590.003(,F) Responsibility Of A 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(G) Re orting It Person in Char!e* 3-306.14(A)(B) Returned Food and Reserviee of Food* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated - 590.003(E) Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCE rood* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 3-201.12 Food in aHennetically Sealed Container* Sanitization Temperatures* Mechanical Warewashing Hot Water 3-201.13 Fluid Milk and Milk Products* 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.1.4 E_=s and Milk Products.Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH, concentration and hardness. 3-202.16 Ice Made From Potable Drinking Water* 'k 5-101.11 Drinkin Water from an Approved System* 4-601.11(A) Filuipment'Food Contact Surfaces and Utensils Clean* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Equipment Food- 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces and UtensiisO Shatlnsfi and Fish From an Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Reereadonal'ly Caught Molluscan Food Contact Surfaces of Equipment* Shellfish* 4-703-11 Methods of Sairitization-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 Auth2-30111 Clean Condifion-Rands and Arms* orit 3-20218 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 590.004(C) Wild Mushroalns* 2-301.14 When to Wash* 3-201..17 Game Animals* 11 Good Hygienic Practices Receiving/Condition 2-401.11. Eating,Drinking or Using Tobacco* 3-202.11 PHFs,Received at Proper Temperatures* 2-401.1.2 Discharges From the Eyes,Nose and 3-202.15 Packa e Ince itj* Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting* 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification * 590.0041 F) Preventing Contamination from 3-20312 Shellstock Identification Maintained* Employees* Tags/Records:Fish Products 13 Handwash Facilities 3-402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records.Creation and Retention* 5-703.11. Numbers and Capacities* 590.004(.1) Labeling of Ingredients* 5-204.11 Location and Placement* q Conformance with Approved Procedures 5-205.11 Accessibility,Operation and Maintenance /HACCP Plans - Supplied with Soap and Hand Drying 3-502.11 Devices 3-502.1S ecialized Pmeessin jjin,Vetcriteria* 6-301.11 Handwashin Cleanser,Availability .2 Reduced ox en tacky 'ng,c 8-103.12 Conformance with A roved Procedures* 6-301.1.2 Hand Drying Provision -Denotes critical[tem in the federal 1999 Food Code or 105 CMR 590.000, - r CITY OF SALEM 'k BOARD OF HEALTH .4 Establishment Name: P J"1 Date: C7 Page: of C item Code c-critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date - No. Reference R–Red Item - Verified. r PLEASE PRINT CLEARLY l ✓� Gn r >>� a 0 sic ..yAaV1 - `�1— L dJl l_ J C z o ;E n "-el c S t_. u G ( .( Q c — 0�- a T /Y'S a UA 1 iC24, L • i 3 Ili Discussion With Person in Charge: Corrective Action Required: L] No Yes 4 ' I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restric ion/ Exclusion k violations before the next inspection, to observe all conditions as described, and to Re-inspection Scheduled ❑ Emergency Suspension c6mply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twentyr-fve dollars-or suspension/revocation of ❑ Embargo ❑ Emergency Closure youwfood permit. ttr ❑ Other: -e ❑ Voluntary Disposal r 3-501.1 +{C) PHFs Received at'lennperatures Violations Related to Foodborne Illness Interventions and Risk According to Law Cooled to Factors(items 1.22) (Cont.) 41°'F/45°F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14Food or Color Additives ly AHF Hot and Cold Holding _7501.16(B) Cold PRFs Maintained at or below 3-202.12 Addtu�es'" 590.004((F) 410145° F* 3-302.'14 Protection from Unapproved Additives* 3-501.16(A) I1ot PHFs Maintained at or above 15 Poisonous or Toxic Substances 140'F. 7-101.11 7dentifI' Intximation-Original 3-501-16(A) Roasts Held at or above I30"F. Containers" 7-10211 Common Name-Working Containers* 20 Time as a Public Health Control 7-201.11 Separation-Storage* 3-501,19 Time as It Public Health Control* 7-202.11 Restriction-Presence and Ilse* 590.004(H) Vtu-iance Ke uiremenC 7-202.12 Conditions of Use* 7-20311 I Toxic Container,-Prohibitions" REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sarntizers,Criteria-Chemicals* POPULATIONS(HSP) 7-204.12 Chemicals for Washin� Produce. Criteria* 21 3-80L11(A) Unpastemized Pre-packaged Juices and 7-204.14 Dfyin A eats.Criteria* Beverages with R'nninq,i,abels'` 3-801.11(B) Use of Pasteurized Lees* 7-205.11 Incidental Food Contact. Lnbricmas* 3-801.11(0) Raw orPartia]tyC'wked Animal Foul and 7-206.11 RestdctedUse Pesticides.Criteria* Raw Seed Sprouts Not Served. 7-206.12 Rodent Bait Stations" 3-801.11(C) Uno re ened food Packa Not Re-served. 7-206.13 Tracking Powders,Pest Control and Monifoiin�^ CONSUMER ADVISORY _ TIMEITEMPERATURE CONTROLS22 3603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods That are Raw.Undercooked m' PHFs Not Otherwise Processed to Eliminate 3-40Lt1A(1)(2) Eggs- 155°F 15 Sec. Patho ens rye`""e"2uoi L s-hvtnedrate 5ecvice 145°F15sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish, Meats&Game Eggs* Animals- 155'17 15 sec. 3-401.11(B)(1)(2) Pork.and Beef Roast- 130"F 121 min* SPECIAL REQUIREMENTS _ 3-401.11(A)(2) Ratites,Injected Meats-155'F 15 590.009(A)-(D) Violations of Scction 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 Poultr,or Ratites-165"F l5 sex. a` above if related to foodborne illness 3-401A 1(C)(3) Whole-muscle,Itact Beef Steaks interventions and risk factors. Other 145°.F* 590.009 violations relaCing to good retail 3-401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Mierowave 165`F* Special Requirements. 3-401..11(<A)(1)(b) All Other PHFs-145'F 15 see. 17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 1(.4 3-403.11 PHF, 165'F 15 sec. * (items 23-30) 3-403.11(B) Microwave-165°F 2 Minute Standing Critical and nim-critical violations, which do not relate to the Time* foodborne illness interventions and risk factors listed above can be 3-403.11(C) Commercially.Processed RTE Food- ,found in the following sections of the Food Code and 105CMR 140"F"" - 590.000. - --T--403.1 I(P) Remaining Unsliced Portions of Beef Item Good Retail PracticesF£ 590.000 Roasts" 23. l0anactententandPersonn_el__ FC-2 .003 26.--- - Water,Plumb'dnPand Wast _ - 18Proper Cooling of PHFs FC 3 .004 25 Equipment and Utensils FC 4 005 3-501,14(A) Cooling Cooked PHFs from 140°F to -- e FC a 006 70'F Within 2 Hours and 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(13) Cooling PHFs Made From Arnbient 29_ S ecial Re uirements .009 Temperature Ingredients to 41"F/45°F 30_ Other Within 4 Hours's `Denotes uiucal itun in the federal 1999 Food Code or 105 CNIX 590.000. L CITY OF SALEM BOARD OF HEALTH Establishment Name: a got-14EL Date: Page: , of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Verified (A� PLEASE PRINT CLEARLY t 1 1� �hDf-"Llrw C , nnooq /1 A Q2 (A�AQI�CUCA490 01- � 7 _ t FF 1 - JJO A,*, t1 L - Pl to T n c SE 2 (;I iL 4 rDiscussion With Person in Charge: Corrective Action Required: ❑ No Yes read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction Exclusion ns before the next inspection, to observe all conditions as described, and to �Re-inspection Scheduled O 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 your400d permit. C/ ❑ Voluntary Disposal ❑ Other. R 9-501.7.4(0:) PHFs Received at Temperatures a Violations Related to Foodborne Illness Interventions and Risk According to I m Cooled to Factors(Items 1-22) (Cont.) 41'Fl45'F Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Coaling Methods for PHFs 14 Food Or Color Additives 19 PHF Hot and Cold Holding 3-202.12 Additives'-' 3-50IA6(B) Cold PRFs Maintained at or below 590.004(F) 41"145,1 P, 3-302.14 Protection from roved Additives* 3-501.16(A) Hot PHFs Maintained at or above 15 Poisonous or Toxic Substances 140°F. 7-1{p..1] klentitgdng Information-Original 3-501.16(A) Roasts Held at or above 130'F. Containers* 7-102.11 Common Name-Working Containers* Time as a Public Health Control 7-207.71 Se.aration-Storage- 3-501,19 Time as a Public Health Control* 7-202.1.1 Restriction-Presence and Use* 590.004(H) Variance Requirement 7-202.12 Conditions of Use REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203.11 Toxic Containers-Prohibit ons* POPULATIONS(HSP) 7-2(M.11 Sam[i zen's,CYiteria-Chemicals* - 7-204.1.2 Chemicals for Washing Produce,Criteria' 21 3-801.11(A) Unpasteurized Pre-packaged Juices and Beverages with Warnine Labels, 7-204.14 Drying A gents.Criteria' 3-801..11(B) Use of Pasteurized Eves' 7-205.11 Incidental Food Contact,Lubricants* 3-801.11(6) Rau or Partially Cooked Animal Food and 7-206.11 Restricted Use Pesticides.Criteria* 7-206.12 Rodent Bait Stations* Raw Seed S Trouts Not Served. 7206.13 'Tracking Powders,Pest Comtrpl amd 3-801.11(C) Unopened Food Package Not Re-served, r` Monitoring* CONSUMER ADVISORY _ TIME TEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of i6 Proper Cooking Temperatures for Animal Fails That are Raw.Undercooked or PHFs Not Otherwise Processed to Eliminate Pathogens., Erlacove tr,mt 3401.I1A(1)(2) Eggs_ 155'F15See. Eggs-Immediate Service 145°1715scc* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish,Meats&Game Eggs" Animals-155'F 15 sec. 3-401.17(13)(I)(2) Park and Beef Roast-190° SPECIAL REQUIREMENTS 3-40 127 min* - 3-401.11(A)(2) knits Injected Meats-155'F 15 590.009(A)-(D) Violations of Section 590.009(A)-(D)in _ sec catering,mobile food,temporary and 3-40L l I(A)(3) Ponhry, 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"17,. 590.009 violations relating to good retail 3-401.12 Raw Animal Foods Coked in a practices should be debited under 7129- Micmwave 165°F„ Special Requirements, 3-401.11(.A)(I)(b) All Other PHFs-- 145'F 15 sec. 