RINCON MARCORISANO - ESTABLISHMENTS Rincon Marcorisano
335 Lafayette Street
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IMPORTANT MESSAGE
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PHONE 'IS/- 3 1(0-
AREA CODE NUMBER EXTENSION
O FAX
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AREA CODE NUMBER TIME TO CALL
f TELEPHONED PLEASE CALL
CAME TO SEE YOU WILL CALL AGAIN.
WANTS TO SEE YOU RUSH.'
RETURNED YOUR CALL WILL FAX TO YOU
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MESSAGE
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SIGNED
FORM 4009
MADE IN U.S.A.
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Massachusetts Department of Public Health Salem Board of Health
Floor
Division of Food and Drugs 120 Washington Street, 4'"
9 Salem, MA 01970-3523
FOOD ESTABLISHMENT INSPECTION REPORT Tel (978) 741-1800 Fax (978) 745-0343
Name Date Tyne of Operation($) Type of Inspection
��d c„) tv C--aco1� V S,- 1 o Y Q Food Service ❑ Routine
AddressRisk ❑ Retail ❑ Re-inspection
9'9,; e, S' Level ❑ Residential Kitchen Previous Inspection
Telephone y 5 -2--L-Z-3 [I Mobile Date:
HACCP Y/N
Owner El Temporary E] Pre-operation
�n5, � o L� l cgre�G�c of ❑ Caterer ❑ Suspect Illness
Person in Charge(PIC) Time ❑ Bed&Breakfast ❑ General Complaint
In: ❑ HACCP
Inspector Ch Cr"3 n Out: Permit No. ❑Other
Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s) violated.
Non-compliance with:
Violations Related to Foodborne Illness Interventions and Risk Factors Anti-Choking Tobacco
Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.009(F) ❑
action as determined by the Board of Health.
FOOD PROTECTION MANAGEMENT, _„_ (=i' '� ,„„ ,�, ,p y.�,, `, El12. Prevention of Contamination from Hands
❑ 1 PIC Assigned/Knowledgeable/Duties ❑ 13 Handwash Facilities
g EMPLOYEE HEALTH
e a 3 r v i-' 3�
era-�. PROTECTION PROMtCNEMICALS
❑ 2. Reporting of Diseases by Food Employee and PIC � a
❑ 14.Approved Food or Color Additives
❑ 3. Personnel with Infections Restricted/Excluded
ern �m*^_ r!wa mfl ❑ 15 Toxic Chemicals
FOOD FROM APPROVED SOURCE
F-1 4. Food and Water from Approved
pproved Source fiTME-frf EMPERATURE CO,,N,TaRu OL�S(�Pa_temiallyar yHazardous Foods) r
❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures
❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating
❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18.Cooling
y PROTECTION FROM CONTAMMATION a "1', ❑ 19. Hot and Cold Holding
.. .... == 3
❑ 8 Separation/Segregation/Protection ❑20.Time As a Public Health Control
❑ 9. Food Contact Surfaces Cleaning and Sanitizing ,.REQUIREMENTS 04R HIGHLY SUSCEPTIBLE Pd0ULATIONS(HSP)
[:121. Food and Food Preparation for HSP
❑ 10. Proper Adequate Handwashing
ec , ��k � 'k E �,", � ' I_Iav� a �,rj
El 11. Good Hygienic Practices [CONSUMgll ADVISORY
❑22. Posting of Consumer Advisories
Violations Related to Good Retail Practices Number of Violated Provisions Related
Critical (C) violations marked must be corrected To Foodborne Illnesses Interventions
immediately or within 10 days as determined by the Board and Risk Factors(Items 1-22):
of Health. Non-critical (N) violations must be corrected Official Order for Correction: Based on an inspection
immediately or within 90 days as determined by the Board today, the items checked indicate violations of 105 CMR
of Health. 590.000/federal Food Code. This report, when signed below
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-a)(sso.005) cited in this report may result in suspension or revocation of
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)(59o.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,590MsWtFor -14.x
Inspector's S/'gla �. 4 ^ Print-bb,, 1 C�tL:.;,c a �`
v �p
PIC'sSigndture: ILS - 'lJ�n s Print: / C �/ /1 I i,i / 4,1A /./� Page - of ?-Pages
Violations Related to Foodborne Illness
Interventions and Risk Factors(Hems 1-22)
PROTECTION FROM CONTAMINATION
FOOD PROTECTION MANAGEMENT S Cross-contamination
1 5911.003(A) I Assignment of Responsibility* 3-302 1 l(A)(1) Raw Animal Foots Separated from
590.003(B) Demonstration of Knowledge* Cooked and RTE Foods*
2-103.11 Person in charge-duties Contamination from Paw 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 3-302.1[(A) Food Protection*
applicants*. 3-302.15 Washin Fruits and Ve. eCables
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 oxtina 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(E) 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 F 9 Food Contact Surfaces
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water
3-201.1.2 Food in a Hermetically Seated Container* Sanitization Tem eratures*
3-20113 Fluid Milk and Milk Products* 4-501.112 MechanicalWarewashina Hot Water
3-202.13 Shell Elias*
Sanitization Temperatures*
3-202.14 Eggs and Milk Products.Pasteurized* 4-501.114 Chemical Sanitization-temp.,pH,
3-202.16 Ice Made From Potable Drinking Water* concentration and hardness. 'w
5-101.1.1 Drinking Water from an Approved System*tem* 4-601.1.[(A) Equipment Food Contact Surfaces and
590.006(A) Bottled Drinking Water* Utensils Clean"
4-602.11 Cleaning Frequency of Equipment Food-
Shellfish
Water Meets Standards in'310 CMR 22.0*
Shellfish and Fish From an Approved Source Contact Surfaces and Utensils*
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* 4-703.11 Methods of Sanitization-Hot Water and
3-201.15 Molluscan Shellfish from NSSP Listed Chemical*
Sources* Ip Proper,Adequate Handwashing
Regulatory Authority
Came and ld Mushrooms Approved by 2-301.1.1 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 2-401.11. Eatin ,Drinking or Using Tobacco*
3-202.11 PHFs Received at Proper Temperatures* 2-401.12 Discharges From the Eyes, Nose and
3-202.1.5 Package Inte it ' Mouth*
3-101.11. Food Safe and Unadulterated* 3-301.12 Preventin 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* 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 Capacifies*
590.004(1) Labeling of Ingredients* 5-204.11 Location and Placement*
? Conformance with Approved Procedures
5-205.11 Accessibility,Operation and Maintenance
/HACCP Plans - Supplied with Soap and Nand Drying
3-502.11 Specialized Processing Methods* Devices
3-502.12 Reduced oxygen Eacka 'ng,criteria* 6-301.11. Handwashing Cleanser,Availabilit
8-103.12 Conformance with Approved Procedures* 6-301.12 Hand D -m�Provision
*Denotes critical item in the Weral 1999 Fwd Cale or 105 CMR 590.000.
CITY OF SALEM
' BOARD OF HEALTH
Establishment Name: e'L.ec' >-,ca+ \ titi s > _ Date: -3- i S-aF Page: 2_ of Z
item Code C-Critical DESCRIPTION OF VIOLATION/ PLAN OF CORRECTION �"F ems;. ",,. �°' Date
No Reference R-Red Item �" * _- .,�..
"' PLEASE PRINT CLEARLY'°* 0 "� � Verified
6-11"j1j11r 11 � - S{lC^� lY f'L�^..-
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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
t comply with all mandates of the Mass/Federal Food Code. I understand that ❑ Re-inspection Scheduled ❑ Emergency Suspension
noncompliance may result in daily fines of twenty-five dollars orsuspension/,revocation of ❑ Embargo El Emergency Closure
1 your food permit.
