The URL can be used to link to this page

MEETING PACKET MAY 2016 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH �,�L�� 120 WASHINGTON STREET,4:m FLOOR Heaftb rent.Promote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL lramdin@salcm.com LARRY RAMDIN,RS/KEPIS,C]-IO,CP-F'� MAYOR HEALTH AGENT NOTICE OF MEETING You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting Tuesday May 10, 2016 at 7.00 PM City Hall Annex 120 Washington Street 3.d Floor Room 313 MEETING AGENDA 1. Call to order 2. Approval of Minutes 3. Chairperson Communications 4. Public Health Announcements/Reports/Updates a. PHN Report b. Health Agent `M1. ,` c. Administrative d. Council Liaison Updates D 90 5. 14 Bertuccio Avenue Sub-Division Hearing cry co 6. Northfields Neighborhood association discussion on restricting tobacco use in children's parks 7. Tobacco regulation draft discussion with Joyce Redford on flavor suspension, creating exclusion zones and suspension language update 8. New Business/Scheduling of future agenda items • Items that could not be anticipated prior to the posting of the agenda Larry Ramd'. Health Agent cc: Mayor Kimberley Driscoll, Board of Health, City Councilors Next regularly scheduled meeting is June 14, 2016 at 7:00pm at City Hall Annex, 120 Washington Street Yd Floor Room 313. Know your rights under the open meeting law MGL chapter 30A ss. 18-25 and City Ordinance section 2-2028 through 2-2033 This notice posted on "Official B I ti oard" City Hall, Salem, Mass. on MAY �O�s at SWAY in accordance with MGL Chap. 30A, Sections 18.25. I_ CITY OF SALEM BOARD OF HEALTH MEETING MINUTES April 12, 2016 DRAFT MEMBERS PRESENT: Dr. Shama Alain, Chair, Janet Greene, Paul Kirby, &Dr. Jeremy Schiller OTHERS PRESENT: Larry Ramdin, Health Agent, Beth Gerard, Council Liaison, Heather Lyons-Paul Clerk of the Board &Erica Rimpila, Public Health Nurse TOPIC DISCUSSION/ACTION 1. Call to Order 7:00pm P. Kirby motioned to take agenda out of order. 2. Minutes of Last Meeting J Greene 2111 All in favor. Motion passed. (March 8,2016) Dr. Schiller motion to approve minutes. P. Kirby 2°d All in favor. Motion passed. 3. Chairperson Announcements Introduction of and welcome to Stephanie Holinko as new Sanitarian. Dr. Alain meeting with Mayor and L. Ramdin on April 28d'. Nancy Crowder has been submitted by the Mayor to the Council as a new Board member nomination, final confirmation by Council on April 28' 4. Monthly Reports-Updates A. Public Health Nurse's Report E. Rimpila went to NJ for TB training. Copy available at the BOH office B. Health Agent's Report Lead paint discussion. L Ramdin went over the procedures for a lead based housing inspection. Naloxone trainings will be done at the City Council meeting on April 28'at 7pm. Board members are invited to attend. Mosquito season discussion. Spraying will only take place when there is a threat of a mosquito borne illness is in the area. Board discussed State Level Tobacco 21 initiative. Universal Steel discussion. Dr. Schiller brought in a letter from a neighbor of the Universal Steel site. Letter is part of the record. Copy available at the BOH office Copy available at the BOH office C. Administrative Report P. Kirby,motioned to accept the reports.J. Greene 2nd All in favor. Motion passed. McGlew Park refurbishing discussion. D. City Council Liaison Updates 5. Briefing by Cindy Rice on 2013 Food L. Ramdin introduced Cindy Rice from Eastern Code adoption Food Safety; There are 13 North Shore communities interested ' in updating their food code to the 2013 version. Changes to the code are: *Inspections will be based on CDC risk factors * Will insure uniformity throughout the state * Will reduce conflict in communities with multi- units in different towns *A value is assigned to the risk assignment of every inspection item. This will improve performance do to better understanding of inspection items. Major Change: * There are 3 definitions for violations now instead of using critical and noncritical (P priority, PF priority foundation, &Core). * There is now a section in the code addressing time and temp control for safety foods * 3 new groups of food; cut leafy greens, tomatoes and melons. *New temperature danger zones. * Date marking is now required. * Some foods are allowed a time without temp control. Written methods are required and food is to be thrown out after 4-6 hrs * Public notice of inspections. Establishments have to post a notice that they were inspected and have copy available for the public. *New restrictions on reheating and reduce oxygen package *Wiping cloth storage in sanitizers. *Auto washer testing. * Pest control requires establishment to be pest free. *A mop sink is now required. * Employee illness requirements. * HACCP plans required. Once the Board has agreed to adopt the 2013 Food Code in principal, trainings will be scheduled for all establishments and inspectors. On May 19d' there is training in Beverly. The Food Code will be updated and a draft provided to the Board for further discussion and vote in the second half of 2016. P. Kirby motioned that we agree in principal to adopt the 2013 FDA food code in preparation for anticipated Health Department activities to bring Salem's regulations in line with this code. J. Green 2nd Motion passed it 6.Joyce Redford &DJ Wilson—Tobacco DJ Wilson spoke to the Board about flavor regulation discussion; flavor restrictions. 