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) 3-30)- 3-403.11(B) Microwave- 165' F2 Minute Standing Criticed and non-critical violations, nisch do not relate to tine Time* firodborne illness interventions and risk factors listen above, can be 3-403.1.1(C) Commercially Processed RTE Food- ,found in the following sections of the Food Code and 105(;Mit 140°F* 590.000. - 3-401.11(E) Remaining Unsliced Portions of Beef Item Good Retail Practices FC 590 000 Roasts"` 23. Manaoement and PersonnelFC-2 .003 18 Proper Cooling of PHFs- 24. Food and Food Protection _--. FC-3 .004 25. EquiPmeni and Utensils FC 4 _ .005 3-501.14(A) Cooling Cooked PHFs from 140'F to 26. Water,Porn and Waste FC 5 006 70117 Within 2 Hours and From 70'F 27. Physical Facility FC-6 .007 _ to 41'Fl45'F Within 4 Hours. ' 26. Poisonous a'Toxic Materials FC -7 .008 3-501.'14(13) Cooling PHFs Made From Ambient 29. Special R quirements Temperature'Ingredients to 41`17145`'17 Within 4 Hours* 111W "b"0�2 ` Denotes critical item in lire Ucrad 1999 Food Code or 105 CMR 590000. Massachusetts Department Of Public Health Salem Board of Health 120 Street, Division of Food and Drugs Sa )m, MA 019 0-35234"Floor e FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name IR Date Tvoe of Operations) Type of Inspection ZQ -(,1,/ � 4 y a 4, ❑ Food Service ❑ Routine Address I t/) I t? Risk © Retail p Re-inspection _ Level ElResidential Kitchen Previous Inspection Telephone 4 G El Mobile Date: Owner ) �p / HACCP YIN [1 Temporary ElPre-operation 1< t, 1 •�•1 i'/ ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) Time// El Bed&Breakfast El General Complaint Inspector I OutlY2In- [I HACCP ao 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 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," ,-,„„- ,?a ;e,"'� s ,mow ❑ 12. Prevention of Contamination from Hands E] 1 PIC Assigned/Knowledgeable/Duties ❑ 13 Handwash Facilities EMPLOYEE HEALTH� a m ......» w x„. .,�-�.;a,�e"�.„a,c.,.�st:.•!1"'..,,' ,us, �,m: ' PROTECTION fROM CHEMICALS ❑ 2. Reporting of Diseases by Food Employee and PIC t,, ,_ �'�- `_-��® � m a��- . [114.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded ❑ 15 Toxic Chemicals ;.FOOD FROM APPROVED SOURCE,,,,,,,,u?, ; ;" :�„�A p,.,❑ „�q=d ," ;;I ONT !yiir i�T1ME/rEMPEAUR RTECROLS PoismFaaizardousFoods 4. Food and Water from Approved Source ,, , r�� � � J ❑ 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 s a �` "1,T1 1 5619. Hot and Cold Holding Elm8 Separation/Segregation/Protection E3 20.Time As a Public Health Control ❑ 9. Food Contact Surfaces Cleaning and Sanitizing 'REQUIREMENTS FOR HIGHLY 1§USCEP-1BLE POPULATIOINS(HSfl)-'- El21. Food and Food Preparation for HSP ❑ 10. Proper Adequate Handwashing ❑ 11. Good Hygienic Practices ICON&UMERADVISORy'_'°` , 0, wz a� p ❑ 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 ' by a Board of Health member or its agent constitutes an 23. Management and Personnel FC-3)( 90004) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.00 ) cited in this report may result in suspension or revocation of , 25. Equipment and Utensils (Fc-0)(550.005) 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: sssomw�,w�,s-iaaoCLQ 1 Inspector's Signature: Print PIC's Signature: / Print• Pagel ofj Pages 1. .. Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Cross-contamination 1 I 590.003(A) Assignment of Responsibility* 3-302.1.1(A)(1) Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103.11 Person in char e-duties Contamination from Raw ingredients 3-302.11(A)(2) Raw Animal Foods Separated from Each EMPLOYEE HEALTH Other" 2 59lM03(C) Responsibility of the person in charge to Contamination from the Environment require reporting by food employees and 3-302.11(A) - Food Protection* a ilicants* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility Of A 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(G) Re ortin by Person in Charge* 3-306.14(A)(B) Returned Food and Reservice of Food* 3 1 590.003(D) Exclusions and Restrictions* Disposition of Adulterated or Contaminated 590.003(F.) 'Removal of Exclusions and Restrictions Food 3-701.11 Discarding or Reconditioning Unsafe FOOD FROM APPROVED SOURCEFood* 4 Food and Water From Regulated Sources F 9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water - 3-201.12 Foal in a Hermetically Sealed Container* SanidzationTerr eratures" " 4-501.1 l2 Mechanical Warewashing-Hot Water 3-20'1.13 Fluid Milk and Milk Products* 3-202.13 Shell Eggs* Sanitization Temperatures* 3-2(12.14 Eggs and Milk Products.Pasteurized'" 4-501.114 Chemical Sanitization-temp:,pH, 3-202.16 fee Made From Potable Drinking Water* concentration and hardness. 5-101.1.1 DrinkingWater from an Approved System* 4-GO 1.11(A) Equipment Food Contact Surfatxs and 590.006(A) Bottled DrinkingWater* Utensils Clean* 4-602.11 Cleaning Frequency of Equipment F x d- 590.006(B) Water Meets Standards in 3 t0 CMR 22.01' ShelHish and Fish Froman Approved Source Contact Surfaces and Utensils*4-7172.1 I. Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of E ui ment* 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 Regulatory Autftorii 2-301.11 Clean Condition-Hands and Arms* 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 g Receiving/Condition 2401.11 Eating,Drinking or Using Tobacco* 3-202.11 - PHFs Received at Proper Temperatures* 2-401.12 Discharges From the Eyes, Nose and - 3-202.'15 Package Into i[ * Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting', 6 Tags/Records:Sheiistock 12 Prevention of Contamination from Hands 3-202.18 -Shellstock Identification * 590.004(E) Preventing Contamination from 3-203.12 Shellsnoek Identification Maintained* Em to ees* Tags/Records: Fish Products 13 Handwash Facilities 3402.11 Parasite Destruction* ___ Conveniently Located and Accessible 3-402.12 Records.Creation and Retention* 5-203.11. Numbers and Capacities* _ 590.004(7) Labeling of Ingredients* 5-204.11 Location and Placement* - 5-205.11 -Accessibility.OierationandMaintenance; 7 Conformance with Approved Procedures P Pians Supplied with Soap and Hand Drying /HACC 3-502.11 S ecialized Processing Methods* Devices 3-502.12 Reduced oxygen packaging,criteria* 6-301.11 Harmwashing Cleanser,Availability 8-103.12 Conformance with Approved Procedures* 6-301.12 Hand Drying Provision *Denotes critical item in the federal 1999 Foal Code or 105 CMR 590.000. - CITY OF SALEM BOARD OF HEALTH Establishment Name: 14 ,/61•-,_4tezI 1 Date: Page: of Item Code C-Critical Rem DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item - Verified 4o- PLEASE PRINT CLEARLY e' / X y 1 It9�4t n ,g r S16 I (OCA IN i C4 JA. or nP t SIO r, ✓/� �/� L u o_-. C } /off — n , O cl. W. 4-' r /1 10 7 QD IJ.J ,M r Ii S 1 fJ I ! o l t ✓ ko( 1111 ^f o J-L 1I ?.'J I` Ore s o C oi-/ n-ry 4- CV Cc�� Ira f I . — s sGI — Je aiij� I due v s J 1 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 ° v untary Compliance ❑ Employee Restriction/ Exclusion S 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. s a✓/i/i LIVoluntary Disposal ElOther: r 3-501.14(C)W PRFs Received at Temperatures Violations Related to Foodborne fitness Interventions and Risk According to 1A v Cooled to Factors(items 1-22} (Cont.) 41°F1451F Within 4 How's." PROTECTION FROM CHEMICALS 3-501.15 Cooling'Methods for PHF' Food or Calor Additives 19 PHP Hot and Cold Holding 14 3-501.16(B) Cold PHF'Maintained at or below 3-202.12 Additives' 590.004(5) 4lV45° F* 3-302.14 Protcction from Una roved Additives* 3-501-6(A) Ilot PRFs Maintained at or above ig Poisonous or Toxic Substances 140°F. „ 7-101A I klentifyinglnfonnalion-Original 3-501.16(A) I Roasts Held at or above 130°F. Containers* 7-102.11 Common Name--Workin, Containers* 20 Time as a Public HeaBh Control 7-201.11 Separation-Stora c 3-501.19 Time V,a Public Health Corms]* 7-202.1 I Restriction-Presence and Use* 590.004(H) aft• cc Re uirement 7-202.12 Conditions of Ilse'., 7-203-1 Toxic Containers-Prohibitions' REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanipurs,Criteria-Chenticall* POPULATIONS HSP 7-2(A-12 Chemicals for lhashine Produce,Criteria" 21 3-80'1.11(A) Unpasteurized Pre-packaged Juices and 7-204.14 Dryin Agents.Criteria* Beverages with It, liibels* Eggs. 3-801.11(B) Use of Pasteurized Eg 7-205.11 Incidental Food Gonias.Lmhricants* ' 7-206.11 Restricted IT e Pesticides.Criteria* 3-801A 1(D) Raw or Partially,Cooked Annual Food and R rw Seed S rroats Not Served. ' 7-206.12 Rodent Bait Stations" 3-801.11(C) Uno erred Foal Package Not Re-served. 7-206.'13 Tracking Pi>wders,Pest Control and Monitorino-' CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of g( Proper Cooking Temperatures for Animal Foods That are Raw,Undercooked or PHF' Not Otherwise Processed to Eliminate F- 3-401.11A(1)(2) .gs- 155OF 1.5 Sec. - Pathe ens F em s-huediam Service 145°F15see* 3-302.13 Pasteurized Fggs Substitute for Raw Shell 3-401.11(A)(2) Contaminated Fish,Meats&Game Eggs* - Animals- 155°F 15 sec. '" SPECIAL REQUIREMENTS 3-401.11(B)(1)(2) York and Beef Roast-130`5 121 min* � - 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 food,temporary and 3-401,11(A)(3) Poultry, Wild Game,Sniffed PHF', residential kitchen operations should be Stuffing Containing Fish,Meat, debited under the appropriate sections Poultry or Rarities-165°F 15 sec. * above if related to foodborne illness 3401.1 t(C)(3) Wttole-muscle,htract Beef Steaks interventions and risk factors. Other 145`17* 590.009 violations relating to good retail 3401.12 Raw Animal Foods Cooked in a practices should be debited under#29- Microwave 165°F* Special Requirements. 3-401.11(.9)(1)(6) All Other PHF'- 145°F 15 sec.' 177 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-403.11(A)&N) PHF,165°F 15 sec. * (Rem523-30) 3-403.11(B) Microwave-165°F 2 Minute Standing Critical and non-critical violations, vvNch do not i elate to the Time' ,foodborne illness interventions and risk factors listed above, can be 3-403.11(C) Commercially Processed RTE Foul- ,found in the following.sections of the Food Code and 105 CMR 140'F" 590.000. 3-403.11(E) Remaining Unsliced Portions of Beef Item Good Retail Practlees FC 580.000 Roasts* 23. Management and Personnel FC-2 .003 24. Food and Food Protection FC-3 .004 Ig Proper Cooling of PHF' --- -25 Equipmeni and Utensils __FC 4 .005 3-501.14(A) Cooling{coked PHF' from 140`5 to -25.