_� J �� v 0 Voluntary Disposal ❑ Other:
Violations Related to Foodborne illness interventions and Risk to Luw Ct),�Ipej�d�t,'170s
Factors(items 1-22) (Cont j 41°R45 F Wilbin 4 Hours,
S01 15 Cooliot�MeLhode for PHIcs
PROTECTION FROM CHEMICALS
Food or Color Additives Ll 9— PHF Hot and Cold Holding
L!4— 3-202,1, Aiklitivc,`� A 50 1.j 6(B) Cold PHI,Maintained at or below
'q90,(X)4(F, 410/45"F'
3-302,14
3-501,16(A'i this PFIFsAfainfarined at or above
PoisPnotm or Toxic Substances
LL�- 1
1 4�1
0511 jdontilyiq Injol ination-- orlyinal Ron -------4
;-561,iti(A) Roasts Hold w or above 130'R
Coruainer,��
2� 1 Time as a Public Heafth Control
_FF - - TT
02 1 1 Common Name L�o IT)t�1!1) -Tic IF,9 1 firile as a Public,Health Control*
7 20Ll i-2011
I i7
1Reomi
stric - Prer;tnco and U;0 titriance Re
utrenient
7-202.12 Curditiorc,of lfso* REOUIREMENTS FOR HIGHLY SUSCEPTIBLE
7-203,11 Toxic 0twaine" -Probiliumill, POPULATIONS(HS
7P Sanithsef,1,Criteria—0,CiniON" --T----
-T- 213-801.19(A) trop oleu rizvd rsie-packaged Juices wid
3-801 i I(fi) x. ofPwteinizcc! L,
1
7-205,11 Incidental Food Coritaciturn iewils"
3-WIAI(D) i Raw or Partmlf,,Ccokd Ammrl Food and
TG
17500.11 aoicfrtd Use PeNticides.cdterta'
Rau Sv��d S trouts hot Seruul
tt 7-206 12 foxiew 13011 Slatlk'M� --4-1 —" I
3-Y01A 1-Q U o encc fkxA P�,�c:ka�LkNot Re-served
1 _L
7- 061;2 'TrickingPimil-m Pes[Control and -L-111-221 _ _ ----
CONSUMER ADVISORY
--F�oorKTYEkey —
TIMMEMPERATURE CONTROLS 22 3-60;�1 Consth Posted fQr conw
s--';�ptoon of
16 Proper Cooking Temperatures for rVdulal PKAS'lhat are Raw, Under")
PHFs Not Odwm i�e Processed to Eliminate
155F 1 5
3.40 1,1 t(A)(,'i Comminuted Fish, tvicies&Garlic
Animals- 155"F I e sec
3-401.11(B)(1)(2) Poik and Beef Roast -1,0 1" 121 min* SPECIAL REQUIREMENTS
90—(y)91,7,)--(D.i T
3-401 1(A)(11) violalion'�of section 590.(X)9(;��)-(D) in
fhitrw, li�jecicd I%atc - 155,F I catering. nobilc ki(xi,ternporaivand
.3-40�1 11,A),;T Pouttry,Wild Game,Stalled PHFs, restilt enuai kitchen operations should be
so fling Conninlin"; Ftsh, Meal, d,+hed under the appropriate ieclions
P Ohms.165'F IS sec. alht,ve if rchiled tel fesr1horno illness
I�I'IiC)(i Intact Ileof Steaks inter vent on9s acid risk faclors, Other
7- 1451; 530.009 violidjow relaur�,,oto good.retail
1401 12 Rain minor(Food,C(tokudw 11 practices>hould be debited" under, #29 -
I-- Miciowave 16.5'F Special Rec)uirertients,
3-401 ll(A)(119h) All Other -- 145'T 15 sec.
7Reheating for Hot Holding WOLA r/ONS RELA COD RETAIL PRACTfCES
-3-T,,)Ti I(A)8 i D) PFIEa 165=F 15 sec. -1 (Items 23-30)
3-403.1 ICS) Microwave- 1(15°v 2 Mimile Standing, CrWrivanrl tion-critical viololunts, which do trot i,elirren)the
foodborne illness riociventiuiv and rokjn(tors hvedahovc am br
3-403.1 9(C) Comfin'relatIv Pi(wessed RTE Forid- found in Oic felkrt,irrg sec tions ql the Food Code and 105('3IR
140"F` 590,000,
3-403-11(E) Rejuandro, Uieliccd Portions of Picel
Roast:*Roasj 23, �ManaSe=0 tand Peoa;otej
IS Fi4 and Food Prolection, PC 1 W,l
Proper Cooling of PHFs L-9--' ----------------- - 3
259EL,�p priiArjd Ltt&�Leh PC--i-
sn � 005
-SOL14{A) Coc,ling C(x*ixt PHFs from 140'F to Watel, ---- ------- ----4
---tiurnbrn PC
70'F Within 2 Hours and From 70'1 -2-11�idV�Usre---------- —�L--!
27, Foss Fac0rt'j 9 PC-6 1 007
T-rc- --- _j
Lo141'F/45'F W'itldn 4 Hours. soriorn;or To4c klaten-317, C -7 008
418) Coating PHR Made Front Ambient '2";cZ p;q roE is 009
Temperature fiigrvdiem�14,4V[745`F j Other
Within 4 1 lours
Dcwlits alucal irtm iri'Th"re lend 1999 Food Code or 1 OS C"'Tic 590 000,
rf ,
335 Lafayette Street Rincon Marcorisano
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
Telephone: a PROTECTION FROM CONTAMINATION
(978) 745-2223.E r Food Contact Surfaces Cleaning and Sanitizing FAIL Critical ❑d RED
Owner. - ' g „-.. �$ mment:There sanitizing solution in the kitchen found too weak. Sanitizing solution of proper concentration must be readily
a
Basiho Encarnacion=� a�"" available at all work stations at all times.
BPICC o� � , .
aslh .Encarnacion `
David Greenbaum
(Date,lnspected Correct.B'y:A
417120 08
Risk Level:
Permit Number
BHP-2008-0351
I.Stlatus.
PARTIALCOMPLY
#'of Critical Violations k
`Time 1W - - x Time OUT. 11'"
(Urgency.Description(s)
BLUE .-
Molations Related to Good:
Retail Practices (Criticah ..
iolations must be'correctedy
immediately or within 10
Fdays)(Non-critical violations,
mlist 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 07,2008 ) Page I oft
Item - Status Violation Critical Urgency
Violations Related to Good Retail Practices (Blue Items)
`Violations.Related;to.., s p Food and Food Pr tection FAIL Critical BLUE
Foodborne.11lnessnterventions
and Rlsk Factors (Require co ant: Label the flour bin"Flour"
;Immediate correctiye:actlon) " bel tF}e rice bin"Rice"
Label the front sugar bin"Sugar"
Equiprrl€nt and Utensils FAIL Non-Critical BLUE
\'Com/m/ent:Label the 3 bay sink"Wash,Rinse,Sanitize"
Thd ba ment shelves need a thorough cleaning and repainting.
e Hotpoint freezer in the basement needs a thorough cleaning and defrosting.
Th rue freezer in the basement needs a thorough cleaning.
Th ame unit has the wrong thermometer. Provide a thermomete that shows temperatures to 0"F amd below.
Thew also has a thermometer that does not show accurate temperatures. Provide a thermometer that shows temperatures to
4 a below.
Tfront Arctic air freezer needs a thorough cleaning and defrosting.
Physical Facility FAIL Non-Critical BLUE
menta The Floor in the employee restroom is in disrepair. Repair the floor to be smooth,impervious and easily cleanable.
T re water stained ceiling tiles in the employee restroom. Investigate the source of the leak and repair. Replace all staine ceiling
les
✓Restroom is currently being worked on.
GENERAL COMMENTS:
Due to the high number of critical repeat violations and the high number of violations not corrected the owner is
required to attend a hearing regarding this matter with the Health Agent on Tuesday, April 8, 2008 at 2:OO13M at the
Board of Health office and monetary citations will be issued for all critical repeat violations.
e
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 07,2008 ) Page 2 oft
SC,
COURT DOCKET NO. CITATION NO.
CITY O SALEM P
VIOLATION NOTICE rD 6 4 5 3
NAME(LAST,FIRST,INITIAL)
S.TREETADDRESS CITY/TOWN STATE ZIP
33S S vcx.. tv015
LICENSE NO. LIC.EXP.DATE DATE OF BIRTH
OWNER'S NAME(LAST,FIRST,INITIAL)
Es)ua ua t �c 3 ` e
STREETADDRESS CITV/TOWN STATE ZIP
1% 1�t1 ��TvS ?\-. 1-\440 lI Tl4k 01 14a1.
REGISTRATION NO. STATE EXP.DATE MAKE/TVPE YEAR COLOR
DATE OF VIOLATION TIME DATE CITATION WRITTEN PERSMN
^f�� C, (�� IWURNO
S--ls Se �PM O S S VYES
LOCATION OF VIOLATION ENFORCING DEPT
33S �-c�Fn �CC� 5 <,i)vtm %>cA
OFFENSE CHAP. SECT. FINES
c
S'
OFFICER I.D.NO. TOTAL
FINE
J a DUE
OFFIO R CERTIFIES QO.PY GIVEN TO VIOLATOR
/ j2t_lN HAND
XI ❑ BY MAIL
O N AILC -PA NLY B POSTAL NOTE,MONEY
ORDER OR BY CH CK MADE PAVA E TO:
CITY CLERK
CITY HALL
93 WASHINGTON STREET
SALEM,MA 01970
TEL.(508)765-9595 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 N
SIGNATURE
SEE OTHER SIDE FOR FURTHER INFORMATION
ENCLOSE PAYMENT IN THIS ENVELOPE,PEEL AND SEAL
COURT DOCKET NO. CITATION NO.
CITY SALEM r 4 5 3
VIOLATION NOTICEPD v 3
-0 \
NAME(LAST,FIRST,INITIAL)
SP EETADDRESS CITYROWN STATE ZIP
33s Lt's by i;�lcl S- SGVv� tr ll o S�
LICENSE NO. LIC.EXP.DATE DATE OF BIRTH
OWNER'S NAME(LAST,FIRST,INITIAL)
3 ) �: a
STREETADDRESS CITY/TOWN STATE ZIP
REGISTRATION NO[ STATE EXP.DATE MA' Vi'EI< YEAR COLOR
DATE OF VIOLATION TIME._ ADATE CITATION WRITTEN PERSONAL
7DYES
�� .�I IWURY
3.2s o�ja.:--,�► L❑PM' Jc�'- `� EINO
LOCATION OF VIOLATION ENFORCING DEPT.
OFFENSE ,y� CHAP. SECT FINES
Q /7
B
S'
C
OFFICER I.D.No. TOTAL=fl
FINE $ G
DUE
OFF&CERTIFIESI� Y GIVEN TO VIOLATOR
HAND
X ❑ BY MAIL
DO NOT MAIL CAS -PAIP NLY BV 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
COURT DOCKET NO. CITATION NO.