28% of Massachusetts cities and j suspension, creating exclusion zones towns are moving towards flavor restrictions. Part and suspension language update. of the regulations that DJ will draft addresses selling flavored tobacco products in establishments as long as there adult only(21+)and they must not it sell food. As long as these are in place they can still sell flavored tobacco products. (document handed out by DJ is part of record). There is also a guidance document on MAHB website. DJ suggested giving the establishments a certain amount of time to sell their flavored products because they cannot give them back. J. Redford spoke to the Board about suspension language in the Salem Tobacco Regulation. The Board wants to update the language to reflect that not appealing the suspension would allow the Health Agent to supply the suspension dates per the previous Board vote. The letter templates to establishments will also need to be updated. DJ Wilson offered the help edit the letter. There will also be a change to application language. Mandatory training should be added to application. J. Redford and DJ Wilson spoke to the Board about exclusion zones. The Board requested the exclusion zones be drafted in a separate document Peabody, Swampscott and Marblehead have language on that. Putting up signs is a start, but enforcement is difficult The draft regulations will be provided to the Board to review at May's meeting. A public hearing will be subsequently scheduled before the Board takes a vote on the topic. 7. New Business/Scheduling of future agenda items *Items that the Chair could not anticipate. *Joyce Redford tobacco flavored suspension, creating buffer zones, suspension language draft regulations for May's Agenda. *DEP person on Universal Steel site to discuss with the Board in May. *Student initiative on banning plastic bags for June agenda. 8. MEETING ADJOURNED: Dr. Schiller motioned to adjourn the meeting. P. Kirby 2°d All in favor. Motion passed. 9:30pm SRespectfully submitted, Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is May 10, 2016 at 7pm At City Hall Annex, 120 Washington Street,Room 313 Salem. Health Agent report May2016 Announcements/Updates • The Department Budget was approved by the Finance Committee. The request to increase the salary of the part-time inspectors to the equivalent of step 1 of the Sanitarians at $28.54 was included in the Mayor's budget (the part-time Inspectors have not had an increase since2010. This adjustment increased the Salary line by $3497.00 (4.36%) The Health expenses budget was reduced 11.76%. The office supplies line was reduced by $300.00 and the Housing-San line was reduced by decreased by$1400.00, instate travel was reduced by$100.00 a total dollar reduction of$1800 The request for another Clerk was not approved, there were increases in staffing in other Departments including an Assistant Building Inspector, Assistant Veterans Agent, additional Police officers and Opiate Outreach worker in the Police Department. • I will be on Vacation from June 8 returning on June 23, I will be out of the country with limited internet and e-mail access, during my absence Elizabeth Gagakis will be respond to complaints and external correspondence. In the event Elizabeth goes out on maternity leave, William Burke, Health Director, Beverly and Jeffrey Vaughan, Health Director, Swampscott provide advice to staff on an emergency basis • The Mayor met with all staff to provide City updates and discuss budget changes Community Outreach • A series of educational workshops on the 2013 Food is being planned and should begin in July, to educate Food Establishments on the differences between the 1999 and 2013 code, the inspection process and reports. • We printed and are providing to area businesses bathroom placards on Overdose signs and actions to take in the event of an overdose. • Recovering in Salem a panel series on opiate addictions is process of filming for broadcast on SATV, the first discussion is already available and being screened Meetings and Trainings • 6 meetings were held with Food establishments to discuss the Food establishment licensing process, expansion of existing facilities. • All Environmental Health staff and Health Agent attended the Massachusetts Environmental Health Association Annual meeting on May 4th. There were presentations on Potable water safety, Lyme disease and Arbovirus threat's to be concerned about in Massachusetts. • Inspectional staff attended a workshop on the 2013 Food Code • Larry Ramdin attended a seminar on"Millenials in the workplace" Environmental Health Activities • All swimming pools were licensed. The inspection licensing processes identified gaps and we will be updating our licensing forms and inspection processes. A briefing workshop for Swimming Pool operators on the updates to the licensing forms and inspection procedures will be discussed. • The Camp Season is upon us and staff are currently conducting inspections and records review for licensure • Beach Sampling will begin on June 14 and will end on August 12 • We met with the Engineering department to discuss the disposal of bulk items which have been an issue since the transfer station closed. We developed a strategy to address the issue comprising of notification and regulatory actions. • We are currently addressing a rodent issue in the Northfields Neighborhood Inspections Item Monthly Total YTD 2015 Total Certificate of Fitness 44 196 534 Inspection Certificate of Fitness 8 16 4 re-inspection Food Inspection 10 60 263 Food Re-inspections 3 24 55 Retail Food 0 12 18 Inspections Retail Food 0 10 1 re-inspection