__ 2y, Water.Plumbing and Waste FC 5 006___ 7WF Within 2 Hours and From 70°F 27. Physical Facility FC--6 007 _ to 4 t°F/45"-F Within 4 Hours. * 28. Poisonous or Toxic Materials FC-7 .003 3-501.14(B) Cooling PFIFs Made From Ambient ?g_ S ectal Re uiremenis ______j-.009 Temperance Ingredients to 41°F/45°F 90 __ -Other__ Within 4 Hours" Denote,critical item in thr federal 1999 Prod Code or 105 CMR 590.00(1. CITY OF SALEM - 't d.- - - - - - -- BOARD OF HEALTH Establishment Name: 1(A40 0 A"o'r' 4= Date: Cl o Pager_ of E nem Code C-Critical Item DESCRIPTION OF VIOLATION PLAN OF CORRECTION 7)ate p� No. Reference R-Red Item Verified PLEASE PRINT CLEARLY -- �: - (EL - n e j 1 vs1 to 4r r 213 \r/! 1' r 's C011� AA rt Y SII ,�t '.1 ,F e Discussion With Person in Charge: Corrective Action Required: ❑ No " Yes 1 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 C de. I understand that noncompliance may result in daily fines of twent a dollars ors spensi Frfrevocation of X Embargo ❑ Emergency Closure your food permit. //q >N�r -.-- t Rl c� ❑ Voluntary Disposal ❑ Other: • 4 3-501.14(0) 'PHFs Received atTemperatures Violations Related to Foodborne Illness Interventions and Risk Awordiog to taw Cooled to Factors(items 1.22) (Cont.) 4PFJ451F Within 4 Homs. PROTECTION FROM CHEMICALS 3-501.15 Cooling Methods for PHFs 14 Food or Calor Additives 19 PHF Hot and Cold Holding 3-202.72 Additives, 3-501.16(B) Cold PHFs Maintained at or below 590.004(F) 41%45°F- 3-301 I4 Protection from Una p proved Additives* 3-501.1.6(A) Hot PHFs Maintained at or above 15 Poisonous or Toxic Substances 40°F. * 7-101.11 Identifying Information-Original 3-501.16(A) Roasts Held at or above 130°F. Containers* 7-162.11 Corti Name--Workin°Containers* 20 Time as a Public Health Control 7-201.11 Se.aration-Stora*e* 3-501.19 Time as a Public Health Conrrol* 7-262.1.1 Restriction-Presence and I)se* 590.004(H) Variance Requirement 7-202.12 Conditions of Use" 7-203.11 Toxic Containers-Prohibitions* REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-204.11 Sanitizers,criteria-Chemiails* POPULATIONS(HSP) 7-204.12 Ch_e_w=ls for Washing Produce,Criteria* 21 3-801.11(A) I Unpasteuri ed Pre-packaged Juices and 7-204.14 Drvin,Agents,Criteria" Beverages with Warn ing Labels- 3-801.11(B) Use of Paste rized'F 7-205.11 Incidental Food Contact_Lubricants* ��s` 7-206.11 Restricted Use Pesticides.Criteria` 3-801.I1(D} Raw or Partially 0cxiked Animal Food and Raw Seed Sprouts Not Served. 7-206.12 R Ideal Bait Stations* ;-801.11(0) Uno erred Fund Packa e Not Re-served. * 7-206.13 Tracking Powders,Pest Control and - Monitoring* CONSUMER ADVISORY TIME/TEMPERATURE EMPERATURE CONTROLS 22 13-603.11 Consumer Advisory Posted for Consumption of 16 Proper Cooking Temperatures for Animal Foods'fhat are Raw, Undercooked or PHFs - Not Otherwise Processed to Eliminate 3-401.17A(1)(2) Eggs- 155 F 15 Sec. Pathogens * "-°rr-zom Eggs-I remediate Service 145°1715sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 3-401.11(A)(2) Comminuted Fish,Meats &Game Eggs* Animate- 155°F 15 sec. 3-40'1.1l(B)(1)(2) Pork and Beef Roast-130°F121mrn* SPECIAL REQUIREMENTS _ 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 590.609(A)-(D) Violations of Section 590.009(A)-(D)in seet catering, mobile food, temporary and 3-401.11(A)(3) Poultry, Wild Game, Stuffed PHFs, residential kitchen operations should be Sniffing Containing Fish,Meat, debited under the appropriate sections Poultry or Ratites-16.5-F 15 sec. #' above if related to foodborne illness 3401.11(C)(3) 1Llhole-muscle,Intact Beef Steaks interventions and tisk factors. Other 145=P* 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. Iq Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3403.11(A)&(D) PHFs 165°F 15 sea:. * (Reins 23-30) 3-403.11(B) Microwave-165°F 2 Minute Standing Critical and non-critical crolrrdons, which do not relate io dee Times' foodborne dines interventions and risk factors listed above, can be 3-403.I1(C:) - Commercially Processed RTE Food- ,found irr the fallowing sections of the Food Code oral 105 CMR 140°F* 590.01)0- 3-4D3.11(B) Remaining Unsliced Portions of Beef Item Good Retail Practices_ FC--( 690.OPt7 Roasts` 23. Management and Personnel FC-2 .003 24. Food and Food Protection FC-3 .004 Ig Proper Cooling of PHFs ---�-- 25 _ Equij e t and Utenslis FC 4 x.005 3-501.1.4(A) Carting Cooked PHFs from 140°F to _ 0 26 _. Water,Plum6ity and Waste FC-5 _ .006 70-F Within 2 Hours arid From 70°F 27. Ph sneak Facilites FC 6 007 to 41.°P145°F Within 4 Hours. . 28. Poisonous or Toxic Materials FC-7 .008 3-501.14(B) Cooling PHFs Made Front Ambient 29. Seciai Re uirements Temperature htgredients to 41°F145°F 30._ _ Within 4 Hours;* ssvor,n.n„xsz.a�� *-Denotes CrAw fl item in the.IFderal 1998 Food Code or 105 CMR 590900. M \,s t Commonwealth of Massachusetts City of Salem { C Kimberley Driscoll ?! Board of Health Mayor b 120 Washington Street,4th Floor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 02/01/2006 WHO'S PLACE OF BUSINESS IS: Reymira's Market File Nujober:BHF-2004-0099 113 Lafayette Street Salem MA 01970 LOCATED AT: 0111 LAFAYETTE STREET SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes RETAIL FOOD BHP-2006-0365 Feb 1,2006 Dec 31,2006 $50.00 TOBACCO VENDOR BHP-2006-0364 Feb 1,2006 Dec 31,2006 $50.00 Total Fees: $100.00 PERMIT EXPIRES December 31, 2006 Board of Health ']'his Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made,all plans for such most be submitted to and approved by the Salem Board of Health. Page 4 of 5 CITY OF SALEM, MASSACHUSETTS BOARD HEAL n �y I s 120 WASHINGTON S STREET, igcc \LVB� o SALEM, MA 0197 TEL. 976-741-18 JAN 2 8 2006 STANLEY J. USOVICZ, JR. FAX 976-745-0343 MAYOR W W W.SALEM.COM JOANNE SCOTT, MPH, RS, �H�ITY OF SALEM HEALTH AGENT 'BOARD OF HEALTH 2006 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT 2 �/�95 Ace TEL# 970-7 % ��/�.� f ADDRESS OF ESTABLISHMENT13 1 - l ,4A /7e- u �� SRe f -fr4/ .fiLeQ1Q 77) MAILING ADDRESS (if different) `��" e- as Qx"n-r'-� OWNER'S NAME ���/ti% F� iti eG�Z C 7 TEL# 02 ADDRESS 056 CITY P STATE .vLIL ZIP 0/!lZ J CERTIFIED FOOD MANAGER'S NAME(S) CERTIFICATE#(s) (required in an establishment where potentially hazardous food is prepared.) EMERGENCY RESPONSE PERSON HOME TEL#_9 ZZ-/ HOURS OF OPERATION: Mon. iD Tue. ed.7_W Thu.2-'a-Fri. -laSat.7- 10 Sun. -K-- &w 9 TYPE OF ESTABLISHM FEE (check only) RETAIL STORE YES NO less than 1000sq.ft. -$ 50 1000-10,000sq.ft. 100 I nore than I 0,000sq.ft. =$250 RESTAURANT YES NO less than 25 seats =$100 25-99 seats =$150 more than 99 seats =$200 ------------------------------------------------------------------------------------- .........----------.......-------------.....------------..... BED/BREAKFAST YES NO $100 ............-- --------------------------------------------------------------- ..........------------.......--------------------------- ADDITIONAL PERMITS F. (Caf justserve) !CE C;PEA";i, YO ORT SOFT SERVE vac __ 'Nin $5 i'OBACCO VENDOR J '�'� YEcd NO . ALL NON-PROFIT(such as church kitchens) YES NO $215� *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. Purs nt to MGL Chapter 62C, Section 49A, I certify under the pains and penalties of perjury that I, to my best k dge and belief, have filed all state tax returns and paid all ;tate taxes required under the law. Aug z< << Ignature Date Social Security or Federal Identification Number Check#8 Date Revised 11/03/05 FOODAP2.adm l� Crry OF SALEM, MASSACHUSETTS Blom)OF HEALTH 120 WASHINGTON STREET;4TH FLOOR SALEM, MA 01970 TEL. 976-741-1800 STANLEY J. USOVICZ, JR. FAx 978-745-0343 MAYOR WWW.SALEM.COM JOANNE SCOTT, MPH, IRS, CHO November 29,2005 HEALTH AGENT Reymira's Market 111-113 Lafayette Street Salem, MA 01970 Dear Owner: On Monday October 3,2005 personnel from the Tobacco Control Program conducted a compliance check to determine if your permitted establishment would sell a tobacco product to a minor. A 17-year-old male purchased cigarettes from a clerk in your store. Documentation is now on file at the Board of Health regarding that sale. Reymira's Market is in violation of Section III(A)of the Salem Board of Health Regulation Affecting the Purchasing of Tobacco Products. According to this section,the sale of cigarettes,chewing tobacco,snuff, or any tobacco in any of its forms to any person under the age of eighteen shall be punished by a fine of (Two Hundred Dollar fine)for the Second offense. FOLLOWING THE THIRD(3RD)OFFENSE,THE BOARD MAY CONSIDER POSSIBLE REVOCATION OR SUSPENSION OF THE PERMIT. The North Shore Tobacco Control Program and the Salem Board of Health have worked with you and your employees to demonstrate methods to ensure compliance with this regulation. Therefore,you are ordered to pay a fine of$200.00 for the violation stated above. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street,4th floor,within ten days of receipt of this notice. Should you be aggrieved by this Order,you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven (7) days of receipt of this Order. At said hearing,you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. You may be represented by an attorney. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports,orders,and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 741-1800. Sierely yours, oanne Scott Health Agent JS/mfp CERTIFIED MAIL: 7003 3110 0005 1992 2216 cc: North Shore Tobacco Control Program Christina Harrington, Board of Health Chairman and Members Ramirez Corporation _ 16 6 111-113 Lafayette Street Date G -_ - Salem,MA 01970 53.85512113 Pay,to the ` l �Q °� _a ,y order of /� LZ©Da 00 Dollars OOOM seaport C DIT UNION - Salem,MA 014 •www.seapomu.org - Memo f 1: 211 855 &40 17300327 &911• 0166 ou9EFn EH PRISES.MC2 2 - R 0,4 �- r ^L CITY OF SALEM, MASSACHUSETTS : BOARD OF HEALTH 120 WASHINGTON START,4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. U80VICZ, JR. FAx 978-745-0343 �� MAYOR WWW.SALEM.COM JOANNE SCOTT, MPH, CHO 4 t �, A e J September 21, 2005 HEALTH AGENTT Cima Supermarket is ���� elk ,00 111 Lafayette Street J 7 ' '9 Salem, MA 01970 Dear Owner: D 41 �,■ '� 9QQ P On Tuesday August 23,2005 personnel from the Tobacco Control Program conducted a compliance 0 check to determine if your permitted establishment would sell a tobacco product to a minor. A 17-year-old female purchased cigarettes from a clerk in your store. Documentation is now on file at the Board of Health regarding that sale. G� Cima Supermarket is in violation of Section III(A)of the Salem Board of Health Regulation Affecting the Purchasing of Tobacco Products. According to this section,the sale of cigarettes,chewing tobacco,snuff, / or any tobacco in any of its forms to any person under the age of eighteen shall be punished by a fine of / (One Hundred Dollar fine)for the First offense. FOLLOWING THE THIRD (3RD)OFFENSE,THE BOARD MAY CONSIDER POSSIBLE REVOCATION OR SUSPENSION OF THE PERMIT. The North Shore Tobacco Control Program and the Salem Board of Health have worked with you and your employees to demonstrate methods to ensure compliance with this regulation. Therefore, you are ordered to pay a fine of$100.00 for the violation stated above. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street, 4th floor,within ten days of receipt of this notice. Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven (7) days of receipt of this Order. At said hearing, you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. You may be represented by an attorney. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports,orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 741-1800. Si erely yours, ? �l� panne Scott Health Agent JS/mfp CERTIFIED MAIL: 7003 3110 0005 1992 1936 cc: North Shore Tobacco Control Program Christina Hnrrington, Board of Health Chairman and Members CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. 11SOVICZ, JR. FAx 978-745-0343 MAYOR wW W.SALEM.COM JOANNE SCOTT, MPH, RS, CHO November 29,2005 HEALTH AGENT Reymira's Market 111-113 Lafayette Street Salem, MA 01970 Dear Owner: On Monday October 3,2005 personnel from the Tobacco Control Program conducted a compliance check to determine if your permitted establishment would sell a tobacco product to a minor. A 17-year-old male purchased cigarettes from a clerk in your store. Documentation is now on file at the Board of Health regarding that sale. Reymira's Market is in violation of Section III(A)of the Salem Board of Health Regulation Affecting the Purchasing of Tobacco Products. According to this section,the sale of cigarettes, chewing tobacco, snuff, or any tobacco in any of its forms to any person under the age of eighteen shall be punished by a fine of (Two Hundred Dollar fine)for the Second offense. FOLLOWING THE THIRD (3RD)OFFENSE,THE BOARD MAY CONSIDER POSSIBLE REVOCATION OR SUSPENSION OF THE PERMIT. The North Shore Tobacco Control Program and the Salem Board of Health have worked with you and your employees to demonstrate methods to ensure compliance with this regulation. Therefore, you are ordered to pay a fine of$200.00 for the violation stated above. A check or money order payable to the City of Salem must be at the Board of Health office, 120 Washington Street,4th floor,within ten days of receipt of this notice. Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for such a hearing must be received in writing in this office of the Board of Health within seven (7) days of receipt of this Order. At said hearing,you will be given the opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. You may be represented by an attorney. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports,orders, and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. If you have any questions regarding this notification please call me at 741-1800. 9oan erely yours,ne Scott/ V Health Agent JS/mfp CERTIFIED MAIL: 7003 3110 0005 1992 2216 cc: North Shore Tobacco Control Program Christina Harrington, Board of Health Chairman and Members 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item _ Status Violation Critical Urgency Telephone: : _ PROTECTION FROM CONTAMINATION 744-5099 Handwash Facilities FAIL Critical RED Owner: Comment:The back handwash sink found obstructed and had no paper towels. Keep handwash sink clear and accessible and Reyna Ramirez Guerrero /r provjde disposable paper towels at all times. PIC: The bathroom handwash sink had no soap or paper towels. Provide soap and paper towels in the bathroom at all times. Inspector: David Greenbaum Date Inspected: Correct By: 2/8/2006 Risk Level: Permit Number: a BHP-2006-0365 Status - A VIOLATION #of Critical Violations: 2 , 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. Feb 13,2006 ) Page 7 of Item Status Violation Critical Urgency RED: - Violations Related to Good Retail Practices (Blue Items) Violations Related to Food and Food Protection FAIL Critical BLUE Foodborne Illness Interventions and Risk Factors(Require Comment:There are many price labels covering expirationlsell by dates. DO NOT cover any expirationlsell by dates with price immediate corrective action) labels. - The following items were found outdated at the time of inspection: 6-packages cooked salami 2-packages of cheese 13-bottles salad dressing 5-8oz mayonaise 1 -72oz mayonaise 2-containers grated cheese 24-jars applesauce 4-packages stuffing Owner must closely monitor all expiration dates to insure no expired product is out for sale. �\ L _�rhere is food stored directly on the floor in both walkins. All food must be stored at least 6-8 inches off the floor. There is food stored directly on the floor throughout the store. All food must be stored at least 6-8 inches off the floor. Equipment and Utensils FAIL Non-Critical BLUE Comment:The produce refrigeration unit has an accumulation of food debris. Thoroughly clean this unit. Both walkin floors have an accumulation of food debris. Thoroughly clean both floors. `- There is food debris encrusted on the walls and ceiling of the back room. Thoroughly clean all walls and ceiling. Physical Facility FAIL Non-Critical BLUE �s Comment: There are many water stained ceiling tiles throughout the store. Investigate the source of the leak and repair. Replace all damaged ceiling tiles. There are many missing light covers throughout the store. Provide protective covers on all light fixtures. GENERAL COMMENTS: 470:Reinspection in one week, all violations to be corrected. This establishment has two outstanding fines for"Sale of tobacco to a minor" violations. The fines are $100.00 and $200.00. These fines must be by 2/23/06 or the Board of Health will hold a hearing to revoke this establishments permit to operate. Copies of the fine letters were left at the establishment on 2/8/06 and 2/9/06. 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. Feb 13,2006 ) Page 2 of ' Item Status Violation Critical Urgency z 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. Feb 13,2006 ) Page 3 of 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-5099 Handwash Facilities FAIL Critical RED Owner:` Comment:The back handwash sink had no paper towels. Provide disposable paper towels at this sink at all times. Reyna Ramirez Guerrero': - PIC: Violations Related to Good Retail Practices (Blue Items) Equipment and Utensils FAIL Non-Critical BLUE Inspector: Comment:There is food debris encrusted on the walls and ceiling of the back room. Thoroughly clean all walls and ceiling. David Greenbaum Physical Facility FAIL Non-Critical BLUE Date Inspected: Correct By: 2/16/2006 Comment: There are many water stained ceiling tiles throughout the store. Investigate the source of the leak and repair. Replace Risk Level: all damaged ceiling tiles. There are many missing light covers throughout the store. Provide protective covers on all light fixtures. Permit Number. GENERAL COMMENTS: BHP-2006-0365 490:All other health code violations cited in the 2/8/06 inspection report have been corrected. Status: PARTIAL COMPLY Future repeat violations will be subject to monetary fines of$25.00 per violation being issued. #of Critical Violations: 1 This establishment has two outstanding fines for"Sale of tobacco to a minor" violations. The fines are $100.00 Time IN Time out and $200.00. These fines must be by 2/23/06 or the Board of Health will hold 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 GeoTMSO2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Feb 21,2006 ) Page I oft Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness Interventions and Risk Factors (Requihe immediate corrective action) 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. Feb 21,2006 ) Page 2 oft I 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency Telephone: PROTECTION FROM CONTAMINATION 744-5099 Food Contact Surfaces Cleaning and Sanitizing FAIL Critical CJI RED Owner: Comment: No sanitizing solution available. Sanitizing solution ofp proer concentration must be readily available at all work Reyna Ramirez Guerrero stations at all times. PIC: Cutting boards are badly stained and scored. Resurface or replace. Handwash Facilities FAIL Critical RED Inspector: David Greenbaum, Comment: Hand wash sink completely obstructed. Hand wash sinks must be kept clear and accessible at all times. Date Inspected: Correct By: No paper towels at hand wash sink. Provide paper towels at hand wash sink at all times. 9/8/2006 Violations Related to Good Retail Practices (Blue Items) Risk Level: Food and Food Protection FAIL Critical BLUE Permit Number: . Comment: Food stored directly on walk in floor. All food must be stored at least 6-8 inches off the floor. i BHP-2006-0365 - Physical Facility FAIL Non-Critical BLUE Status: Comment:There is water damage and mold on the ceiling of the backroom. Open There is damage on the wall above the three bay sink. #of Critical Violations: 3 GENERAL COMMENTS: Time IN: Time OUT: 795:This establishment has begun packaging meat products. This is not an approved process for this establishment. Establishment must immediately cease and desist this operation. Owner must present a plan for Urgency Description(s): approval by the Health Agent prior to beginning this process again. 