CITY OF SALEM VIOLATION NOTICE
PD6453
NAME(LAST,FIRST,INITIAL)
��NLS 'mrati.U�J-,c,-N�d a
ST�REETADDRESS C CITY/TOWN STATE ZIP
ST
LICENSE NO. LIC.EXP DATE DATE OF BIRTH
OWNER'S NAME(LAST,FIRST,INITIAL)
s
STREET ADDRESS CITY/TOWN ?'STATE)(" Zip
)& r0`uv)-'�5 `jam-. 01TNO Grp oN�nA,
REGISTRATIORNO. ,STATE. -EXXfP.DATE MAKE/TYPE YEAR COLOR
DATE OF VIOLATION TIME DATE CITATION WRITTEN °ERSOrvnL
AM Lj. �. �� rvuA❑V
PES
�I ❑PM ❑NO
LOCATION OF VIOLATION Ni-ENFORCING DEPT
335 •, `I. - , e,; y - (1 'boli
OFFENSECHAP. SECT. FINES
B
C
OFFICER I.D.NO. TOTAL P
�-C, %� )."Y^- FIN E
DUE `�'llc
OFFICIER CERTIFIES('OPY GIVEN TO VIOLATOR
4�6
0 HAND
X f, ❑ BY MAIL
DO N6T MAIL CASH-PAY bNLY 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
COURTDOCKETNO. CITATIONNO
CITY SALEM PD6 !j�,53
VIOLATION NOTICE
NAME(LAST,FIRST,INITIAL) .
STREETADDRESS CITY?OWN STATE ZIP
LICENSE NO. LIC.EXP.DATE DATE OF BIRTH
OWNER'S NAME(LAST,FIRST,INITIAL)
STREETADDRESS CITY/TOWN STATE ZIP
REGISTRATION NO. STATE EXP.DATE MAKETYPE,i YEAR COLOR
DATE OF VIOLATION TIME _ DATE CITATION WRITTEN PERSONAL
f}� (]AM iwuRr
❑PM".. tS v!�' (�# ❑VES
1 El NO
LOCATION OF VIOLATION ,1:. ENFORCING DEPT.
OFFENSE CHAP. SECT. FINES
e�
C �F
OFFICER 1.0.NO. TOTAL FINE �j
✓ 1..."}�. .V r�' "' , y^., DUE �'.. 0
OFFICER CERTIFIES COPY GIVEN TO VIOLATOR
/� 0-dN HAND
X ❑!' BY MAIL
DO N1 MAS
AIL CH-PAr6NLY BY POSTAL NOTE,MONEY
ORS=o:no-nv_C"ECK.MADE PAYABLE T0:
City of Salem - ----]
Board of Health
720 Washington Street 4th floor
I HEREB Salem, MA 07970 D ON
REVERSE,CONFESS70-THE OFFENSE-CHARGEDTAND ENCLOSE
PAYMENT IN THE AMOUNT OF
$ CASE#
SIGNATURE
SEE OTHER SIDE FOR FURTHER INFORMATION
ENCLOSE PAYMENT IN THIS ENVELOPE,PEEL AND SEAL
'30dX 3 al TO EXP'DSE ADHZ5;VE.?°MOVE LINZR H3A.l 3A7N3`J 3A
H3NIl 3A)N3'd'3A1S3H3V 330aX3 Dl TO EXPOSE ADH"_31VE, R'NTVE J�
Violatiot; Notice-------------------------City of Salem Place
Stamp
Here
To Offender: Post Office
You have the following alternatives with regard to disposition will not deliver
Oof this matter(1) You may elect to pay by check, money order without stamp
or postal note either in person Monday through Wednesday.
from 8AM to 4 PM (Thursday 8AM to 7 PM) Friday 8AM to
12PM at,the Board of Health 120 Washington Street; or by
mail to t#te Board of Health within 21 days of the date of this
notice.This will operate as a final disposition of the matter, .
with no,7esulting criminal record. (2) If you fail to pay the fine;
you will be summoned to appear at a hearing at Salem District Salem
f oS
Court. The hearing will operate as a final disposition, with no City CityBoao S Health
resulting criminal record, provided any fine by the hearing 0
officer is paid within the time specified. (3) If you fail to pay 120 Washington Street 4th floor
the imposed fine or appear as specified, a criminal Salem, MA 01970
complaint will be issued against you.
I
CITY OF SALEM
BOARD OF HEALTH
Establishment Name: Date: Page: of
Item Code w r & C-Critical Itempv s * ,. DESCRIPTION OF,VIOLATION/PLAN OF CORRECTION Date
No. Referenced R_'=Red Item "ti r _ - - ...r`�"" "= � Verified =
' -.� PLEASE PRINT CLEARLY �� ^. -`"
LEDiscussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes
this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee RestrictionExclusion
efore the next inspection, to observe all conditions as described, and to ❑ Re-inspection Scheduled ❑ Emergency Suspension
h all mandates of the Mass/Federal Food Code. I understand that
ance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure
ermit.
❑ Voluntary Disposal ❑ Other:
inir In d z Cooled to
Ylotaflor>s Rotafed to Foodborne tttnese interventions and Risk h cording is l.aw Cooled to
Factors(it 1-22) (Coof.) 11 F/45'F Within 4 Hous. x
Cool klVetnodsfarIIHFs
PROTECTION FROM CHEMICALS _ Iy 1 — PHF Hot and Cold Holding
Lqq , ,,.,... _�„_,,,,. Food or Color Addrnves�. 'I-St7r )'&(B) � Cold PRl��tatntained at or below I
-2!212 I—Additive, 590 a;34fF; 4t°!QS° €'_
” 't 3t12.14 Protection fraxn t nal)pj) ed Atdrtives` 1-501 16(A) Har FFLI c:vgaintaineii at or above
SS Poisonous or Toxic Substancesr„Y
t0L11 identif}anginfaimauan- ltrgSna R(r<,stsHold atorabove 23{�'F.
comainers, -
7 102,11 E Common Name orki C oat liners* 2d Time as a Public Health Control
�„. ----- --
3-501,19 Tame ac a I'ubfie I-Ieal h C antral'
7 °Ot.11a�a on 5frirae
far+anise Ra tore mors£
i '202.11 Reatnct an Presence,and t,fr,'� _� _.._.__. _ _______......_. __....._...___...�W....._._._. �_...._._._
7 2{}'2.II Condition of Us F3EI UIREIS�ENTS FOR HIGHLY SUSCEPTIBLE
7203.iI ToxicContarnes Prahihi!ions POPULATIONS NSP}
r7 204.1 t Sumurer< Crite i i Che mic is
1
1-21104 122 {'}R7ll14 ifs f ix t5 a<hutq I'.adncn Criteria", ( 2f { - `�l I 1 til) t;npa.teuri ced Tkc trackaged Juices and
t Bet raes.with iWaroina
7 7)d.14 I) tnK A eats C nteria� 01 11fB) Us.o Pa<teniYr�d ice_
2p5.11 Incidental ! >xl Contact Lubniearas' ,. 3-la)111(D) Raw or Partialli Cuai, rl Ani:not Ftxai and
1 ?21)6.i 1 Resorcled i se P ri !Flee.Cnten t
c---. - f R rw Sc ed Sprotns hat Ser4cd
7 oC I R(xlem But SUMR)ar, 3-901 l l tf', LrEa erred F xx Pu a tiaF Rc-se ved
7-206,13 Fra eking Powde rc.Pest(Anarol and
MOniForin ,. _ w CONSUMER ADVISORY
TIMSTEMPERATURE CONTROLS 22 3-6(;1 11rim Adrisais T'risted for Colnumptx'on of 1
rCaakin Ta `nim t I ttls Fhat ruRaw Under",okedi-i
16 raper g mpetatures taf� 'Not Othe yi< c processed )Hlitntnare
PHFs P dloi!i_wn
341.F1 i(l)(2i Ergs 155`r t5S - _._..
--3 I• Cni Anne- atG 4u r! c 1 45 -15efc� =. -I0? 13 Piste rrrcd 5=ihsfita
F•gg.: sz RaShell
iz
3-40LII(A)(2.; Comminuted Fish MeatsAc£!erne r"`------. --.-------
Amro zts-
155"F 15 sec .,. SPECIAL REOUIREMENTS
.-40
Ltl{D}tl_j(2) 3 Pork and l2tc*Roast
_-I301�1
' 121_ nink carcring. inoh—ilc.foox590.009(A)-(D)
—te-m—
40 porary andc90.7o (n) in15 S�)d9{A3 ( )} ofI(B)(2) R It rd s
i sac. I
dant=tet�*chen o rations 4ioutel be
�3-40t_IIfA(3) Poultry,WildG;erne,.StuffedP14 s, � ���"
Sniffing Contcu,rag Fish Mat debited ender Fire appropdaty ;ecltoas
Poultry orRatiti s 165'F 15 sic above if dated to food-home illness
3-401.1 C) tiytiolc mus Ic G»ct&i P Steaks inter ventions and tisk factors, Other
t'45"'F"` 590.009 violation,;relating to good retail
340!J2 Raw Amatal fu xis Cooked in a ,settees should i-re debited under X129-
4hctawave 165,F
bAll( her Pill 145"F15 sec.