General Nuisance 0 5 25 Inspections Food— 1 2 0 Administrative Hearings Housing Inspections 8 47 181 Housing re- 1 8 37 inspections Rodent Complaints 3 6 19 Court 0 3 7 Hearings/filings Trash Inspections 30 99 138 Orders served by 0 3 7 Constable Tanning Inspections 0 0 7 Body Art 0 0 1 Swimming pools 6 0 17 Bathing Beach 0 0 106 Inspection/testing Recreational Camps 1 1 12 Lead Determination 0 2 1 i Septic Abandonment 0 0 0 Septic System Plan 0 0 0 Review Soil Evaluation 0 0 0 Percolation tests 0 0 Total 120 518 1433 Erica Rimpila RN BSN BA Salem Board of Health Public Health Nurse Public Health Nurse Report Reporting on April 13th, 2016 to May 10th, 2016 Disease Prevention and Health Promotion • Investigated reportable diseases and reported case information to MDPH. • Coordinating follow up with North Shore Pulmonary Clinic on 1 current active tuberculosis cases. Coordinating follow up with BMC TB Pulmonary Clinic on 1 current active tuberculosis case. • MAVEN update: Vibrio will be treated as an immediate disease from May 1st-October 31 st. • MAVEN update: Zika Virus Infection category added to MAVEN. Zika Virus Infection previously categorized as Arbovirus. • On May 9"'received tuberculin PPD solution from TB Program in Tewksbury for follow up on 1 Class B1 TB case. • Flu Shots are still available. Meetings/Trainings • On April 13'b and 14th attended the annual MA Public Health Nurse Conference in Brewster. Presentation topics included:Armed Intruder, Tick Update, Hoarding and Ebola Emergency to Recovery. • On April 2 1"attended training for Employee Emergency Preparedness presented by Lt. King. Reviewed standards that can be implemented in an armed intruder/active shooter emergency. • On April 26`h attended the North Shore Public Health Nurse meeting in Manchester by the Sea. Attended demonstration on completing Foodborne Illness events on MAVEN. • On April 27�h attended first day of Local Public Health Institute course in Devens. Classroom content included Introduction to Public Health and Leadership and Collaboration in Local Public Health Practice. Completed online course modules: Orientation to Local Public Health in MA, Emergency Risk Communication,Public Health Law and Legal Issues in MA, Emergency Preparedness in MA and Drinking Water and Private Wells. • April 2016 MAVEN Webinar: "Massachusetts 2016 -Public Health Reporting and Surveillance of Vibrio Infection" detailed case investigation and follow-up of Vibrio parahaemolyticus (Vp) for both LBOH and MDPH. Vibrio will be treated as an immediate disease from May 1 st -October 31 st. • On May 6e,attended Immunization Updates in Haverhill. Reviewed updates on Epidemiology of Vaccine Preventable Diseases, Community Immunity, Compliance/Vaccine Storage and Handling, Clinical Immunization and the Massachusetts Immunization Information System (MIIS). • On May I Oh attended first day of three day MEMA 300 Course in Tewksbury. The course focused on the Intermediate Incident Command System for Expanding Incidents(ICS-300). Monthly Report of Communicable Diseases: April 2016 Disease New Carry Over Discharged/ Total#Of Running T,'otal for ,total for. Reported Closed Cases this Total for ?015 -2ff* Month 2016 Tuberculosis 1 2 0 3 4 4' S (Active) Latent 3 0 3 3 18 ;,• Y1 Tuberculosis* Arbovirus* 0 0 0 0 0 0 0 4b { Babesiosis 0 0 0 0 0 177 0 Calicivirus/No 0 0 0 0 0 1 rovirus Campylobacte 3 0 1 3 6 I P 10 riosis Chikungunya 0 0 0 0 0 Dengue* 0 0 0 0 1 0 Ehrlichiosis 0 0 0 0 0 d I. Enterovirus 0 0 0 0 01 Giardiasis 1 0 1 1 2 !2 0 Group A 0 0 0 0 0 4 2. Streptococcus Group B* 0 0 0 0 1 7 G Streptococcus Human 0 0 0 0 1 1 0 Granulocytic Ana lasmosis Haemophilus 0 0 0 0 0 1 0: Influenzae Hansen's 0 0 0 0 0 "0 ° 0 - Disease Hepatitis B* 2 0 2 2 4 1 0 2` Hepatitis C* 10 0 10 10 23 29 37 'nfluenza* 5 0 5 5 16 Legionellosis 0 0 0 0 0 1` b Lyme 5 0 5 5 10 Z 7 Disease* Malaria 0 0 0 0 0 Meningitis 0 0 0 0 0 OS 2 Mumps 1 0 1 1 2 0 0 Pertussis 0 0 0 0 0 1 2 Salmonellosis 0 0 0 0 3 `6 _ 3 Shigatoxin 0 0 0 0 0 1 Producing Organism Shigellosis 1 0 0 1 1 0 4 Streptococcus 1 0 1 1 6 3 2. Pneumoniae* Varicella* 0 0 1 0 1 Vibrio 0 0 0 0 0 Ok ' . '0 West Nile 0 0 0 0 0 >'ersoniosis 0 0 0 0 0 0' Zika Virus 1 0 0 1 1 0 Infection Total 34 2 30 36 100 ` `$ 14$ April 2016 *Notifications only, LBOH not required to follow up or investigate per DPH. Summary of Current Communicable Diseases Active Tuberculosis: Case 1: Continuing to provide Directly Observed Therapy for case. Case's expected completion of treatment is August 2016.No new updates. Case 2: Continuing to provide Directly Observed Therapy for case. Case's expected completion of treatment is August 2016.No new updates. Case 3: This case is suspect Active TB case. Lab results are pending. I Campylobacter: Case 1: Case traveled to Mexico during incubation period. Case denies work as a foodhandler or in a daycare setting. Contacts do not report illness. Case has been closed. Case 2: Case reports travel to all-inclusive resort in Dominican Republic. Case does not suspect food or beverage. Case suspects event during travel which included outdoor water activities. Case denies work as foodhandler or in daycare setting. Case is linked to Case 3. Case 3: Case linked to Case 2.Follow up in progress. Giardiasis: Case denies work as foodhandler or in daycare setting. Case does not suspect food or beverage. Contacts do not report illness. Case has been closed. Mumps: Suspect Mumps case is a Salem State University student that lives on campus. This case had 2 previous