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)741.1600 GeOTMS®2006 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Sep 12,2006 ) Page I of r` Item Status Violation Critical Urgency RED: fip .,yartFt Violations Related to Foodborne Illness Interventions' and Risk Factors (Require , immediate corrective action)£ 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. Sep 12,2006 ) Page 2 of �fw�• .rr s1 a.,, F w�i'���c4'y� �-t "h.` F, , 7i kp1 i'er*!,MT' R*Mv..`rry-"S#w. '�4 ...n" ,:' ^ `Eyr r. Alta Lm a3'� .' +.-mpswrc.tkxh `;b+.wt x xa ,xt uc nRa *+R.,K1a.^M "'rN•sYr y*`-e:va ; - A.y L;,ir „2`YP _ r CITY OF SALEM, MASSACHUSETTS , k i• 120 WASHINGTON STREET, 4TH FLOOR ._ p _ a 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: RETAIL FOOD Name of Establishment: Reymira's Market Address of Establishment: 113 Lafayette Street Owner's Name: Reyna Ramriez-Guerrero Restrictions: Application Date: 12/13/2004 Permit for Food Establishment 314-05 Frozen Desserts/Ice Cream Permit for the Sale of Tobacco Products 65-05 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 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 01970 V" .� TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 2005 APPLICATION FOR PERMIT TO OPERA E A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT2 ,eel4e5 �P&! TEL# 1/7K- /Yy-�QQ,� ADDRESS OF ESTABLISHMENT /^//-/(3 MAILING ADDRESS (if different) R2G� OWNER'SNAME _ 2aezUc4 TEL# / woy-" r7 F -.x-,35- 117 x312 ADDRESS //,/G /��f CITY C r STATE , . ZIP 01,Y?_0 CERTIFIED FCrOD MANAGER' AME(S) RTIFICATE#(s) 1 (required in an establishment where potentially hAzardous food is prepared.) EMERGENCY RESPONSE PERSON9gvP&&xfL1vtez�upizeeeer HOME TEL# Gy7S-7 j� z7�y HOURS OF OPERATION: Mon.2-/D Tue. IOWed.7-/D Thu.'?-1 O Fri. 7-IL?_Sat. 7-i-O Sun. 8-g TYPE OF ESTABLISHMENJ FEE check only RETAIL STORE E NO less than 1000so.ft. =$ 50 1000-1 - 0 =$100 more t anan 10, .000sq.ft. =$250 RESTAURANT YES 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 $5 TOBACCO VENDOR NO $50 ALL NON-PROFIT(such as church kitchens) YES 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 b t know) and belief have filed all state tax re urns and aid all state taxes re wired under the law. h t p q �yir/// ii U� C)rcC.o-� r��✓+r� 7�Z/lD5 CI S7 - �r�� �1`�c7� Signature Date Social Security or Federal Identification Number ----------------------- �r --------------------------------- Revised 11/03/03 FOODAP2.adm Check#&Dale CITY OF SALEM � BOARD OF HEALTH Establishment Name: \ 1ey nll( GS M cc Let Date: tR (0KZ'1 Page: I of Item 'Code C-Critical Item ::'DESCRIPTION OF VIOLATION/PLAN OF CORRECTIOW , Date No. (Reference -R-Red Item` - - Verified _..d PLEASE PRINT CLEARLY 0-jp cA+ 1' _k _1� � CA_JQVP � 1 i nc� A, 1 tea . 6_n-xc-IcA e� 4 c���f--fir ,ter 4(F_ (m JS1 haiA82 Pax 1cx hwlllnr/: l nIah�,((Pd nCCC..kQC-le-< (AIP)IIS C at ro\1, C1qL_r way �2 c c: (I - om �4vpf t I Yt Y\QAA i roc. J CX_ 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. ❑ Voluntary Disposal ❑ Other: i � J V i I'l(c) PHFs Received it Temperatures Violations Related to Foodborne Illness Interventions and Risk Accordim,to Law Cooled n) Factors(items 1-22) (Cont) 4 l'F/45`�Within 4 Hours. PROTECTION FROM CHEMICALS 3-501.15 Conlin"Methods for for APHFs L14 Food or Color Additives 14 pHF Not and Cold Holding — 3-501.16(6) Cold PHFs Maintained at or below 202.12 Addinivcsx 590 O(A(F) 41145° F, 3-302.14 Protection froruLJ'jraL)2roNed calditives:t' 3-501,16(A) I lot PFI} Maintained at or above IS Poisonous or Toxic Substances 1401'. * 7-101.11 identifying information-Original 3-5 4.1 1 A) Roasts Held at or ribli Conta<ners* 7-102,11 Common Name-Workins Containers' 21) Time as a Public Health Control 7-20 1.11 _.S��aradoa-Stom,ce4 3-501.19 Time as it Public 14cralib ConuroP 7-202.11 Restriction-Presence mid 590-004(H) Variance Re airement 7-202.12 onditions of Ilse" 7- REQUIREMENTS FOR HIGHLY SUSCEPTIBLE -' D3,11 Toxic-Containers-Prohibitions"' POPULA IONS(HSP) 7-204.11 Sanitizets,Criteria- Cherrncals' E-7901—1](A) Unpasteurized Pre-packaged Juices and 7-204,12 Chemicals for l>4'ashin Produce,Criteria* 7-204.14 Divinu kaents Criteria' --- ------ - -— 7-205.11 incidental Food Contact. Lubricants- 3-801..11(B} Tis,of Ptstwi,,It 3-801_l I(D) Raw or Partially Cooked Ammill board and 7-206 11 Restricted Use Pesticides.Criteria' Raw Seed Spro Lars Not Served. 7-206.12 odcui7iiait Stations'" 3-801.1](C) Unopened Food Package Not Re-served-4' L= fracking Powders,Pest Control and 111�onitorm- CONSUMER ADVISORY TIMEJEMPERATURE CONTROLS 22 3-603.11 Consumer Advisory Posted for Consumption of Proper Cooking Temperatures for Amoral Foods'lliat are Raw.Undercooked or PHFs Not Otherwise processed to Eliminate PathaRens -- Ele-ir VI-1vi 3-401.1]A(l)(222) 155°F 15,Sec. Eggs-linmediase Service 145"F75sec* 3-302.13 Pasteurized Eggs Substitute felt Raw Shell 3-401.11(A)(2)(A)(2) Contaminated Fish, Meats&Gallic Animals- 15Y7 15 sec.'" Pork and Boot Roast- 130-F 121 jam* 3-401 1](13)(1)(2) SPECIAL REQUIREMENTS 3-401.11(A)(2) Rrinct;7 Injected Mcats- 155°F 15 590,009(A)-(D) Violations of Section 590.009(A)-(D)in sec.* catering.mobile food,temporary and 3-401.1.1{A}(3) Poultry,Wild Game,Stuffed Pfffii, rcsidectial kitchen operations should be Stuffing Containing Fish, Meat, debited under the appropriate sections 2oultr or Ratites-165�F 15 sea * above if related to foodborne illness 3-101A 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 Food,E;rkecl in a practices should be domted under#29 1 Microwave 165°F* Special Requirements. 340 1.11(A)(1)(b) All Other PHFs -- 145°F 15 sec. * I —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-crithail violatimis, which do not relate to the Time" fiflodborne illness interventions and risk jkietlirs listed above, can he 3-403.1 I(C) Commercially Processed RTE Food- fiflund in the fallowing sectuare,of the Food Code and 105 CMR 140'F" .590.000. 3-403.11(') Rearamilm-Unsliced Portions of Beef Item coal Retail Practices PC 590.000 Roasts"` 23, Manartiment and Personnel FC-2 .003 —18 Proper Cooling of PHFs 24.--- Food and Food Protection FC--3 .004 25 E w moil and Utensils FC 4 005 3-501.14(A) Coaling Cooked PHFs from 140°F to .....---2& Walef,_Plumbin2and Waste 6 FO-5 000 70'F Within 2 Hours and From 70°F 27, Phys;ical Facility _ __ I FC-6 .007 to 4171457 Within 4 Hours. —Poisorous or Toxic.M;1e­ria1s ---7[­FC--7 008 3-501.14(13) Cooling PfJFs Made From Ambient F60-9 Temperature ingredients to41`F/45°F ..K.... Other Within 4 llours* "Denotes critical item in the rcricial 1999 Food Code iar 105 CsJk591)000,. t 4 CITY OF SALEM BOARD OF HEALTH Establishment Name: Date: /-7 (< P1 Page of Item, Code _ . ,.C-CriticalItemrs; � -af ` �ir ' , 'k 'DESCRIPTIONOFVIOLATION/PLAN OF CORRECTION °-'� �c`, ' Date e'' No Reference R Red Item 9 �. "'?`�fi / , `* a' �.,y s ; ua.�..�. . ,.avar xz, r , �' k '- �' Verified, w..,. "Q ''J`r'./. xe �'GY, !'` sf 'a PLEASE PRINT CLEARLY uux e..Yl,. ,. 5�r. _ .� �.� iv 4„,.,,!-'J (- n1 (r) on c, x-,c- cR- I4_ CMwlm VCO I } � r ty�c-' tu.dtnq M�W_ aoc c, �Qse. tue ih �r�tfi kcic�t h s- �re t�.�so�af' t erhe v\ -RidVr,t -Mctt 4R1 -�o cvS�aYYtQ,rS• . t �c - '�� MV C1+ -hut <a(P .Jirh a �?lC nyl��W�s o� - f11 Yvt'v� 4� c(7eX . C4�JP Ui G . — WcRlk-in ug p c t F pt rd nac"kctp7ekelh6 ( )kit ( --vf r i CV irc� o vYrxin�a n •� (�✓ � 0C o -�i��'1 �av In'n's(” . �`�Y`Q it-, i'f's `2 �� t C2 �1i1i/ne_c�i�n WiU b Clr�vc'� c,d .v .\cin • g �_ 1�? - Ol(/ _. Discussion With Person in Charge: Corrective Action Required: ❑ No f f,❑ 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. /yr✓r / y� �.`�_� ❑ Voluntary Disposal ❑ Other: r r i i .3-501 )4(c) PHFs R,�ceive.d at Temperatures Vlolaffina;Relided to Foodborne Illness Interventleris and Risk Acva-dini to Law Cooled to Factors(item 1-22) (Cont) I I'F/45'F Within 4 fforus. T3t11.1-5 --'--T"oolim-, Wlhods for PHF ,PROTECTION FROM CHEMICALS L1�7 L14 Food or Color Additives 3.g0!.16(B) Cold PHF.g Maintained at lo b-dow 7�-20212 '590.0ftfil') 41145'�F, 3-3(32.14 or,) 3-50 1.16(A) I[(it plif's Maintained at of above Poisonous or Toxic Substances 1111111 3-50I76(A) Roa,ts field at or above 130'F, me a- a Public Health control Punt as a Pu61x,F�auh T1 OTI1 1 coomcai Nam 3--5o"—u -- IT me—a- blE -TYFE--T-� ott)JAWH) Vari 7-202.1 Re,trici;ori Prollewx and Uc- 1-202.12 -orafiuoii�of I lw 7-20-1�H Toxi(;C-onlu-m-e-o REQUIREMENTS FOR HIGHLY SUSCEPIRIBLE POPULATIONS(HSEL d Pro l�-pacvagcd Juit ts will 21 Untaiacurizv T-204.112 (hellcats for ning LaWu; 7204-14 Bevra,,=with Will I b Is' trill- 14L q ---- -1 T lead F,)d Cvntact.Kuhr icaros'� i_:i� I L 1 7-206.12 1 Rottertz Baa ftatlonl, 3-W Alfc)- U r-"' -0il—F CONSUMER ADVISORY TIME(rEMPERATURE CONTROLS l 2 i i ConmotcrAokkcry Posted foroninniption of kpintal F,:,i rils That arc Raw, Undercooked to Proper Cooking Temperatures for pi4FS Not ise Prr,%tcsed to Eliminate 3-401.11 A(l)(2) Flys (55'F 15 St c. Pataeurizcd Ec,.,;Stibstion.- lot R;ov ShOl 11i5`F15,,ec, -401.11'(1)(2) t coninioulted Esb'?views& cjaore st SPECIAL REQUIREMENTS 3 401-1 ItToo) 23 Pork and F3 el Roast 1301-, 121 min* o Ar-j)) Violilun),, f'SeCtro-o--)4)-A0�0054AWD) in 3-40 Ll I(A)t Riititcs,lnreocd Mcdts 15t'P 15 590,009( sce. catering, mobih7 futril,tentporary and 3-401.11iAu3ji rcsidellhal Kitchen Operations 41ould be Surifing Corilhoong Fish,Meat, debut under the appropriate sections Poulin;or Riancs-165"T, 15sec. tillove if rwJaied to toodhorne idncss —340 1 1 1�(C 1 1,3) and risk fiactors %ff 590.009 violations relatin.