4petlal kerirliretttettts.
d7 ___ Reheating for Hot Holding Vtt?L AT€CJfttS RELATED TO GOOD RETAIL PRACTICES
3-403.I I(AjT:(B) PIIt v 165°F 15 se _ (hears 23-141)
3 403.I 1(B) 4lictawvve iCaS'e2 Minnti.Standing Crat.,a and r nn cAisccat matrons. ivinth do ria relart w the
Time" _ jaodborne tR wv i mrerventioru and n4 jaetnrs bated alcove, con be
3 d 3.1 I(C.) C ommercially Prrxesied Ri'F__RXI -_ /inawt bi the faIhm in,sections cl the Food Cade and 1175 C'h1R
140'F�
cat�umrc,i 5n
X28 3 4u3 1tu3 f_(P)
Proper Coo 3ngla4 R 8aoi s of Hcef 24, �n Food Peer o re€ — �FC a 004
i 0M
3-5{tt.[dCfl} �04FrW hi P f tram 4 H From)7)ft 8� Fc>3sannus or Tom 3nd'Naste cC 5 OU6 1
( - 26 Wates Pit Tbi� _.� ._.
II < '" ' 27 Fh ref Paciii#y, FC' 6-
007 i
S omM!tonea � — �f3 �
�..�_ .......____. ..
3-St3L 14(br C`oohng PHFs,Made From Ambien[ � � '9 �.��lai Rvci47rement,. ._... .. t .. . 0�' .__..
Temp e nare.7n nediertts tit 41”F/45`F E30 tither
Within 4lkurs
"Ft.notes mdcat eelb hi thr i"de int 1904 Fond C. Ie ya 105 e MR 5911000.
t
i
CITY OF SALEM
> BOARD OF HEALTH
Establishment Name: Date: Page: of 3
;ttem ; Code ,,,,"a C-Critical Item ;, rr r ,� , DESCRIPTION OF VIOLATION/ PLAN OF CORRECTION $y Date s
No s Reference c R 'Red Item ' .,', ' ?�'':� ;ry ' ,,p k- - �=1^�'-^%" '' F �' r "" �»�<,� Verified q -
rJ,
TA
Discussion
OR
4,C„+,1„ i. � �i'Se ,�, '�� .:.�'h�i,./�� �1"' 'Y,.,PLEASE PRINT CLEARLY .:�.,�lf �f � `,(,+�”
4
Ill
I<[j
{Sl
}
1
i
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 C1 Voluntary Compliance ❑ Employee Restriction/
violations before the next inspection, to observe all conditions as described, and to Exclusion
P ❑ Re-inspection Scheduled ❑ Emergency Suspension
comply with all mandates of the Mass/Federal Food Code. I understand that
noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure
your food permit.
❑ Voluntary Disposal ❑ Other: ;<
i
f �
s
i
€.7 i(C) PHFs Received at J'e;,praturcs
Violations Related to Foodbame Illness interventions and Risk According to Lav Cooled to
Factors(iteors I-V) (Cont) 1 1 CF/45'F Within 4 Hows,
PROTECTION FROM CHEMICALS LI9 PHF Hot and Cold Holding
or Additives
[F-E Cold PHFs Maintained at or below
3-202,12 1 Atutivaz�* 54
6
4rr-) 4 1 V45�F'
3-30214 Protection from L2aEkan2Ld�Ltives' .-f -
I lot PHFq klairiat tied at of above
L Poisonous or Toxic Substances le, 140"F, * I
—3501,l61A) Rolans Held at 130"'T,
Fol 11 Identifying,Infea matron -Original
Contaillers,
L20 Time as a Public Health Control
101 11 Common Narne-- Workim,Containers
-----` ""''"—,- j 1501,19 T'i me as a Public Health Control'
7-2 1 1�oa 11 F-79�T004(H) �Ear
LLLI I _T ton
-R;,,�tricumi - Presence and U�e*
L
17 262.12 of Use*
73Q3.11 — *
7REQUIREMENTS FOR HIGHLY SUSCEPTIBLE
1 -103 11 Toxic Coroaincr� -ProlubviofW'
POPULATIONS(HS
C j§?
264.1€ Sarfilizeos'criteria-CheraieMsl 21 ;-801 II(A)
,:26Z 12 fieprical&for Reverures with Wee arnit
7-204,14
Criteria"
I�L�of PatcuneMEops�
7-205.11 IncCOMM
idental Food IAd)riCaTuS"
II
es tia_l
gCN
Rakww Paru�dl,,Cook-d Ajumal Fe<A and
cfitem)* T -
Criopened Ford Pact,
7-206.12 Rialem Ben Staoon,'
-0 13 6 Trackinto pomlem PeatPeatControl and
lefoluitofine'
CONSUMER ADVISORY
22 34�0,A 1 Con�umer Acly;smy Posted for C011of tiono
TIME/TEMPERATURE CONTROLS Aodoe)l B-XxIs'11nat are Raw, Undenxroked of
fliPtion of
16 Proper Cooking Temperatures for Not Ofliei wise Processed m Eliminate
PHFs
Fgg,�- 155`F 15 S,.,,c.
TIC)
ediate Servi" 145f'Fl5seu i L302.13 N.steurmxi Fgg,SoNtitihe for Raw Shell
Comminuted Fcsh-kleats&Garric
1 rtnnnt€s 17n"F15sec
SPECIAL REQUIREMENTS
3-401.1 1,B)(10) I Porls. and Btet Roam - Iffl-, 121
r.40 1.11(A)(27
Rattles, Meats - 155 F 15
- 590 00o(A)-(D) I Violruioo,�of Section 590.009(A)-(D) in
set. cateringmolmic food,temporaty and
remdential kitchen operations qi(aArl he
ki--4(tl I(Ay�3} Poultry, Wild Gino Stu red PHK
sluffbig Containing Fish,Meat, deboed under the appropriate sealon's
alluve if rehiled to foorlhorne illness
13--101 INC—)(3) —rNVh,,I, unml.. bract ltt f Steaks intej ventionq aud risk kaidom Other
145 I• 590.009 atolafions relating to good retail
i 3.401A2, RawAntuna(FoiKls Coked in I inacticeshould be dehited under#29
i Miciowave 165'1,'* Spo'clal Re uireniunts.
3-40I,f I(A)(i')(b) All Othei PUB-- 145'T 15 sec.
17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
;101.I t(A)&f I) Plff,s 165'F I5sec. (items 23.30)
'101.11(ji) Microwave- 165'F Mortue. Standing Ciuo,oi and non,uncal viokitoms, which do ria;relate to the
TirrrO' ficidborne illness onerventiony and ri.4-fin lors toed mime con be
3-103,11{C} Commercially Processed RTE Food- haold in the fodancsirrg su tr ma of the Food Code and 105 CMR
140'P 9A 000,
Rernainuu, UnFliced Portions of Bcef Item Good Retail Practices FC 690,000
.-403,11(F) —— ----- — --,.I
Rnasts'r X23. fiefia_nagnmcrt and Per antl_
Proper Coaling of PH—Fs T-Rsodaral Food Protection. ------------1 FC 3 �004 i
L TFC 4 1'X75
T501 140k) Cmiling Cooked PHF's from 14()"F 7tol
26, Water,Plumbingrjlia�k -5 006
ao
70'F Within 2 flours and From 70'1' 1 2T Ptiy,,mt Facility.. FC-6 -C&-----------
Lo 4 I'T/45F Willa o 4 Hrxiu� 28-1 '008
-Eotsonous or Toxic MaleriAls FC -7
�m)I I T(B-) Cooling PHFs Made From Ambient 29 ectal R�Gu�remapt �_ 049
T(urpffaulfe Ingredients to 4PF/451F 3o� I Other
----------
Within 4 Hours'
aa-
-Denotes 1Vtk:Al stern m 1w!'Aeral 1999 Foal elite or 405 04k 5900M
CITY OF SALEM
BOARD OF HEALTH
Name of Establishment: Rincon Marcorisano
Address: 335 LafayetteStreet
Owner(s): Basilio Encarnacion
Phone: 978-745-2223
Date: April 8, 2008
Repeat violations at this establishment were observed during routine inspections,
re-inspections, and re-re-inspections. Therefore, the owner of the establishment
was asked to appear before the Health Agent to discuss those violations. He and
his daughter, Betsy Encarnacion appeared.
Repeat violations include: sanitizing solution not available at each food prep
area, or not at the proper concentration; potentially hazardous foods stored
above ready to eat foods; foods not properly labeled; cutting boards not cleaned;
not cleaning of equipment or utensils; and not labeling of the three-bay sink.
After discussion regarding the requirement of complying with the Food Code on a
daily basis in order to decrease the risk of foodborne illness, the owner agrees to
have his daughter become a Certified Food Manager within the next two months.
In addition, the owner understands that his permit to operate a food
establishment may be suspended or revoked if he does not comply with the code
and repeat violations or critical violations are observed by the Board of Health.
The owner will call the Board of health to tell what class his daughter will enroll
in.