doses of MMR vaccine. Lab results are negative for Mumps. University Student Health Services referred case to Primary Care Physician for further follow up and alternate diagnosis. Case closed. Shigellosis: Case denies work as foodhandler or in daycare or school setting. Case investigation in progress. At Zika Virus Infection: This is a contact case. Case meets criteria for lab work. l Massachusetts Department of Public Health May 2, 2016 Weekly Zika Virus Update �H of M,q NN O U to V U ?'OF I�i Zika Virus Weekly Update Massachusetts Department of Public Health May 2, 2016 Report Number: 013 DPH Activities Summary: • All questions related to Zika virus testing requests should be directed to the 24/7 Epidemiology line, 617-983-6800. • MDPH Epidemiology Staff continue to receive calls from clinicians, local health, and concerned residents regarding Zika virus and its public health implications in Massachusetts. The weekly call volume regarding Zika is shown below. Total calls received during business hours since January 11 is 1277. Please note in the graph below, Zika calls are shown in purple/blue as a proportion of the total calls received on the 6800 line. Weekly Call Volume to Epidemiology Program During Business Hours, January 11,2016-Present 400 - - --- "■Total Cells ■ZNe Cells 350 300 250 - -- - 200 - - E Z 150 100 so l� I 0 ; Week • The MA State Public Health Laboratory(MA SPHL) uses a PCR test to detect the genetic material of Zika and chikungunya viruses and the Zika IgM MAC-ELISA to test for antibody response to infection. Additional work is ongoing to reach full testing functionality which will include PCR, ELISA and PRNT(confirmatory)testing for Zika, chikungunya and dengue viruses. • Staff members of the Bureau of Infectious Disease and Laboratory Sciences and the Bureau of Family Health and Nutrition Birth Defects Surveillance are continuing to develop collaborative plans to coordinate investigations of infants born to mothers with evidence of Zika virus infection. More information will be forthcoming as plans are finalized. • MDPH is collaborating with the MA Department of Agricultural Resources and the Mosquito Control Districts on continuing to enhance the surveillance efforts for Aedes albopictus which have been ongoing since 2008. I Laboratory Testing Summary: • The MA SPHL tested 3 samples (2 serum and 1 urine) from 3 patients by PCR and 37 samples from 37 patients using the IgM ELISA test. Positive PCR tests are confirmatory while positive IgM tests require further testing by PRNT, currently being done by CDC,to confirm the results. Weekly Volume of Samples Submitted to MA SPHL for Zika Virus Testing 140 120 100 so 60 ■Weekly Sample Volume 40 20 0 .y ,yN`rwmmmn`tY4Y .+� v,ymL. .+ N b.aoe`veo�v e�t'w�•\tN SNry M�r�n" av o N New or Revised State Guidance: None National Activities CDC Updates: HIV Infection &Zika Virus Publications: Update: Ongoing Zika Virus Transmission—Puerto Rico,November 1, 2015— April 14, 2016 Guidance: All Countries and Territories with Active Zika Virus Transmission Educational materials: Controlling Mosquitoes at Home Zika Activity Book: For kids in areas with Zika Media Reports First Test from a Commercial Lab to Receive Emergency Use Authorization for Testing Patients in the United States, including Puerto Rico, for Zika Infection—Quest Diagnostics For further information regarding Zika go to: http://www.mass.gov/dph/zika Please share with colleagues and throughout your agency, organization and/or associations. If you have comments, questions or feedback, contact us at the 2417 Epi Line (617)983-6800 or by email atDPH.EmergencyPreparedness@state.ma.us. Health Dept. Clerical Report FY 2016 Burial Permits Permits Plan Reviews Certificate of Copies/ Fines Revenue Permit Fees $25 Fitness $50 July-14 $475.00 $2,210.00 $1,950.00 $4,635.00 Food Service Est. <25seats $140 August $700.00 $985.00 $1,500.00 $3,185.00 25-99 seats $280 >99 seats $420 September $1,475.00 $2,165.00 $4,300.00 $300.00 $8,240.00 Retail Food <l000sq' $70 October $725.00 $3,295.00 $1,400.00 $5,420.00 l000-10,000 $28o >10,000 $420 November $600.00 $2,384.14 $180.00 $1,400.00 $200.00 $4,764.14 Temp.Food 1-3 days s3oo December $1,375.00 $52,268.00 $2,600.00 $56,243.00 4-7 days shoo >7days s January-15 , Example of>7 day tempfood permit. $325.00 $10,780.00 $650.00 $11,755.00 ; 14(da s)divided bY 7=2 x$600=$1200 February $750.00 $7,470.00 $2,500.00 $10,720.00 Frozen Desserts $25 March $1,450.00 $890.00 $360.00 $1,550.00 $300.00 I', $4,550.00 Mobile Food $210 April $550.00 $1,000.00 $1,450.00 $3,000.00 Plan Reviews New $180 May $0.00 Remodel sgo June Catering $25Perevent/$zoo $0.00 catering kitchen Body Art Est. $315 Total $8,425.00 $83,447.14F $540.00 $19,300.00 $800.00 1$112,512.14 Body Art Practitioner 135 Review Plans s18o Fiscal Year Budget 2014 Suntan Est. $140 Rec. Day Camp $10 Salary Starting Ending Expenses/Budget Ext.Paint Removal s35 Full Time $357,223.00 $76,923.84 Starting Endinq Transport Off.Subst. slo5 Part Time $16,545.00 $10,935.00 $18,300.00 $3,292.26 Tobacco Vendors $135 Overtime $2,000.00 $0.00 Swimming Pools Seasonal $140 Balance $375,768.00 $87,858.84 Health Clinic Revolving Account Annual$210 Nonprofit$40 $11,374.81 Title V Review s18o Well Application s18o Disposal works $2 t DRAFT — 4-22-16 Regulation 24 of the City of Salem Board of Health Restricting the Sale and Use of Tobacco Products A. Statement of Purpose: Whereas there exists conclusive evidence that tobacco smoke causes cancer, respiratory and cardiac diseases, negative birth outcomes, irritations to the eyes, nose and throat (Centers for Disease Control and Prevention(hereinafter "CDC'), Health Effects of Cigarette Smoking Fact Sheet, (January 2012)); whereas among the 15.7% of students nationwide who currently smoked cigarettes and were aged less than eighteen(18) years, 14.1%usually obtained their own cigarettes by buying them in a store(i.e., convenience store, supermarket, or discount store)or gas station during the thirty(30) days before the survey(CDC, Youth Risk Behavior, Surveillance Summaries. 