- to good retail 3-4(}1.32— Kra anlrnat F iKxla—C(viLied in—i practices should be debited under#29 - i Nlicrowave 165'F Special 11-401,11(Af(l)(Io M!Other PHB - I 4TT 15 sec- Lf7 Reheating-for Not Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES .3-403,11(A)&-i I)) PIIf-, 165'T 13 sw% (Itarra;23-30) 403 11(B) -%ficitmave- 165'f-2 Mottle Standing Ciilv a!and riorl.criocal viol,,niont, whrrh do no,rehire, to the Trine, firodborne iflnesl interveritivns mid iiA jarrorr fivicd of oris_(an bl' -T4103 I ommeIcudly Prmessed RTE Food- found it,thes foltnwing szcfioria rjf the Faird Code rind I(Li CUR f 140'F" 590.000' " -- ec 3-4.03.11(11) Renrajnnilp Item Good Retail Practics r 590.000 Roaslsl _Manfs�sinertfand Per orinel FC -2 1 W3 Proper Cooling of PHFa 124, Food and Food Prorection 1 FG 3 004 i 75TW-1 4(A) Water,plumbingjalcil +V sty I FC-5 i 006 25, Equi and Uteitsile Cooling Coop PHI's frour 14WT to —------- 70'P Within 2 Hunts and From 51 m" ' r-277-7' Physical Fauility_ 6 x.06! to 4 PF/45F Within 4 flour 28 LPa,o nus or TO 51 eteriais r i 7 008 Cooling PHF�Madt From AmmentL '009 Tollipetaurre In&redicias to 41 1145`FII 30 ------ Within 4 Horurs* r r, 0111 LAFAYETTE STREET Reymira's Market City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency i Telephone: TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) 1744-5049 Hot and Cold Holding FAIL Critical ❑d RED Owner:' Comment:Walk-in fridge holding at 48°F.Repair or turn down to ensure temperature is 41°F or lower. If only whole fruits and Reyna Ramirez Guerrero vegetables are stored in walk-in fridge,fridge may stay at present temperature.If packaged fish is stored in walk-in fridge, temperature must be 41 OF or below. i PICT - Violations Related to Good Retail Practices (Blue Items) Reyna Ramirez Food and Food Protection FAIL Critical BLUE Inspector: Comment:The following outdated items were removed from shelves: ( Elizabeth Salandrea Date Inspected:Correct By: 2 packages parkay margarine spread 10/23/2008 4 goya chicharrones e Risk Level: Owner to closely monitor all expiration dates. 0 Packaged meat all has safe food handling labels,and all have hand written dates on the incorrect labels.Ensure all packaged meat Permit Number: has all the correct labelling at all times.Owner states they will be purchasing a new labelling machine if current one cannot be BHP-2008-0091 fixed. Status`: PARTIAL COMPLY I#of Critical Violations: #2 Time IN: Time OUT: Urgency Description(s): BLUE: All other violations noted in the 10/16/08 inspection report have been corrected. Violations Related to Good Retail Practices (Critical Repeat critical violations noted during future inspections will result in monetary fines being issued. violations must be corrected immediately or within 10 bays)(Non-critical violations . must be corrected immediately or within 90 days) a _ City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeOTMSO 2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Oct 24,2008 ) Page I oft J Item Status Violation Critical Urgency RED: Violations Related to Foodborne Illness.Interventions and Risk Factors (Require, immediate corrective action) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Oct 24,2008 ) Page 2 of2 '.,..-'4+++'w^*. `�ya�+�Vk�,®sT tr�r�yr'.sTrk'fae'x�fif't.t+s5Ft�7'�Jr�'t`sc?'P..�'r� c ,. A..hrw..i.. 'F'.ara'»�f'd....v4rr�ts'F+.+.h�..�'+•-,-e`•t , h-+.'a.!- �. ;� Massachusetts Department of Publlc' 20 1W S Board Street,4'h Floor Health Board Health Y . 120 Wr r Division of Food and Drugs Salem, MA 01970-3523 FOOD ESTABLISHMENT INSPECTION REPORT Tel. (978) 741-1800 Fax (978) 745-0343 Name Datfr Tvoe of Operation(s) Tvoe of Inspection /4 A 5 -09 0 Food Service (Routine Address ( � /� r Risk Retail - _E1 Re-inspection \\ PlK/ r= Level ❑ Residential Kitchen --Previous Inspection Telephone /� /1 CrP U q ❑ Mobile Date: Owner ) �t 115 / HACCP Y/N ❑ Temporary ❑ Pre-operation AA ❑ Caterer ❑ Suspect Illness Person in Charge(PIC) P AT r ElBed& Breakfast El General Complaint ❑ HACCP Inspector `r '•putt .h Permit No. ❑Other Each violation checked requires an explav on 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. I 'FOOD PROTECTION MANAGEMENT a® m.W.„ .,� F_ ❑ 12. Prevention of Contamination from Hands ❑ 1 PIC Assigned/Knowledgeable/Duties ❑ 13 Handwash Facilities EMPLOYEE HEALTH9, 7" `f a ' I9 �# , t�a.w•P�,', . : ;�` ,,, ,L.!r ? jslr' I-" �PROTECTION FROM CHEMICALS, ❑-2„Reporting of Diseases by Food Employee and PIC ' '.- a �=- �� _ `• • �� a _( � . . `3 . ❑ 14.Approved Food or COlor Additives 3. Personnel with Infections Restricted/Excluded [115.Toxic Chemicals FOOD FROM APPROVED SOURCE �`ZM' r= '__' � 5' '�+ „,-!!! 4: 'Food and Water from A roved Source TIME/TEMPERATURECpNTROLS(Potemlally Hazardous Foods) ` 0 PP E]'5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 60 Tags/Records/Accuracy of Ingredient Statements [117. Reheating •�_7:,Conformance with Approved Procedures/HACCP Plans El18. Cooling PRO_TEG`TION FRO CONTAMINATION 1a ��" ` �"MIiF�Mm- `' El 19. Hot and Cold Holding �.�( l t�'�.� moi. ct� Af� �`'u`��_ I/.vim)Zl 8 Separation/Segregation/Protection ❑20.Time As a Public Health Control O'`9. Food Contact Surfaces Cleaning and Sanitizing ;.REOUIREMENTS FOR Hid HLY SUSCEPTIBLE POPULATIONS(Htiij- ❑21. Food and Food Preparation for HSP v ❑ 10. Proper Adequate Handwashing D�CONSUMER ADVISORY;. El 11. Good Hygienic Practices �dvi ❑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 I 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;. 23. Management and Personnel (FC-2)(590.003) by a Board of Health member or its agent constitutes an !) 24. Food and Food Protection order of the Board of Health. Failure to correct violations`' J (Fc-3)(5cited in this report may result in suspension or revocation of OI 25. Equipment and Utensils (Fc-a)(s90. 0a)o.00s) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (FC-5)(590.006) establishment operations. If aggrieved by,this'order, your 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.PR ` 30. Other DATE OF RE-INSPECTION: 5_( Ct_0 Gj S 59010SPWFO m 14'6c E Inspector's Signature Print: PIC'sSignature: ({� ' / Print: cn.t Pagel of s i e Violations Related to Foodborne Illness Interventions and Risk Factors(items 1-22) PROTECTION FROM CONTAMINATION FOOD PROTECTION MANAGEMENT 8 Cross-contamination �1 59l).003(A) Assignment of Responsibility* 3-302.11(A)(O Raw Animal Foods Separated from 590.003(B) Demonstration of Knowledge* Cooked and RTE Foods* 2-103.11 Person in charge-duties Contamination from Raw ingredients 3-302.11(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 3-302.11(A) i Food Protection* a flicams* 3-302.15 Washing Fruits and Vegetables 590.0030 Responsibility Of AFood Employee Or An 3-304.11 Food Contac with Equipment and Applicant'ro Report To The Person In Utensils* Charge* Contamination from the Consumer 590,003(G) Re actin b Perspn in Charge* 3-306.14(A)(B) Returned Food and Resetzice of Foal* 3 590.003(D) Exclusions and Restrictions* Disposition of Adulterated orContaminated 590.003(8) Removal of Exclusions and Restrict ons Food 3-701.11 Discarding or Reconditioning LJnsafe FOOD FROM APPROVED SOURCE Food* 4 Food and Water From Regulated Sources r9 Food Contact Surfaces 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 3-201.12 Foci in a Heretically Sealed Container* Sanitization Tet eratures* - 3-20113 Fluid Milk and Milk Products* --Z501.112 Mechanical Ware.washing-Hot Water 3-202.13 Shell Eggs* Sanitization Temperatures* 3-202.14 Eggs and Milk Products.Pasteurized* 4-501.11.4 Chemical Sanitization-temp.,pH, 3-202.16 Ice Made From Potable Drinking Water* concentration and hardness. 5-101.1.1 DrinkingWater from an Approved System- 4-601.1'1(A) Equipment Food Contact Surfaces and 590.006(A) Bottled Drinking Water* Utensils Clean` 590.006(B) Water Meets Standards in 3 LO CMR 22.0* 4-602.11 Cleaning Frequency of Equipment Foorl- Contact Surfaces and Utensils* Sheffish and Fish Froman Approved Source 4-702.11 Frequency of Sanitization of Utensils and 3-201.14 Fish and Recreationally Caught Molluscan Food Contact Surfaces of E ui ment* Shellfish* 4703.11 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 Authority 2-301.11 Clean Condition-Hands and Arms* 3-202.18 Shelishmk Identification Present* 2-30112 Cleaning Procedure* 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-201.17 Game Animals* It Good Hygienic Practices 5 Receiving/Condition 2401.11 Eating,Drinking or Using Tobacco* 3-202.11, PHFs Received at Pro er Temperatures* 2-401.12 Discharges From the Eyes, Nose and 3-202.15 Package integrity* Mouth* 3-101.11 Food Safe and Unadulterated* 3-301.12 Preventing Contamination When Tasting* 6 Tags/Records:Shellstock 12 Prevention of Contamination from Hands 3-202.18 Shellstock Identification* 590.004(F) Preventing Contamination from 3-2031.2 Shellstock Identification Maintained* Eat Io ees* Tags/Records:Fish Products 13 Handwash Facilities 3402.11 Parasite Destruction* Conveniently Located and Accessible 3-402.12 Records,Creation and Retention* 5-203.11 Numbers and Capacities* 590.004(7) Labeling of Ingredients" 5-204.11 Location and Placement* 7 Conformance with Approved Procedures 5-205.11 Auessibility,Operation and Maintenance lHACCP Plans Supplied with Soap and Hand Drying 3-502.11 Specialized ProcessingMethods* Devices 3-502.12 Reduced ox en ackan<.-criteria* 6-301.11 1 Handwashing Cleanser,Availability 8-103.12 Conformance with A. roved Procedures* 6-301..12 Hand Dryin«Provision +'Denotes critical item in fhe federal 1999 Food Code or 105 CMIZ 590.004 �10, U CITY OrF SALE 1 BOARD OF HEALTH �a 0) Establishment Name: lip i) aj., V A ,()'n �o� . Dater-���y� �� Page: C�L' of Item Corley y, C-Critical item ✓ s xhw DESCRIPTION OF VIOLATION/PLAN OF CORRECTION " s, ry mate No Reference `R-Red Item '`a.„ *'` '^ r sem ` + v". r`� ry,,e. ,' Verified .' we rek'rzs.,�� �, , s'zr.,4'�W+," .�t A,,! #`, ti. !sem-+ PLEASE PRINT CLEARLY !_0D_/L, _ ,(� 1 F�1-v1, 10WA R7-,(p A 0 SCS v, o- �Q_ II Oil A 0A , UJ_ rK h nAV — -F �.'C�( .— 1)rn�a" l l'f" 0'i I 1 ;;vVU71P) , b n-E" �A )o C(fie l.t oq To F ( �/1/��� D } I A/1 U )m P k- z AL _ 1 ,�L.. -v, i� A I l, ) 0,/, _ !- t�'r�� -2, G-1 N" 1)Tn.� r Discussion WithPerson in Charge: �J ; Corrective Action Require ❑ yNo�� ��Yes �f 5"N Voluntary Compliance ❑ Employee Restriction / I have read this report, have had the opportunity to ask questions and agree to correct allExclusion 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 r ` tion of ❑ Embargo ❑ Emergency Closure noncompliance may result in daily fines of twenty-five dollars or suspension/revoca ( I your food permit. ❑ Voluntary Disposal ❑ Other: KIM, Telopmilurcs 1 14('�--) Reonvell ,, I d",, ikean"Ji, C Violations Related to Foodborne illness Interventions and Risk ik i ca L", f7coWd to Factors(items 1-22) (Cont) With-in 4 fil qa; PROTECTION FROM CHEMICALS3-5FLT5 ctxlfies ImAhnds for Pffus C91Food or Calor Addnrves _.._ —-Ilr- —6 -PHF Hot and Cold Holding -- 5 E ) F old p 7 E(s � 111,04ainTin �W I:at b,+,7 �17-2021'2 T Addhivc,,,�' 590,0(1,41) 4 i /45`F� 3-30114 pnscclion frof!