Joanne Scott Date
Health Agent
Basilio Encarnacion J Date
CITY OF SALEM
BOARD OF HEALTH
Date: January 10, 2007
Name of Establishment: Rincon Marcorisano
Address: 335 Lafayette Street
Owner(s): Basilio Encarnacion
Phone: 781-589-6891
The new owner for this establishment, Basilio Encarnacion, and the Certified
Food Manager, Magalis Encarnacion, presented a Menu for review in
accordance with the State Food Code.
FLOOR PLAN
A Hand Sink must be located in each food prep and service area.
Hand sinks must have wall hung soap and paper towel dispensers. These
must be stocked at all times. Hand sinks must be used for hand washing only.
All floors, walls, and ceilings where food, utensils, paper products, etc, are
stored, prepared or served must be intact, impervious, and easily cleanable. This
includes any storage of these items in the basement. «.y
A three bay sink for washing, rinsing, sanitizing largeequipment will be
used.
A dishwasher may be installed later. This dishwasher must have a final
rinse of 180 F or it must have a chemically fed sanitizer with an alarm for the final
rinse.
A revised floor plan must be submitted to the Board of health prior to the
issuance of a permit.
MENU/FOOD PREP
All foods, including fish, meats, etc., must be purchased from a wholesaler
licensed by the State.
Fruits and vegetables must be washed prior to preparation. This may be
done in the 3`d bay of the 3-bay sink. Other foods may be washed in this bay.
This bay must be sanitized before and after washing.
All food must be held at 41°F or lower, or 140°F or higher, at all times.
Therefore, soup and other hot items should be brought to boiling before being
held hot. Salad display items, such as tomato slices, must be cold prior to being
held cold in the salad unit.
Food may not be added to containers in salad or buffet unit. Instead, a
sanitized container with new product may replace the existing container and the
old product may be placed on top of the new product.
There may be no bare hand contact of ready-to-eat foods. Gloves, tongs,
or tissues must be used when handling such food.
FOOD PREP
Reviewed receiving, holding, heating and serving of fish soup and a goat
dish.
CERTIFICATION
There must be a Certified Food Manager working at this establishment full
time. When a CFM is not onsite there must be a Person-in-Charge (PIC) who is
fully trained in sanitation techniques and has a thorough understanding of the
operation.
There must be someone on site, during all hours of operation, who is
trained in choke saving.
UNDERCOOKED FOODS
If you plan to sell undercooked eggs or meat, you must place a notice on
your menu warning of the increased possibility of food borne illness.
The advisory was given to Mr. Encarnacion.
EXTERMINATION
Monthly services of a Licensed Pest Control Operator are required.
Please keep receipts for inspections.
SANITIZING SOLUTION
Sanitizing Solution must be accessible at each prep station and for the
patrons' tables.
Test strips corresponding to the kind of sanitizer, must be on hand to
check concentration of solution. Solution must be made daily, tested, and the coj'pl
results recorded on a log sheet for examination by Board of Health inspectors.
Solution may be prepared in the 3'd bay of the 3-bay sink and spray
bottles may be filled there. Spray bottles with clean paper towels may be used,
as well as wiping pails with wiping clothes always held in the solution in the pail.
Outside area of premises, including the dumpster area and grease holding area,
must be kept clean and sanitary.
An opening inspection is scheduled for ,
466 rine Scott Date
Health Agent O
Basilio Encarnacion, Owner Date
Commonwealth of Massachusetts
City of Salem
Board of Health Kimberley Driscoll
120 Washington Street,4th Floor Mayor
SALEM,MA 01970
Food/Retail Establishment Permit
DATE PRINTED: 01/14/2008
ESTABLISHMENT NAME: Rincon Mareorisano
File Number:BHF-2007-000003 335 Lafayette Street
SALEM MA 01970
LOCATED AT:
SALEM, MA 01970
Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes
FOOD SERVICE BHP-2008-0351 Jan 14,2008 Dec 31,2008 $280.00
ESTABLISHMENT
Total Fees: $280.00
PERMIT EXPIRES December 31, 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 3 of 3
• QTY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
r� 120 WASHINGTON STREET,4" FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISOOLL FAX(978) 745-0343
MAYOR ISCOTTCaisALEM.COM
JOANNE SCOTT,
HEALTH AGENT
2008LICATION FOR PERMIT TO OPERATE A FO ESTAB ISHMENT
NAME OF ESTABLISHMENT \ aM1 TEL# 2
ADDRESS OF ESTABLISHMENT FAX# `
MAILING ADDRESS(if different)
EMAIL-Business': Website:
OWNER'S NAME c ! �� TEL# 1 r-
ADDRESS
STREET TY STATE ZIP
CERTIFIED FOOD MANAGER'S NAME(S) CERTIFICATE#(S)
(Required in an establishment where potentially hazard s foo i Ire
EMERGENCY RESPONSE PERSON HOME TEL
DAYS OF OPERATION 1 Monday Tuesday Wednesday Thursday Friday SatujAay Sunda
HOURS OF OPERATION
Please wife in time of day.
for example 11am-11 m
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
OYE� less than 25 seats =$140
(Outdoor Stationary Food Cart$2 25-99 seats =$280
more than 99 seats =$420
-
-------------------- - -
-- --N-----O -------------------------- --- -------------------------------------—.-----$---100-------
BEDIBREAKFASTI YES
CHILDCARE --------------------------------------------------------_---------------------------- --- ._-
ADDITIONAL PERMITS
MAKE (notjust serve) ICE CREAM, YOGURT/SOFT SERVE YES NO $25
TOBACCO VENDOR YES NO $135
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 fled all state tax
returns and p id all state taxes required under the law.
r
Signature Date I'J Social Security or Federal Identification Number
-------- ---- - ----- ---- -----------------------/ ------ ------- ------------'—�-q�---� '----
Reviscd 4/24/07 OOD P200 . dm C ckft&Datc C? b_� ���C�d"6• Q-d-V
1r
335 Lafayette Street Rincon Marcorisano
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
Telephone: ' PROTECTION FROM CONTAMINATION
Food Contact Surfaces Cleaning and Sanitizing FAIL Critical RED
Owner: Comment:The kitchen cutting board is badly stained and scored. Resurface or replace the cutting board.
Basilio Encarnacion
PIC:
Jose Perez Violations Related to Good Retail Practices (Blue Items)
Inspector: Equipment and Utensils FAIL Non-Critical BLUE
David Greenbaum Comment:The ladels above the kitchen hand wash sink must be moved to prevent cross contamination.
Date Inspected:Correct By:
7/24/2007 The 3 bay sink must be labeled"Wash-Rinse-Sanitize"
Risk Level: The floor in the rice closet needs a thorough cleaning.
The basement shelves have an accumulation of food spills and splatter. Thoroughly clean the shelves.
Permit Number:
BHP-2007-0384 The lights in the basement must be sheilded from breakage.
Status:
PARTIAL COMPLY Physical Facility FAIL Non-Critical BLUE
#of Critical Violations: Comment:There are gaps around the front and back screen doors. Seal all gaps.
1 GENERAL COMMENTS:
Time IN: Time our. All outstanding violations must be corrected. Owner may be called for a hearing with the Health Agent or
Urgency Description(s): monetary fines may be issued for all outstanding violations.
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. Jul 24,2007 ) Page I oft
i
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 24,2007 ) Page 2 oft
335 Lafayette Street Rincon Marcorisano
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
Telephone: PROTECTION FROM CONTAMINATION
I Food Contact Surfaces Cleaning and Sanitizing FAIL Critical 0 RED
Owner: /_ Comm .The kitchen cutting board is badly stained and scored. Resurface or replace the cutting board.
Basilio Encarnacion
PIC: a cutting board on the front True unit is badly stained and scored. Resurface or replace the cutting board.
Thomas Cruz Violations Rela d to Good Retail Practices (Blue Items)
Inspector: Food and F od Protection FAIL Critical BLUE
David Greenbaum
Date Inspected:Correct By: Comment:The Beverage air reach in in the kitchen has uncovered food. All food in storage must be covered.
71161200' I Equipment and Utensils FAIL Non-Critical BLUE
Risk Level: Comment:The ladels above the kitchen hand wash sink must be moved to prevent cross contamination.
Permit Number: --ar The 3 bay sink must be labeled"Wash-Rinse-Sanitize"
BHP-2007-0384a Arctic air freezer in front needs a visible,accurate thermometer.
Status:
PARTIAL COMPLY The floor in the rice closet needs a thorough cleaning.
#of Critical Violations: The basement shelves have an accumulation of food spills and splatter. Thoroughly clean the shelves.
2 The lights in the basement must be sheilded from breakage.
Time IN: Time OUT:
Physical Facility FAIL Non-Critical BLUE
Urgency Description(s):
BLUE: Z�''Comment:There are gaps around the front and back screen doors. Seal all gaps.
Violations Related to Good GENERAL COMMENTS:
Retail Practices (Critical
violations must be corrected A final reinspection will be conducted on Friday, July 20, 2007, all outstanding 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. Jul 16,2007 ) Page 1 oft
Item Status Violation Critical Urgency
RED:
Violations Related to
Foodborne Illness Interventions
and Risk Factors (Require
immediate corrective action)
a
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 16,2007 ) Page 2 oft
335 Lafayette Street Rincon Marcorisano
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
Telephone: FOOD PROTECTION MANAGEMENT
PIC Assigned/Kno Iedgeable/Duties FAIL Critical ❑.� RED
Owner: Com ent:There was no Certified Food Manager or Person in Charge at the time of inspection. A CFM or knowledgeable PIC must
Basilio Encarnacion b employed full time at this establishment.