2009,MMWR 2010:59(No. SS-55)at 11); whereas nationally in 2000, sixty-nine (69%) percent of middle school age children who smoke at least once a month were not asked to show proof of age when purchasing cigarettes (CDC, Youth Tobacco, Surveillance Summaries. 2000,MMWR 2001:50(No. SS-04)); whereas the U.S. Department of Health and Human Services has concluded that nicotine is as addictive as cocaine Or heroin(U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking Attributable Disease:A Report of the Surgeon General,Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.); whereas despite state laws prohibiting the sale of tobacco products to minors, access by minors to tobacco products is a major problem; whereas according to the CDC, cigarette price increases reduce the demand for cigarettes and thereby reduce smoking prevalence, cigarette consumption, and youth initiation of smoking (U.S. Department of Health and Human Services. Reducing Tobacco Use:A Report of the Surgeon General. Atlanta, GA. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000 at 358); Whereas the 2012 U.S. Surgeon General's Report on Preventing Tobacco Use Among Youth and Young Adults, reports that in 2005 Ringel, Wasserman, &Andreyeva(U.S. Department of Health and Human Services, Nicotine Addiction,Atlanta, GA: U.S. Department of Health and Human Services, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1988) conducted logistic regression analyses to examine whether increased cigar prices and state tobacco control policies affected the rate of cigar use. (U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults,Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012 at 706). Using the 1999 and 2000 iterations of the National Youth Tobacco Survey, Ringel and colleagues analyzed data from 33,632 adolescent participants aged nine to seventeen. They found that increased cigar prices significantly decreased the probability of male adolescent cigar use and found that a 10% increase in cigar prices would reduce the sample's cigar use by 3.4% (Ringel JS, Wasserman J,Andreyeva T, Effects of Public Policy on Adolescents'Cigar Use:Evidence From the National Youth Tobacco Survey, 95 Am.J. Pub. Health 995-8(June 1, 2005); whereas according to the CDC's youth risk behavior surveillance system, the percentage of high school students in Massachusetts who reported the use of cigars within the past 30 days went from 11.8% in 2003 to 14.9% in i_ 2009 (CDC, Youth Risk Behavior. Surveillance Summaries, 2009.MMWR 2010;59(No. SS-55)at 72; CDC, Youth Risk Behavior. Surveillance Summaries, 2003.MMWR 2004;53 (No. SS-02)at 54); whereas nicotine levels in cigars are generally much higher than nicotine levels in cigarettes. (Nat'l Cancer Institute at the Nat'l Inst. of Health, Questions and Answers About Cigar Smoking and Cancer (Oct. 27, 2010)); Whereas commercial Roll Your Own(RYO) machines enable loose, unpackaged tobacco to be poured into a machine and placed into empty, unpackaged cigarette tubes to be inhaled by individuals who smoke them. This procedure provides risk of contamination of the tobacco and unsanitary conditions in the machine and is injurious to public health; whereas commercial Roll Your Own(RYO) machines located in retail stores enable retailers to sell cigarettes without paying the federal and state excise taxes that are g PY g imposed on conventionally manufactured cigarettes (RYO FILLING STATION, www.ryofllingstation.com (Feb. 27, 2012). High excise taxes encourage adult smokers to quit and deter youth from starting (Kenneth E. Warner, Smoking and Health Implications of a Change in the Federal Cigarettte Excise Tax, 255 J.AM.MED.Ass'N 1028(1986), Frank J. Chaloupka&Rosalie Liccardo Pacula, The Impact of Price on Youth Tobacco Use, in 14 SMOKING AND TOBACCO CONTROL MONOGRAPHS: CHANGING ADOLESCENT SMOKING PREVALENCE 193 (US Dep't Health and Human Services et al. eds., 2001)). Therefore, inexpensive cigarettes, like those produced from RYO machines, promote the use of tobacco, resulting in a negative impact on public health and increased health care costs, and severely undercut the evidence- based public health benefit of imposing high excise taxes on tobacco; Whereas the federal Family Smoking Prevention and Tobacco Control Act (FSPTCA)„ enacted in 2009, prohibited candy- and fruit-flavored cigarettes 21 US.C. §387g, largely because these flavored products were marketed to youth and young adults, Carpenter CM ;Wayne GF, Pauly JL, et al. 2005. "New Cigarette Brands with Flavors that Appeal to Youth: Tobacco, Marketing Strategies."Health Affairs. 24(6): 1601-1610;Lewis M and Wackowski O. 2006 "Dealing with' I n Innovative Industry:A Look at Flavored Cigarettes Promoted by Mainstream Brands."American Journal of Public Health. 96(2):244-251; Connolly GN. 2004. "Sweet and Spicy Flavours:New Brands__ for Minorities and Youth."Tobacco Control. 13(3):211-212; U.S.Department of Health and Human Services. 2012. Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeon' General.Atlanta: U.S.National Centerfor Chronic Disease Prevention and Health Promotion, Office on Smoking and Health,p. 537, www.surgeongeneral.gov/library/reports/preventing-vouth-tobacco-use/ re ort. d and younger smokers were more likely to have tried these products than older smokers, U.S. Department of Health and Human Services. 2012. Preventing Tobacco Use Among Youth, and Young Adults:A Report of the Surgeon General.Atlanta: U.S. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health,p. 539, www.surgaeongeneral.gov/ library/reports/preventin-a-youth-tobacco-use/full-report.pdfneither federal nor Massachusetts laws restrict sales of flavored non-cigarette tobacco products, such as cigars, cigarillos,,, ;smokeless tobacco, hookah tobacco, and electronic devices and the nicotine solutions used in these devices; and the U.S. Food and Drug Administration and the U.S. Surgeon ;General have stated that flavored tobacco products are considered to be "starter"products' that help establish smoking habits that can lead to long-term addiction; Food and Drug Administration. 2011. Fact Sheet: Flavored Tobacco Products, www.fda.Qov/downloads. %TobaccoProducts/ProtectingKidsfromTobacco/FlavoredTobacco/UCM183214.pdf US Department of Health and Human Services. 2012. Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeon General.Atlanta: U.S. National Center for Chronic Disease Prevention and Health'.` Promotion, Office on Smoking and Health,p. 539, www.surgeongeneral.gov/library/reports/preventing' youth-tobacco-use/full-report.p4f 1 i Whereas the sale of tobacco products are incompatible with the mission of health care institutions because they are detrimental to the public health and undermine efforts to educate patients on the safe and effective use of medication; Whereas educational institutions sell tobacco products to a younger population, which is particularly at risk for becoming smokers and such sale of tobacco products are incompatible with the mission of educational institutions that educate a younger population about social, environmental and health risks and harms; Now,therefore it is the intention of the City of Salem Board of Health to regulate the access of tobacco products. B. Authority: This regulation is promulgated pursuant to the authority granted to the City of Salem Board of Health by Massachusetts General Laws Chapter 111, Section 31 that 'Boards of Health may make reasonable health regulations". C. Definitions: For the purpose of this regulation, the following words shall have the following meanings: Adult-only retail tobacco store: An establishment that is not required to possess a retail food permit whose primary purpose is to sell or offer for sale but not for resale, tobaccoi products and tobacco paraphernalia, in which the sale of other products is merely incidental, and in which the entry of persons under the minimum legal sales age is prohibited at all times, and maintains a valid permit for the retail sale of tobacco products as required to be issued by the Salem Board of Health.; Blunt Wrap: Any tobacco product manufactured or packaged as a wrap or as a hollow tube made wholly or in part from tobacco that is designed or intended to be filled by the consumer with loose tobacco or other fillers. Business Agent: An individual who has been designated by the owner or operator of any establishment to be the manager or otherwise in charge of said establishment. Characterizing flavor: A distinguishable taste or aroma, other than the taste or aroma of tobacco, menthol, mint or wintergreen, imparted or detectable either prior to or during consumption of a tobacco product or component part thereof, including, but not limited to, tastes or aromas relating to any fruit, chocolate, vanilla, honey, candy, cocoa, dessert; 'alcoholic beverage, herb or spice; provided, however, that no tobacco product shall be determined to have a characterizing flavor solely because of the provision of ingredieni,. information or the use of additives or flavorings that do not contribute to the, distinguishable taste or aroma of the product.' Cigar: Any roll of tobacco that is wrapped in leaf tobacco or in any substance containing tobacco with or without a tip or mouthpiece not otherwise defined as a cigarette under Massachusetts General Law, Chapter 64C, Section 1, Paragraph 1. 2 00 Commercial Roll-Your-Own(RYO) machine: A mechanical device, by whatever manufacturer made and by whatever name known, that is designed to roll and wrap tobacco into products. RYO machines located in a private home, used for personal consumption, are not Commercial Roll-Your-Own machines. Component part: Any element of a tobacco product, including, but not limited to, the tobacco, filter and paper, but not including any constituent., !Constituent: Any ingredient, substance, chemical or compound, other than tobacco;; Water or reconstituted tobacco sheet, that is added by the manufacturer to a tobacco product during the processing, manufacturing or packaging of the tobacco product._ Such term shall include a smoke constituent., Distinguishable: Perceivable by either the sense of smell or taste E- Cigarette: Any electronic device, not approved by the United States Food and Drug, Administration, composed of a mouthpiece, heating element, battery and/or electronic circuits that provides a vapor of liquid nicotine to the user, or relies on vaporization of ,any liquid or solid nicotine. This term shall include such