��Addhlcc` Poisonous or Toxic Substan'ses 3 501,16(A) f4a PHF,, Maintained at of above 1=5 -- 1-T-�i-- it 161.11 )""n"t k) Rmms Held at igntrave 130'F, Time as a Public Health Control C 101,11 C 01imlol i an�-�Wor�i a -Ti 0,a S—allu tRc TI e-�,Th—co—rlt I al"_ IT 9 S -,ZI-90—()04(�,-) l V a r iari cc, R(cttio'lon -Po,�a:nce,and Ui,e* ��-20112 Conditiom of Use' LIL-1—--- 7-201H Toxic REQUIREMENTS FOR HIGHLY SUSCEPTIBLE i Cknuamcu,- POPULATIONS{HSP) anill7ei"Crilerra - Cion llckds, F21, -.301��t J`CAZ Vilptiqlcurizcd Pre-pacliaged Junes and -2-pl.1 (1rcylicak for-W Ben tra"act wdh-)t,-W 1�ul-LA-h 7-204,14 3's0'AI(B) 1 Uicut Pa,wilriz(A Let's' "Ical RX hwid- A Cold act,IA1111 icruo s 1-801 i I il)) Raivor PanialiC(x)k,d Aukirlil F(KYJ acid 6 ResoiclrdUtc Peoicides CyiniiaIII Mt11tin ck.*fir otq,Not Served, 7-206J2 licident B�h suaiomsl Tracking P,-�E Control and L�-XKDI:11K,_5 Re—,Cr%cr I CONSUMER ADVISORY 22 3��03 I T17CO er Ad,,iiory PoqNd tor("n7lommitar et TIMEITEMPERATURE CONTROLS Aniviol Foods"Mat arc Raw, UnderotiAcd cin 16 Proper Cooking Temperatures for PHFs -w Nco Otlwrw;sc Procogsed�o Flimmate ,Oi,I]Akla(Z) Fl g.- 155'F 15 r -Svicv l"5,T15stc- le�Subslhrae Ir"I Raw Shell c —Meats& Gan)-c - Animals 15 sec SPECIAL REQUIREMENTS 1-1(A-)( -11-lot I, and Brut Roact ne,;,­ 1 Rai �n2-1 Iniected %atl� - 1�5 y,15 catering, mobile filfal, temporary and Jlounry,Wild Game,Staffed 111-117s, kitchen operations Miould be Stidiing Contili,in,1 ish Sc 1 debit under the approterit1te ectjMS aRove rfrelattA to kxxlfirarne illncs,� Pouhry or Rirtnes-165'P 15 sec. ficactl3ccf Steaks iniclivention.q and tisk facharq, Other -590.009 violations relating to aiiod retail practices should list debitecl usidei #29 - i0wiowave 165'f- * Spittal Requivcnwnts. l5sec, Reheating for Not Holding VIOLAVONS RELATED TO GOOD RETAIL PRACTICES 3-03.1 I(A)&(D) _LjI-IFS 265°1 15 Sc. . (Items 23-30) Miciuwsnc l(5"F2)vb;uu,-,Sjaading I inie, - 3-4`13.11(C) Cotnmiundh,Plcxe ssed RTEKN�d- found in serwns of the Food Code and 105 CXIR 140T' 0Q 0 I------- -------- Reneninn, Unshced Portions of Ilett Item 590SOO 5-403, I(F, Retail Practices C -_Tert and odnnal I FE -2 063 A�ttqa __L Per ....... 24, 1 Food and Foad Polection FC 3 �004 IS 1 Proper Cooling of PHFs ---------- EC I ant and Utensils FG-4 005 31-501.14A) 1 Coid ine CixiktA PHFr from 14W F to 26,- --v`Jatei arid 14'a-,te 1 FC-5 i 0 70"F Within I R)ueq and Frold"iVi I Phya4�1 Facility a 4 Hnuu. -'�e--r-Potsoricais or T.,imQ Vjte o 4 PF/fY F i4- thin f jaiF- 7 2ii, riT a 3501.14; (Cl Cooling PHFb Made Flour Ambient 00.9 s lo 41'F/45'FOther ---------------J tYqhin 4 fhms' Item M!hi,[ I �Ielal 191�9 Fo(Y C"IR`iT WO CITY OF SALEM BOARD OF HEALTH /_ - Establishment Name. ��a n,�n r n .r A �Y�,\ � n � o�i' Date Page: J� of S nem Code., C-Critical Item „_,} ,.'- .DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. References 7R-n-Reditem ,x - `^- '^"+" "* r - `�'"" Verified r., f t PLEASE PRINT CLEA�R/LY� l C,vV1 PJB (7/ 4 1 �( a Sino A-12 rk,1:2 -6 U r is 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 P Y Y your food permit. ❑ Voluntary Disposal ❑ Other: i c+ Recowedta Teuiporaturci FT�0 I 14(C) Violations Related to Foodborne hismirs Interventions and Risk According to Law Coolod to Factors thisall 1-22) (Coat) 41'F/43'1-, Within 4 Hours, PROTECTION FROM CHEMICALS 75 �Co0hnNfeLhnL—f!aPRFs — r19 PHF Hot and Cold Holding Li4—— Food or Color Additives —I -- 3-50!.16(B) Cold Pffs Maintained at or below 3-2()2, 590,004ff W/45"P1 3 ;302.14 Plotmoon frital IS 3-50 1,1 O(A) liot PHF.�Maintained at or above Poisonous or Toxic Substances 140'F, e coneaiaers� --4iLX!11r 110141 I abort 130'F, I Time as a Public Health Central Cominm RaaTM, - Workim,Cowaincrt,* im�"as a Public Health Control, 2(F11 I S'n)al auori- St to,a 7-10��].1 Rcst'iction--Pr(cincrand 111ac* _ ---- - — - --­ 7-202.F2 -F.trachirojol'U�0' REQUIREMENTS FOR HIGHLY SUSCEPTIBLE 7-203 11 Toxic Colnamcl POPULATIONS HSP 7 04.71 San;117en'('rhc-i;t -chenlicils* Unpa�tcilrixcci Prc-iiactagcd Juiccs aed 7-204,12 Chemicals as ��a tlhcE'Poxhic,"('21iterial with ku -abets 7-204 14 4- 1,11(— Lit EAal -TIIt-- Lie-via- B) US�Of PaSno67eL11=L ----.-- F'oixl C'untict. 3-801.1 Iti)) Raw Rroil and Uve Perici(7es,CrinniaT kav Sted 06.12 —L - LsLlroia4 Not st�f tcd. Rmicna Bmt Smtion�� RX)d llaclia"c Tol'Re sina 1 7-2 �no en�(L— 1 7-206 1 Track!tig PovdeN,PIZ-sE Control and L-1 Nlonitol-inc4 CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS --22 3410; it IIlum cA, 16 Proper Cooking Temperatures for Aniniol F,,wcls Ilett arc Raw, Undenexrked cr Not(Nierwise Processed to 1-I'lifyDihire PRFs 3-401,IiA(1)(2) Fgg,,- 155 15S�c. licintxiiate Servicc 3-302.1 Pasteurotcd F�. :;Subsutijte foo katk shot 145"F]5,�ecl 99 Comminuted Fish,Meats& GWIX, ------- Animals 15'F 15 s'ec, SPECIAL REQUIREMENTS —T '0"F 121 nun* 5%.00-9�A)—(D)—in 201.I I(Epi and M-liAtiai I-� 3 teats- 155'F 1.5 as catering. nikAnlgl, fixiii, temporary and 3-401-II(A)(3) poulrry5'yk ild Game,stuffedfiFFS" recidential kitchen operations should her stoffing Containing Fish Meat, dchiled under the appropriate, wctocis Poultry of Hautes-1 65"7 15 sec. above if related to foodborne illness ml act kie�f Steaks interventions and cisk fitclory, Oflier 145F 41 590.009 vloialimis rchnhtg to good Ictid, 3-40102 Ra% Animal Foods Cookcd in a practices.3hould be debitmi under 1129 - Microwave lWF Skii-vial 401 il(A)(I)(b) Alt Oth�l PFW - 145"l:15 sec, Reheating for Hot Holding RELATED TO GOOD RETAIL PRACTICES _3 10T1 (A T&' F)) PHF; F'f (Items 23-30) 740115) - — — Bcmwavc 105F 2 f0muce,Slanding� 't-! Crac(,al and exon-critical vocolioiiv, a-hith do not relate to 1hp. I Tinge. ,foodborne illness intetventiaets erttd rest farmrs livledabol'c, carr Le 3-403.11(r) I Concircycialiv Picicessed RTE Hoot- found ni the fiolhin mg ie(vions r�j 'he hwd Code and 105 C.'MR 140P J90000. 3-403A 1(B3 Remainin,Unsficed Portions of Beef item Good Retail Practices FC 590,00 RoaslO 239 ManNeme'l and Persocript FC -2 1 �003 Proper Cooling at PHFz Protection FO 9--,1 00 4 Equipment amit1teiLsils 005 3 50 1 A4(A) Cooling CookedPHFi; from I40'F to 26 -Nater PlUmbing , and Waset 70°1, Within 2 Hours and From 70' j 27F - I-pe's Phys-ical Facility FC- 1 1 FC-7 008 3 S 14(B) Cmling PHR Made FroinAuribient 30 0t2 ,h, F)l 8— Terrairtature lagrecieuts to 414/45 --—-------- L 4.1lours' Dcaxes ritual iter in Tev lelleral 1999 or 165 C%M 540000 CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET,4"r FLOOR - TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 NLkYOR I_DIONNE SALEM.CONI JANET DIONNE, ACTING HEALTH AGENT 2009 APPI IGATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT NAME OF ESTABLISHMENT /Q 16L1�S AaAl-i TTEL# ADD—DE_c S OF E OTM1 C IIQ,_I A!.E IT L.�,`�'/� r ,(/L ! '1 Mff ! � � / / 1 •�W� MAILING ADDRESS(if different) EMAIL- Business': 6L{L 4 y t vC ebsite: OWNER'S NAME` zl GvZ EL# �y11 n ADDRESS KFM( q /qe � STREET CITY STATE ZIP CERTIFIED FOOD MANAGER'S NAME(S) CERTIFICATE#(S) (Required in an establishment where potentially hazardous food is prepared) EMERGENCY RESPONSE PERSON HOME TEL# DAYS OF OPERATION 1,Monda "°I Juesda .' i :wetlnesda ' Thursda >., - rFdda Saturday' - 'Sunda HOURS OF OPERATION Please write in time of day. `` r-V i -`/•°3b I '••'�(7 �✓(� �''� '1;�b (.(-pv( : 30 Aiv( �j:D 0 ,�`7 : • dFor ezamplellam-11pm �aaiV �W -D M I Cb6D �lD° 0 � 11 • i' TYPE OF ESTABLISHMENT FEE (check only) RETAIL STORE YES NO less than 1000sq.ft. =$70 1000-10,000sq.ft. =$280 more than 10,000sq.ft. =$420 ---- - - RESTAURANT YES NO less than 25 seats =$140 (Outdoor Stationary Food Cart$210) 25-99 seats =$280 more than 99 seats =$420 BED/BREAKFAST/ YES NO $100 CHILDCARE SERVICES --------------------------------------------------------------------------•------------------------------------------------- ADDITIONAL PERMITS MAKE (not just serve) ICE CREAM, YOGURT/SOFT SERVE YES $25 TOBACCO VENDOR O $135 ALL NON-PROFIT(such as church kitchens) 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. Purs Itto MGL Chapter 62C,Section 49A, I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have filed all state tax re nd paid all s e taxes re d under the law. gnaiure Date Social Security or Federal Identification Number --------------------------" - --/-------- - -- ------------------- Revised 424107 FOODAP2008.adm Check#&Date --.�,� �`�`t $ 00 G ig ci,59 5 a t ' Commonwealth of-Massachusetts s # City of Salem _Board ofHe_altn _ __ IGmberiey Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 FoodlRetail Establishment Permit DATE PRINTED: 01/12/2009 ESTABLISHMENT NAME: Reymira's Market Fite Number:BHF-2004-000099 113 Lafayette Street Salem MA 01970 LOCATED AT: 0111 LAFAYETTE STREET I SALEM,MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions i Notes RETAIL FOOD BHP-2009-0358 Jan 9,2009 . Dec 31,2009 $70.00 TOBACCO VENDOR BHP-2009.0359 Jan 9,2009 Dec 31,2009 $135.00 Total Fees: $205.00 i i PERMIT EXPIRES December 31,2009 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 1 r CITY OF SALEM l BOARD OF HEALTH r Establishment Name: 4 S � �� Date: C� 2I �� Page: of Item = -Code 4F ;C,-Critical nem r,, g , ,: , ,DESCRIPTION OF VIOLATION/ PLAN OF CORRECTION, �; Date ' f No. ,y _Reference. .R=Red Item �„, y r o = '� �Verifietl a F. rss_ ,. ✓. -,v i� zm,. us -- PLEASE PRINT CLEARLY�- m - �i 1_I,Yas 1voI( 1 1t)N , +'��IVI eYl( Ihe ori tikM n_� s_. T)965h, i t, n)(*Tn o 1 M '7 W 17) 4! rh 6 4N ) q (� o I -i(A o 049 `If/ik �'��ttt� a il�Sr f aly Irk R . A ,)AMI—CAU �P Y1�P� >Ptnio ix�C 16 r wV v t Za (1 ! � 0- i p.C, O!1 . cxit cce "z Inc " t,d �rz nai Ir•4 ; I--)n le, 6ILQnvA IYIA1Xn k-r_ c )na l J � V' Y Y .art Cal U n r � �It �IPc11 � Ice �I1S �,t 11 t� k sphilr _ r. co, vrr,_� ltnn P a V410r-A-t �lIrlr)- -jr �I{ r iP. � l .Ce+ t r.VI WS V)�:Y1 (17Y7.b-P (-,V ,t "J4` ^ � �1�, �� In,a' � p(r .1 � lx,r �S I A l7 O h�o,r l� J t_-Gi�1Q 1 11MDv1 T YIIt�Ac V\O"t�r I "t"'lYp {;LP,( IMrf' lA) llr �/1 (�:��0� ab L �,1 I r- I'rc- 1 I,f n (1fD.