PIC:
Inspector:
David Greenbaum
Date Inspected:Correct By:
7/9/2007
Risk Level:
Permit Number:
BHP-2007-0384
Status:
VIOLATION
#of Critical Violations:
5
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. Jul 09,2007 ) Page 1 of
Item Status Violation Critical Urgency
RED: PROTECTION FROM CONTAMINATION
Violations Related to Separation/Segre 'ation/Protection FAIL Critical ❑� RED
Foodborne Illness Interventions
and Risk Factors (Require l-�Co ant:There a re potentially hazardous foods stored above ready to eat food in the basement walk in. Store PHF below RTE
f d to cent cross contamination.
immediate corrective action)
ere are pans of food stored directly on top of food products in the basement walk in. Cover all food prior to storing pans on top.
Food Contact Surfaces Cleaning and Sanitizing FAIL Critical RED
Comment:The kitchen cutting board is badly stained and scored. Resurface or replace the cutting board.
./ Diffy-knives found in the knife rack. All knives must be properly cleaned and sanitized prior to storage.
There i�sanitizing solution available in the kitchen. Sanitizing solution of proper concentration must be readily available at all
`;oak stations at all times.
. ,The cutting board on the front True unit is badly stained and scored. Resurface or replace the cutting board.
Th is no sanitizing solution available in the front prep area. Sanitizing solution of proper concentration must be readily
k;,available at all work stations at all times.
Handwash F ililies FAIL Critical ❑d RED
om ent:The kitchen hand wash is missing soap. Provide soap in a wall hung dispenser at this sink at all times.
e front hand wash sink is completely obstructed and knives being washed in it. Hand wash sinks must be kept clear and
accessible at all times and used for hand washing only.
The front hand wash sink missing soap and paper towels. Provide soap and disposable paper towels at this hand wash sink at all
imes.
Th root restroom missing soap. Provide soap in the restroom at all times.
si m the front restroom has low hot water pressure. Restore hot water pressure to this sink immediately.
I T employee restroom missing soap. Provide soap in the employee restroom at all times.
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 09,2007 ) Page 2 of
t Item Status Violation Critical Urgency
Violations Related to Good Retail Practices (Blue Items)
Food and Food Protection FAIL Critical BLUE
r-.-,..y ment:The Maximum reach in in the kitchen has uncovered food. All food in storage must be covered.
The Beverage air reach in in the kitchen has uncovered food. All food in storage must be covered.
Equipment and Utensils FAIL Non-Critical BLUE
mment:The Maximum reach in in the kitchen has an accumulation of food spills and splatter. Thoroughly clean this unit.
e same unit needs a visible,accurate internal thermometer.
Bhang the kitchen soap dispenser.
-a- The ladels above the kitchen hand wash sink must be moved to prevent cross contamination.
�`�The 3 bay sink must be labeled"Wash-Rinse-Sanitize"
The verage air unit in the kitchen needs a visible,accurate thermometer.
^ The air freezer in front needs a visible,accurate thermometer.
LiT a front True unit needs a thorough cleaning.
Tgriddle has an accumulation of food debris. Thoroughly clean the griddle.
'
e mop stored in the bucket. Clean mop and store mop head down not touching any surface to air dry.
' The floor in the rice closet needs a thorough cleaning.
-the basement shelves have an accumulation of food spills and splatter. Thoroughly clean the shelves.
_',�TTie�Frigidaire freezer in the basement needs a thorough cleaning and defrosting.
Lrre same unit needs a visible,accurate thermometer.
Hotpoint freezer in the basement needs a thorough cleaning and defrosting.
T same unit needs a visible,accurate thermometer.
I T True freezer in the basement needs a thorough cleaning.
T e same unit needs a visible,accurate,internal thermometer.
asement walk in needs a visible,accurate, internal thermometer.
Z The lights in the basement must be sheilded from breakage.
T umpster found in the open position.Dumpster must be closed unless it is being used.
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 09,2007 ) Page 3 of
r+
Item Status Violation Critical Urgency
Physical Facility FAIL Non-Critical BLUE
,zg,,- Comment:There are gaps around the front and back screen doors. Seal all gaps.
Other-See Notes FAIL BLUE
Comment:Owner has added equipment including a dishwasher and a walk in in the basement. All changes to the establishment
including adding new equipment must be approved by the Board of Health.
There are many critical violations cited in the report regarding proper sanitizing and hand washing. Any future repeat violations
will be subject to monetary fines being issued.
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. Jul 09,2007 ) Page 4 of
I0
335 Lafayette Street Rincon Marcorisano
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
Telephone: PROTECTION FROM CONTAMINATION
Handwash Facilities FAIL ❑ RED
�Wner: Comment:The kitchen soap dispenser does not work properly. Repiar or replace the saop dispenser.
Basilio Encarnacion
PIC: Violations Related to Good Retail Practices (Blue Items)
Basilio Encarnacion Special Requirements FAIL BLUE
Inspector: Comment:Owner to hire a licensed pest control operator to conduct monthly extermination services. Owner have contract fo
David Greenbaum opening inspection. Terminix has been contacted and will be in the establishment on 1/25/07. Owner to fax a monthly
Date Inspected:Correct By: extermination contract to the Board of Health.
1/24/2007 GENERAL COMMENTS:
Risk Level: In accordance with the Federal Food Code and the State Sanitary Code all other requirements to open have been
met.
Permit Number:
BHP-2007-0384 Expected opening is Friday, January 29, 2006.
Status:
Open The owner has expressed he would like to add a dishwasher to the kitchen of this establishment in the future.
#of Critical Violations: Prior to changing or adding any equipment owner must contact the Health Agent for approval.
1
Time IN: Time OUT:
I
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 25,2007 ) Page 1 oft
ir 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 25,2007 ) Page 2 oft
335 Lafayette Street Rincon Marcorisano
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
j]Telephohe: PROTECTION FROM CONTAMINATION
r(978) 745-2223 Separation/Segr tion/Protection FAIL Critical RED
Owner: omment:The walk in has PHF stored above other food items. Store PHF below other food items to prevent cross contamination.
i Basilio Encarnacion Food Contact Surfaces Cleaning and Sanitizing FAIL Critical RED
PIC:
Jose Perez Comment:There is no sanitizing solution in the kitchen. Sanitizing solution of proper concentration must be readily available at all
..._ work stations at all times.
Inspector:
David Greenbaum
Date Inspected:Correct By:
14/3/2008
ti
$Risk Level: .
f
#Permit Number:
1 BHP-2008-0351
Status:
PARTIAL COMPLY
1#of Critical Violations:
3
Time IN:a :,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
GeoTMSO 2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Apr 04,2008 ) Page 1 of
s� 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: Label the flour bin"Flour"
immediate corrective action) Label the rice bin"Rice"
Label the front sugar bin"Sugar"
Equipment and Utensils FAIL Non-Critical BLUE
Comment: Label the 3 bay sink"Wash,Rinse,Sanitize"
e- The basement shelves need a thorough cleaning and repainting.
Thi- rPrigidaire freezer in the basement has an accumulation of food debris,spills,splatter and frost. Thoroughly clean and defrost
iis unit.
The Hotpoint freezer in the basement needs a thorough cleaning and defrosting.
s The True freezer in the basement needs a thorough cleaning.
The same unit has the wrong thermometer. Provide a thermomete that shows temperatures to 0°F amd below.
The walk in also has a thermometer that does not show accurate temperatures. Provide a thermometer that shows temperatures to
r 41°F and below.
-�� The front Arctic air freezer needs a thorough cleaning and defrosting.
13-91ront Pepsi unit needs a general cleaning.
Physical Facility FAIL Non-Critical BLUE
Comment:The floor in the employee restroom is in disrepair. Repair the Floor to be smooth,impervious and easily cleanable.
�-. There water stained ceiling tiles in the employee restroom. Investigate the source of the leak and repair. Replace all staine ceiling
tiles.
GENERAL COMMENTS:
A final reinspection will be conducted on Monday, April 7, 2008, all outstanding violations must be corrected.
Due to the high number of critical violations and the high number of violations not corrected the owner may be
required to attend a hearing regarding this matter with the Health Agent.
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 04,2008 ) Page 2 of
�i
Item Status Violation Critical Urgency
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 04,2008 ) Page 3 of
335 Lafayette Street Rincon Marcorisano
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
Telephone: PROTECTION FROM CONTAMINATION
(978) 745-2223 _ _ _ _ Separation/Segre ion/Protection FAIL Critical ❑.� RED
Owner: Co ment:The Frigidaire freezer in the basement has ice stored directly on potentially hazardous food. Store ice separate from
Basilio Encarnacion F to or
cross contamination.
PIC: The walk in has PHF stored above other food items. Store PHF below other food items to prevent cross contamination.
JosInspector:
Perez Food Contact Surfaces Cleaning and Sanitizing /FAIL Critical d❑ RED
Inspector. - - ///
David Greenbaum C` Comment:There is no sanitizing solution in tMC6 i or the front food prep area. Sanitizing solution of proper concentration
Date Inspected:Correct By: must be readily available at all work stations at all times.