devices whether they are manufactured as e-cigarettes, e-cigars, e-pipes, e-hookah or under any other product name.' Educational Institution: Any public or private college, school, professional school, scientific or technical institution, university or other institution furnishing a program of higher education. Employee: Any individual who performs services for an employer. Employer: Any individual, partnership, association, corporation, trust or other organized group of individuals that uses the services of one (1) or more employees. Flavored tobacco product: Any tobacco product or component part thereof that contains_ a constituent that has or produces a characterizing flavor. A public statement, claim or indicia made or disseminated by the manufacturer of a tobacco product, or by any person authorized or permitted by the manufacturer to make or disseminate public statements concerning such tobacco product,that such tobacco product has or produces a characterizing flavor shall constitute presumptive evidence that the tobacco product is a ;flavored tobacco products) Health Care Institution: An individual, partnership, association, corporation or trust or any person or group of persons that provides health care services and employs health care providers licensed, or subject to licensing,by the Massachusetts Department of Public Health under M.G.L. c. 112 or a retail establishment that provides pharmaceutical goods and services and subject to the provisions of 247 CMR 6.00. Health care institution includes, but is not limited to, hospitals, clinics, health centers, pharmacies, drug stores, doctor offices and dentist offices. Minor: Any individual who is under the age of twenty-one (21). 3 . Permit Holder: Any person engaged in the sale or distribution of tobacco products • directly to consumers who applies for and receives a tobacco product sales permit or any person who is required to apply for a tobacco product sales permit pursuant to these regulations, or his or her business agent. Smoke Constituent: Any chemical or chemical compound in mainstream or sidestrearr tobacco smoke that either transfers from any component of the tobacco product to the ;smoke or that is formed by the combustion or heating of tobacco, additives or other component of the tobacco product; ,Smoking Bar: An establishment that primarily is engaged in the retail sale of tobacco products for consumption by customers on the premises and is required by Mass. Gen_eral, Law Ch. 270, §22 to maintain a valid permit to operate a smoking bar issued by the Massachusetts Department of Revenue. "Smoking bar" shall include, but not be limited to, those establishments that are commonly known as "cigar bars" and "hookah bars". Tobacco Product: Any product containing, made, or derived from tobacco or nicotine that is intended for human consumption, whether smoked, chewed, absorbed, dissolved,': inhaled, snorted, sniffed, or ingested by any other means, including, but not limited to ,cigarettes, cigars, little cigars, chewing tobacco, pipe tobacco, snuff; or electronic ;cigarettes, electronic cigars, electronic pipes, electronic hookah, liquid nicotine, "e-' liquids" or other similar products, regardless of nicotine content, that rely on vaporizatiori or aerosolization. "Tobacco product"includes any component or part of a tobacco', product. "Tobacco product"does not include any product that has been approved by the; United States Food and Drug Administration either as a tobacco use cessation product or for other medical purposes and which is being_marketed and sold or prescribed solely for the approved purpose; Vending Machine: Any automated or mechanical self-service device, which upon insertion of money, tokens or any other form of payment, dispenses or makes cigarettes, any other tobacco product. D. Tobacco Product Sales to Minors Prohibited: 1. No person shall sell tobacco products or permit tobacco products to be sold to a minor; or not being the minor's parent or legal guardian, give tobacco products to a minor. 2. Required Signage a. In conformance with and in addition to Massachusetts General Law, Chapter 270, Section 7, a copy of Massachusetts General Laws, Chapter 270, Section 6, shall be posted conspicuously by the owner or other person in charge thereof in the shop or other place used to sell tobacco products at retail. The notice shall be provided by the Massachusetts Department of Public Health and made available from the City of Salem Board of Health. The notice shall be at least 48 square �• inches and shall be posted conspicuously by the permit holder in the retail establishment or other place in such a manner so that it may be readily seen by a person standing at or approaching the cash register. The notice shall directly face the purchaser and shall not be obstructed from view or placed at a height of less 4 than four(4) feet or greater than nine (9) feet from the floor. The owner or other person in charge of a shop or other place used to sell tobacco products at retail shall conspicuously post any additional signs required by the Massachusetts Department of Public Health. b. The owner or other person in charge of a shop or other place used to sell tobacco products at retail shall conspicuously post signage provided by the City of Salem board of health that discloses current referral information about smoking cessation. c. The owner or other person in charge of a shop or other place used to sell tobacco products that rely on vaporization or aerosolization, as