(( V1,1 0 ri'I ' -a (' v r , V11C 61 V)r�pr� /1,a kl, r� C ,rk� �irA / 7 "A J .1, 151 (1 C>0U'1 Cf VP-nr`J C! tQc,n� o I1 V i x I}( . .. _6�Y" 4+ Discussion With Person in Charge: Corrective'Action Required: °U 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 f noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure i your food permit. ❑ Voluntary Disposal ❑ Other: i i4 Violations Related to Foodborne fitness intervention and Risk according to Law Cooled to Factors(Vohs 1-22) (Cont) 3-50L]5 PROTECTION FROM CHEMICALS 19 PHF Hot and Cold Holding Lj4—-- Food or Color Additives 3-501,16(B) C0141 PHI-s Maintained at or b'-low 11-202,F2 jfA:djdilli,es r 590(A40') 4IV45'F, 3-30114from�fbuLI Addi11wics' 111 t-50€ 16;A) I loi PHI-q Nlaortained at oy above I5 Poisonous of Toxic Substances 140T. W, 11 ldentHSmi,laifia nunion--Oriainal 3-501�I h(A) Rmists Held at w above 130"F, Contjanens` 11.—.------..----- Time as a Public Heatth Control 7 102,11 1 Common News- Workin,Contaon,,r,* L�p--- 3-�i()! 19 Ti aw as a Public Health Control 7-20L 11 snLLuon- sloia e 590,004(ffi var4ance R 7-20111 Restrict -po"sc�rrce'wd 7.252.E condmons of'Use� REOUIREMENTS,FOR HIGHLY SUSCEPTIBLE --i-103 If Toxic Comaineo;--Poahi-biham�* POPULATIONS HSP 7-11 1,204. Sarrkir,7eTs�Cfheriit --C�cmicals%- I- I— [-1S0111(A) Uninmeurized Pre-padaged Juice$and- 1 7-204�12 Chante us for Nirast k"fited; abd iewfans wdlmniL� 14 _Rmljj� gm,.Cracria�� Lis Use(if pastnmized Lgg" 1 7-205Al Incidental Fo,xi 1-uh-r-icatits" 8l1 1 i—(D) t—Rawor"P�h=all,;Cw)kdAuiuifJ Food and 206.11 R es i i gel d Us e f I e—�,l i—de r',C r—it e i i a*—— Raw S �otScqwd 7-206.12 p(Acan B' ait sualom, �a s�a Rc-seedry l-.---T-,---- L3-8G1- :Ll�(L- n�e—d F4L—,x x L at 7 106 13 'Flacking Dovvdcci�P's�Control and Maaitarin CONSUMER ADVISORY TIMEITEMPERATURE CONTROLS Aniinal FWfbai'Tt Paw.Uralercookid v; 1-6 --- Proper Cooking Terripinatures for PHFr Not Otherwise to Eliminate 3.401 .99, Ts, F 15 Sc. ........ 145'T15sec, 3-30 11 f1csicurrZod Egite subs ave ba lZirw Shelf l(A)(2) Comminuted Fisfc Mews&Umry Ainmals lil T' 15 rec. - ---- SPECIAL REQUIREMENTS 1-55�F 15 3-401. J;i2) PoiI, and Ilea Roast- 130"1 12) rrifi* 1.11 LlB)i A)(2�—I Rxiles, li�rectod WAtz� 590,W9(A)-kf)i Vichnions of Section 590.W%W-(D) in -T40 ( - oatra-mg, mobil- "id,tempkgiov and residewial kitchen oft-rarions should tic 746711,`Ati� 4�111cultr i�—Ild Carne,Storied 1'.NFs: solffiog Conninkin.Fish, Meat, delafted under theappropriate.Rei:110fls Pouhry or Rathes-165'1'15,�cc. abovc if relatcd ho ftx)dborne i llncss ----------- 5-401 11,Q-1l Imact Beof Steaks intin ventiorv;and risk fachors, Other 1459 590.009 violation,reladno to wod retail 3-401.12 Raw Animal Frxxls CeNikcd ma practice's Arould lae debited under #29 - Nficiowjve 1651 * Special Reitjuhcrncnts. ------------ 3-401A hAl(l)(b) Ali Wier FHFs-- 145t.F' 15 sec, v 7— Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 111F, 165 T I (Iteim 23-30) Crn,;csat and non-cronal violalion,5, wbich do noi relate w 11w +-403,1 ffli� MiProwave- 165°F 2 N'hnnh,Standing I nwf fiiodhorne rilness imef ventArry and rikfeu-tars?wr f above ((,n b(, i-403.I 1(C} Commerciill, Procecsed FTE Food finind in ibcTal!moung sei-fiotH o.0he Food('6de and 105(-'NfR 190.000. --L—�(11` .I� --r -------3-403.11(E} Remaining Unshced Portkat � I I IL of Bw! i PC 590.0w 1 Roasl'0 HY-7 — 24 ' Food and Faud Prntrrctian PC 3 004 Proper Cooling of PHFs D, q�ypment and Utensils 'FC-4 005 EE4�-5bl 711(A) ctx:A ing CooLut PRFs form WWI, to 2.6Vl�steK'J�l irnbiN and Waste I FC-5 i 006 '017, Within 2 Hours and From 70`t! 27. Ph slra]Facillhi QFC -6 -007---.--. to.4 1 T145�F'Within 4 Hotrs� 29 _ 0- 7 Persorloas-or loxic maler its '008 k—, Cooling PHFs Made Front Ambient Tvmperaiure ingredients h,4PF/45'F 0 her Within.1 Hoof v' -- Dcnitel critical Irem to tar& lend 1999 rood(,xk or 105(AIR"0 000, ` 0111 LAFAYETTE STREET Reymira's Market 1 City of Salem RETAIL FOOD - Food Establishment Inspection HACCP: ❑ Item Status Violation Critical Urgency 'Telephone. PROTECTION FROM CONTAMINATION 744-5099 Separatio Segregation/Protection FAIL Critical ❑d RED Owner: omment:Walk-in freezer has meats stored above french fries and other items.Organize freezer to properly separate potentially Reyna Ramirez Guerrero hazardous items from ready to eat items. PIC: Food Con ct Surfaces Cleaning and Sanitizing FAIL Critical ❑d RED Steven NovaCo ment: No sanitizer was available at front counter.Sanitizer must be available in all areas at all times. Inspector: � Some knives in knife rack had debris on them.All knives must be properly washed,rinsed and sanitized prior to storage. Elizabeth Salandrea GoodHygienic Practices FAIL Critical WRED Date Inspected:Correct By: Comment: Employee pepto bismol was in front counter fridge.Employee items may not be stored in units with items to be sold to 110/16/2008 customers. ,Risk Level: Handwa Facilities FAIL Critical 66 RED VComment: Handwash sink in back room had sponge in it. Handwash sink may not be used for anything but handwashing and must T Permit Number: - be free from obstructions at all times. BHP-2008-0091 TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) Hotand old Holding FAIL Critical ❑d RED (Status "VIOLATION Comment:Produce fridge at front had packages of fish in it;the fridge was holding at 80°F.Fish is potentially hazardous and must be discarded.Unless turned down to hold temperature of 41°F or lower, produce fridge may not be used to hold anything except r#of Critical Violations: whole un-cut fruits and vegetables. Time IN: Time OUT: Walk-in f'dga holdirZq at 50°F. Repair or turn down to ensure tem-,.IQperature is 41°F or lower. 4 h10Mp- 191'1 oT tV oYtjy vets 1�rvlts, crxr �eore, lam: h� ° Walk-in freezer holding at 15°F.Repair or turndown to ensure temperature is °F or lower. Urgency Description(s): v.10 BLUE: Violations Related to Good Retail Practices(Critical violations must be corrected immediately or within 10 days)(Non-critical violations I must be corrected immediately I or within 90 days) City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Oct 17,2008 ) Page 1 of Ir Item Status Violation Critical Urgency RED: 7 Violations Related to Good Retail Practices (Blue Items) Violations Related to E Food andFoodProtection 1 FAIL Critical BLUE Foodborne Illness.Interventions I + /comment:There are plastic containers ooffmmariinnaatCed�r'aw meat being sold out of the fridge at the front counter;tongs used to and Risk Factors Require handle the meat are being stored in a paper bag at the bottom of the fridge. Deli meat and cheese is also being sliced with a slicer immediate corrective action) ! at the front counter and sold.These are not allowable activities under establishment's current retail food permit.Establishment must immediately cease selling the sliced deli meat/cheese and the marinated raw meat. The following outdated items were removed from shelves: -27 cans del frutal drinks 17 constanza garlic paste 16 Pepsi —13 packages parkay margarine spread aop, 12 minute maid lemonade 12 sierra mist 11 bottles canada dry gingerale 11 bags plantain chips 10 betty crocker frosting 8 schweppes ginger ale 8 nestle cerelac baby cereal 6 la yogurt 5 red bull sugar free 5 goya minced garlic 4 pure country of .-4 goya chicharrones 4 boxes krispy saltines 3 cans canada dry gingerale 3 sunny d ` IS 3 tormenta light energy drinks lam' l 3 cans river queen peanuts 2 packages bar s salami 1 can brisk iced tea off' __ p 1 Al s uce sauce `^ ,5� ��.yv oyy 5� p a�ZS TnJ 1 bag howard's pork strips (mled Z3Y1 cY� Owner to closely monitor all expiration dates. \_o, o kk Most packaged meat for sale in back freezer and front fridge are not labelled properly,and some packages ripped open.All meat packaged by establishment must be labelled properly,and any packages with ripped plastic must be removed. Equipment d Utensils FAIL Non-Critical BLUE Equipment Fridge at front counter needs general cleaning in door tracks. 7loor of the walk-in fridge needs thorough cleaning. �11a a -in freezer has ice accumulation on back of the fan.De-ice the fan. op in back room is being stored on the pipe to the handwash sink.Mop must be stored hanging up to air dry to prevent cross contamination. City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Oct 17,2008 ) Page 2 of i Item Status Violation Critical Urgency P - tic wrapping machine in back room has accumulation of food and other debris on it.Thoroughly clean the entire machine. Freezer in back of store needs thorough cleaning on the bottom. retire wall cooler needs general cleaning along the bottom and the racks. VThhe corner in the back room next to the handwash sink needs thorough cleaning and organizing. "S 'y sink had dishes and other items in all 3 bays.3bay sink must be used properly to wash,rinse and sanitize dishes and utensils,and must not be obstructed. Physical F ility FAIL Non-Critical BLUE Physical Light in back room needs protective cover. wee corner in the back room next to the handwash sink is missing some floor tiles.Replace all missing floor tiles. Other-Se Notes FAIL BLUE omment: Back room appeared to have fruit flies at time of inspection,specifically in corner next to handwash sink.Owner to hire services of licensed pest control operator to eliminate fruit flies; please forward invoices for service to the Board of Health. Reinspection in one week, all violations to be corrected. Owner to meet with Health Agent to discuss violations on this report and to discuss activities that are allowed and not allowed under current permit. City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800 GeoTMS®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Oct 17,2008 ) Page 3 of