'
3/25/2008 qt-- ,AII ting boards in the kitchen are badly stained and scored. Resurface or replace all cutting boards.
Risk Level:
t h tting board on the front True unit is stained and scored. Resurface or replace the cutting board.
Permit Number: Good Hygienic Practices - FAIL Critical 66 RED
BHP-2008-0351 _ C ant: Employee observed drinking in the front food re area. Employees must eat and drink in a designated employee area
9 prep9
Status: r m the dining room to prevent cross contamination.
VIOLATION Prevention of Contamination from Hands FAIL Critical ❑d RED
#of Critical Violations: /
7 Comment:The ice scoop in the front Arctic air freezer has no handle. Provide an ice scoop with a handle and place in the ice
_ __ __ �/Vhandle side up.
Time IN: Time OUT: TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods)
Urgency Description(s): Hot and cold Ho ing FAIL Critical J❑I RED
BLUE: mment:The front True unit has a temperature of 50°F. Repair unit to maintain a temperature of 41°F or below.
Violations Related to Good Time As a Public Health Control FAIL 0 RED
Retail Practices (Critical
violations must be corrected C ment:There is meet and chicken thawing at room temperature in the basement. Thaw all meat/chicken in a refrigerator, under
immediately or within 10 cold running water or in a microwave. Not at room temperature.
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 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 men , he Maximum refrigerator has uncoverd food. All food in storage must be covered.
immediate corrective action) re are scraps of chicken in the flour. Keep the flour free of food debris to prevent cross contamination. Clean and sanitize the
flour bin.
flour bin stored directly on the floor.Store all food at least 6.8 inches off the floor.
Label the flour bin"Flour"
Labe)the rice bin"Rice"
vFfie walk.in has uncovered food. All food in storage must be covered.
Tre is food stored directly on the walk in floor. Store all food at least 6-8 inches off the floor.
\fir Label the front sugar bin"Sugar"
Equipment and Utensils FAIL Non-Critical BLUE .
mment:The Maximum refrigerator needs a thorough cleaning.
T
ljhdT
canopener needs a thorough scouring.
Label the 3 bay sink"Wash,Rinse,Sanitize"
T ood filters have an accumulation of grease. Thoroughly clean the hood filters. The entire Ansul system was due for cleaning
L,__3/`6108.
VTr }�e a rage air reach in needs thorough cleaning.
e rice bin needs a thorough cleaning.
-- The basement shelves need a thorough cleaning and repainting.
T rigidaire freezer in the basement has an accumulation of food debris,spills,splatter and frost. Thoroughly clean and defrost
d
is unit.
it ,Air The Hotpoint freezer in the basement needs a thorough cleaning and defrosting.
t 7�\ The True freezer in the basement needs a thorough cleaning.
Z
The s me unit has the wrong thermometer. Provide a thermomete that shows temperatures to 0°F amd below.
I he walk in needs a thorough cleaning, including all shelves.
The walk in also has a thermometer that does not show accurate temperatures. Provide a thermometer that shows temperatures to
41°F and below.
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
Item Status Violation Critical Urgency
T front True reach in needs a thorough cleaning.
The front Arctic air freezer needs a thorough cleaning and defrosting.
The front Pepsi unit needs a general cleaning.
Physical Facility FAIL Non-Critical BLUE
�--�- Comment: The floor in the employee restroom is in disrepair. Repair the floor to be smooth, impervious and easily cleanable.
There water stained ceiling tiles in the employee restroom. Investigate the source of the leak and repair. Replace all staine ceiling
tiles.
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®2008 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Apr 02,2008 ) Page 3 of
i Pest Control
Company Cotitacf
Address Telephone
City Address
State Zip City
Telephone State Zip
❑ Multiple Locations Attach Location Listing
11111 l HER 111 111 1 ill,
Ter minommertiai� est Conoi. ce
Terminix win perform regularly scheduled service at the above service address for the control of the following pests:
Service Frequency
Roaches im Mice ❑ Monthly X Semi-Monthly
Silverfish Ants(excluding Carpenter,Pharaoh and Fire) ❑ Bi-Monthly ❑ Weekly
❑ Rats ❑ Other ❑ Quarterly ❑ Other
Additional SeDipe Info atiou
h '
rAdtk'IIdmusrtndirated Forms are ParYofthr�Agreen:ent
_ ._ _. ., ..... __•-..__ _,,.,. ..-...a.... .._ .._. ........«..,....,,+�.a,.,.,.,fix. a,�.......,.."......»...'F w..�..'ure......... .., +'m � .:.�-.
❑ Customer Preparation Checklist Part I ❑ Sighting Log ❑ Equipment Sales
❑ Customer Preparation Checklist Part 2 ❑ Customer Prep.Checklist for Apartments ❑
❑ Service Schedule Checklist ❑ Optional ❑
Payment Schedule
Down
Initial Service Charge $ ' LL-,—
Regular Service Charge $
,%k+u Payment Amount Sequence Number
Annual Total $ � ='y- Received At
Completiondvance Amount i?eposit Number
Les i.44 - ear-APayment r $`�� _ _
Account Number
Total Due $
YOU may recognize a 3%discount for pre-paying one years service charge in advance'
This is to certify that Tax Exemption Certificate Number has been furnished with this Agreement to Terminix.
This agreement is subject to the Terms and Conditions on the front and back, ....
including the Mandatory Arbitration provision.
CustomeriAgent signature
This agreement is for an initial period of twelve months from the date of the first service and,unless canceled by the Purchaser,will automatically
continue on a monthly basis until canceled by either party upon thirty (30) days notice.This agreement is not valid unless accepted by customer
within 30 days of submission.
In the event you have any questions or complaints,you may contact
Terminix Authorization aTerminix representative by calling 1-800-TERMINIX(1-800-837fi464)
Terminix Office s ' Telephone dk-'r� `y" V ' �1 By _.
Address ��*
Title ... —
iL 1 'G�k-'U Date —..
fel 1 lihlt 'rATI Vh(pont name) PAT
? _..
—� TI>ItM IX 1113 N13SLN1" [VI"SICNA'fUlt P;
7ERNI N.
"Not avaBable in Califomfa
wyyw.terminix wm
Key k 33231 Rev.1105 R0'1105
W,005 Tho Inn,im Internnfionnl Company t_P.
IMPORTANT MESSAGE
T
FOR
DATE J /2/ TIME Fl
M ��,{e c_�Ca6 IIi"iVi 4
OF '/Leezt v�. "i �uS((/e��..��c�'.-+Sl!1,,�7r/ 3
PHONE ��� *7 U_ ��T�
AREA CODE NUMBER EXTENSION
U FAX
U MOBILE
AREA CODE NUMBER TIME TO CALL
TELEPHONEO PLEASE CALL
CAME TO SEE YOU WILL CALL AGAIN ..__
WANTS TO SEE YOU RUSH:
RETURNED YOUR CALL ' WILL FAX TO YOU
MESSAGE
I
-4 Jt EPS W
a A is
SIGNED
FORM AL
MACE IN U.S.A.
i
� o
s
s.
335 Lafayette Street Rincon Marcorisano
City of Salem
FOOD SERVICE ESTABLISHMENT - FOOD SERVICE Inspection
HACCP: ❑
Item Status Violation Critical Urgency
Telephone: PROTECTION FROM CONTAMINATION
Handwash Facilities FAIL ❑v RED
Owner:
Comment:The kitchen soap dispenser does not work properly. Repiar or replace the saop dispenser.
Basilio Encarnaclon
PIC: Move wall hung soap and paper towel dispenser to prep area hand wash sink.
Basillo Encarnacio_n Violations Related to Good Retail Practices (Blue Items)
Inspector: Equipment an tensils FAIL BLUE
David Greenbaum omment: Provide a visible,accurate thermometer in the refrigerator compartment of the Magic Chef unit.
Date Inspected:Correct By: Physical Facility FAIL BLUE
1/22/2007 Cmant:There are water damaged ceiling tiles in the employee restroom. Investigate the source of the leak and repair. Replace
Risk Level: I stained ceiling tiles.
Special Requirements FAIL BLUE
Permit Number:
BHP-2007-0384 i Comment: Owner to hire a licensed pest control operator to conduct monthly extermination services. Owner have contract fo
opening inspection.
Status: GENERAL COMMENTS:
Open
#of Critical Violations: A final opening inspection will be conducted on Wednesday, January 24, 2007 at 11:OOAM.
1
Time IN: Time OUT:
Urgency Description(s):
BLUE:
Violations Related to Good
Retail Practices (Critical
violations must be corrected
immediately or within 10
days)(Non-critical violations
must be corrected immediately
or within 90 days)
City of Salem Board of Health 120 Washington Street,4th Floor SALEM MA 01970(978)741-1800
GeoTMS®2007 Des Lauriers Municipal Solutions, Inc. Commonwealth of Massachusetts ( Rev. Jan 22,2007 ) Page 1 oft
Item Status Violation Critical Urgency
RED:
Violations Related to
Foodborne Illness Interventions
and Risk Factors (Require
immediate corrective action)
4
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 22,2007 ) Page 2 oft
. + .'
m
r * ttComonwealth of Massachusetts
» 'K 4 "'4 A 6 32i4 d i
>vli?yv4
3t Y' k S CI Of.Salem r t
Ea.. % `,'�;='f'''. +f'� nd'4 m1
. Y • � .. S ,. 4. ,. Y r s�, 51`� S rM1 .4 i
.Board
s FGmbedey Dnscoll '
120 Washington Street,'4th Floor - g rrMayOf -; r
SALEM,MA 01970
Food/Retail Establishment Permit
DATE PRINTED: 01/11/2007
ESTABLISHMENT NAME: Rincon Marcorisano
File Number:BHF-2007-000003 335 Lafayette Street
SALEM MA 01970
LOCATED AT:
SALEM, MA 01970
Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes
FOOD SERVICE BHP-2007-0384 Jan 11,2007 Dee 31,2007 $150.00
ESTABLISHMENT
Total Fees: $150.00
PERMIT EXPIRES ,December 31, 2007
Board of Health
This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in
a prominent location in the Establishment.
In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made,all
plans for such must be submitted to and approved by the Salem Board of Health. Page 1 of 1
4
CITY 6F ALBwti MAS ACMU&'ET"f"
e `
120 WASHINGTON STREET,,4TT9 f'L-O R
SALEM, MA 01%70
TEL, 978.741.1 aOO
FAX 978-345=034-3
STANLEY J. usov1CZ, .567, JOANNE SCO`flr, MPH,. IRS, CiHO
MAYOR HCAL.R`VA AGENT
2004 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT
NAME OF ESTABLISHMENT TEL
ADDRESS OF ESTABLISHMENT RINCON MACORISANO
13ASILIO ENCARNACION I
MAILING ADDRESS (if different) 781-589-8891 V
335 LAFAYETTE STREET 6
OWNER'S NAME
SALEM, MA 01970
�
# nn II� p�
ADDRESS ff✓ ✓JV V S I' IRG'v
CITY ! rnh STATE 144
zip olpDO
CERTIFIED FOOD MANAGER'S
NAME(S) Lfn.C2/� ,? Q RTIFICATE#(s) 0 '� 5-7
(required in an establishment where potentially hazardous food is prepared.)
E ERGE CY RESPONSE PERSON &4S*//10 �,Alc yw4cL t),y HOME TEL
Li sea - syi S�
HOURS QF OPERATION:
Mon. 1/ Tue. ✓ Wed. L/ Thu. Fri. Sat. C/ Sun.
TYPE OF ESTABLISHMENT FEE check only
RETAIL STORE YES NO less than 1000sq.ft. _$ 50
1000-10,OOOsq.ft. =$100
more than 10,000sq.ft.=$250
RESTAURANTYES NO ess than 25 seats -$100
25-99 seas =$15
BED/BREAKFAST YES more aseats� $100
ADDITIONAL PERMITS
MAKE (not just serve) ICE CREAM, YOGURT, SOFT SERVE YES $5
TOBACCO VENDOR YES $50
ALL NON-PROFIT(such as church kitchens) YES $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.
�
1/�� to a
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 returns and paid all state taxes required
under the law.
Signature e ate Social Security or Federal Identification
Number Q/,2
&
Revised 11/03/03 FOODAP2.adm Check#&Date RINCON MACORISANO
BASILIO ENCARNACION
978-745-2223
TAX ID#043347-058
335 LAFAYETTE STREET
SALEM, MA 01970
RINCON MACORISANO f
BASILIO ENCARNACION
978-745-2223 f
335 LAFAYETTE STREET R
_ SALEM, MA 01970
CITY OF SALEM
" BOARD OF HEALTH
Establishment Name: Yms' L\ SAX Date: Page: 1 of
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date
No. Reference R—Red Item " " -
PLEASE PRINT CLEARLY Verified
vm
ftiR� cN. al\� f2EPQ�nk-
fi
14
SvAo't -7� P C�,P+5"
C�� YarJ nal 1 .rr0,l �� aa� C � �lc�t )l��\�J D3A .: A.I \
MNVU\
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 LI 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 of ❑ Embargo ❑ Emergency Closure
your food per mit. � �7 -/Jj` j
�52�/ �/i� ❑ Voluntary Disposal Ll Other:
3-SOi.14(C) PHFs Received atTemperatures
Violations Related to Foodborne illness Interventions and Risk According to l.aw Cooled to
Factors(items 1-22) (Cont.) 41°F/45"F Within 4 Homs,
PROTECTION FROM CHEMICALS 3-501_15 Cooling=Methods for PHFs
PHF Hot and Cold Holding
24 Food or Color Additives l4
3-501.16(B) Cold PHFs Maintained at of below
3-202.12 Additives" 590.004(F) 4V/45°F� -
3-302.14 Protection from Una s roved Additives'" 3-SOI.16(A) Ifot PHFs Maintained at or above
15 Poisonous or Toxic Substances
40'F. *
7-107..11 Identifying Information 3-501.1.6(A) Roasts Held at or above 130°F.
Container'"
7-102.11 Common Natne-Working Containers" 20 Time as a Public Health Control
7-201.11 Se_snation-Stm�aee"' 3-50L'19 Time as a Public Health Control*
Use*
590.004(H) Vru'iance Re uircYvent
7-202'11 Restriction-Presence and Use
7-202.12 Conditions of Use*
7-20111 Toxic Containers-Prohibitions', REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULIONS(HSP}
7-204.11 Sanitiurx.Criteria--Chemirrtsa'
AT
7.204.12 Chemicals for Washing Produce,Criteria" 21 3-801.1)(A) Unpasteurized Pre-packaged Juices and
7-204.14 Drtim w ants,C asteria* Beverages with 4G rrmnt:I.ibaIs*
7-20511 Incidental Food Contact,Lubricants*
3-SO A I(B) Use of Pasteurized f..a*
7-206.11. Restricted Use Pesticides, Criteria* 3-801.11(D) Raw or Partially Cooked Animal Food and
Raw Seed Sprouts Not Served. s
7-206.12 TraRodcingnt Po dens,Re 3-801.L1(C) Uno erred Paxi Paeka=e Not Rc-served. *
?-?06.13 Tracking Powders,Pest Control and
Monitoring*
CONSUMER ADVISORY
TIME)TEMPERATURE CONTROLS 22 3-60111 Consumer Advisory Posted for Consumption of
16 Proper Cooking Temperatures for
Animal Foods,chat are Raw.Undercooked or
' PHFs Not Otherwise Processed to Eliminate
3-401.11A(1)(2) Eggs- 155`F'15 Sec.
Patho ons
E gs-Immediate Service 145°Fl5sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
3-401.11(A)(2,) Corruninuted Fish, Meats&Game __L_3-_1112
E qs*
Animals- 155°F 15 sec. *
3-401.11(6)(1)(2) Pork:and Beef Roast- 130F 121 min* SPECIAL REQUIREMENTS
3-401.11(A)(2) Ri ites,Injected Meats 155°F 1.5 590.009(A)-(D) Violations of Section 590.009(A)-(D)in
sec.', catering, mobile food, temporary-and
3-401.1 l(A)(3) Poultry,Wild Game, Stuffed PPIFs, residential kitchen operations should be
Stuffing Containing Fish, Meat, debited under tate appropriate sections
Point*,or Ratites-1b5°F 15 sec. * above if related to foodborne illness
3-401.11((')(3) Whole-muscle,Intact Beef Steaks interventions and risk'factors. Other
145°F 590.009 violations relating to good retail
3-401.12 Raw Animal Foods Cooked in a practices should be debited under t/29-
_ Microwave 165`F* Special Requu-enrents.
3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec.
17 Reheating for Hot Holding VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-403.11(A)&(L)) PHFs 1650F 15 sec. s' (Items 23-30)
3-403.11(6) Microwave- 165'F 2 Minute.Standing Critical and non-critical violations, which do not relate to the
Time" brodborne illness interventions and risk factors listed above can be.
3-403.1 1(C) Commercialk Processed RTE Food- faarnd in the following sections of the Food Code and 105 CMR
140°F* 590.000.
3-403.11($) Remaining Unsliced Portions of Beef Item Good Retail Practices FC 690.000
23. Manu ement and Personnel FC-2 .003
Roasts" - ----___....----�.
1g Proper Cooling of PHFs 24. Food and Food Protection _ FC-3 .004
25 _Equipment and Utensils FC 4 .005
3-501.14(A) ('noting Cooked PHFs from 140°F to -- - - -- _.---
26 Wafers Plum6inq and Waste FC 5 . .006
70°F Within 2 Hours and From 70°F 27. Ph sicai FacilityFC-6 .007 _
to 41°F(45°F Within 4 Hours. * 28. Poisonous or Toxic Materials FC-7 .003
3-501.14(13) Cooling PI Me Made From Ambient 29. Sacral 43e uiremsnts _ _ .009
Temperature Ingredients to 41 T,/45'F 30, Other
Within 4 Hours* as°`
"Denotes critical item in tha i'sderal 1909 Food Code or 105 CeIR 590 000.
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JOANNE SCOTT, MPH, RS, CHO
Health Agent
120 Washington Street
Salem,MA 01970
(978)741-1800
City of Salem F-'�s:;^ �::. FAX(978)745-0343
Board of Health :':.;- EMAIL jscott@salem.com
JOANNE SCOTT, MPH, RS, CHO
Health Agent
120 Washington Street
Salem, MA 01970
. (978)741-1800
City of Salem FAX(978)745-0040
Board of Health EMAIL jscott@salem.com