defined herein as "tobacco products", at retail shall conspicuously post a sign stating that "The sale of tobacco products, including e-cigarettes, to minors under 21 years of age is prohibited." The owner or other person in charge of a shop or other place used to sell e-cigarettes at retail shall conspicuously post a sign stating that "The use of e- cigarettes at indoor establishments may be prohibited by local law." The notices shall be no smaller than 8.5"by 11" and shall be posted conspicuously in the retail establishment or other place in such a manner so that they may be readily seen by a person standing at or approaching the cash register. These notices shall directly face the purchaser and shall not be obstructed from view or placed at a height of less than four (4) feet or greater than nine (9) feet from the floor. 3. Identification: Each person selling or distributing tobacco products shall verify the age of the purchaser by means of valid government-issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person under the age of 27. 4. All retail sales of tobacco products must be face-to-face between the seller and the buyer. E. Tobacco Product Sales Permit: 1. No person shall sell or otherwise distribute tobacco products at retail within the City of Salem without first obtaining a Tobacco Product Sales Permit issued annually by the City of Salem Board of Health. Only owners of establishments with a permanent, non-mobile location in Salem are eligible to apply for a permit and sell tobacco products at the specified location in Salem. 2. As part of the Tobacco Product Sales Permit application process, the applicant will be provided with the City of Salem Board of Health regulation. Each applicant is required to sign a statement declaring that the applicant has read said regulation and that the applicant is responsible for instructing any and all employees who will be responsible for tobacco product sales regarding both state laws regarding the sale of tobacco and this regulation. 3. Each applicant who sells tobacco is required to provide proof of a current tobacco sales license issued by the Massachusetts Department of Revenue before a Tobacco Product Sales Permit can be issued. 5 4. The fee for a Tobacco Product Sales Permit shall be determined by the City of Salem Board of Health annually. All such permits shall be renewed annually. 5. A separate permit is required for each retail establishment selling tobacco products. 6. Each Tobacco Product Sales Permit shall be displayed at the retail establishment in a conspicuous place. 7. No Tobacco Product Sales Permit holder shall allow any employee to sell tobacco products until such employee reads this regulation and state laws regarding the sale of tobacco and signs a statement, a copy of which will be placed on file in the office of the employer, that he/she has read the regulation and applicable state laws. 8. A Tobacco Product Sales Permit is non-transferable. A new owner of an establishment that sells tobacco products must apply for a new permit. No new permit will be issued unless and until all outstanding penalties incurred by the previous permit holder are satisfied in full. 9. Issuance of a Tobacco Product Sales Permit shall be conditioned on an applicant's consent to unannounced, periodic inspections of his/her retail establishment to ensure compliance with this regulation. 10. Issuance and holding of a Tobacco Product Sales Permit shall be conditioned on an applicant's on-going compliance with current Massachusetts Department of Revenue requirements and policies including, but not limited to, minimum retail prices of tobacco products. 11. A Tobacco Product Sales Permit will not be renewed if the permit holder has failed to pay all fines issued and the time period to appeal the fines has expired and/or has not satisfied any outstanding permit suspensions. 12. Maximum Number of Tobacco Product Sales Permits. At any given time, there shall be no more than 60 Tobacco Product Sales Permits issued in City of Salem. No permit renewal will be denied based on the requirements of this subsection except any permittee who has failed to renew their current permit within(30) days of expiration will be treated as a first-time permit applicant. Applicants who purchase a business that holds a current Tobacco Product Sales Permit at the time of the sale of said business may apply within sixty (60) days of such sale, and if complying with all application requirements shall receive, the permit held by the Seller if the Buyer intends to sell tobacco products. New applicants for permits who are applying at a time when the maximum number of permits have been issued will be placed on a waiting list and will be eligible to apply for a permit on a "first-come, first-serve" basis as issued permits are either not renewed or are returned to the Board. . F. Cigar Sales Regulated: 1. No person shall sell or distribute or cause to be sold or distributed a single cigar. 6 • 2. No person shall sell or distribute or cause to be sold or distributed any original package of two or more cigars, unless such package is priced for retail sale at $5.00 or more. 3. This Section shall not apply to: a. The sale or distribution of any single cigar having a retail price of two dollars and fifty cents ($2.50)or more. b. A person or entity engaged in the business of selling or distributing cigars for commercial purposes to another person or entity engaged in the business of selling or distributing cigars for commercial purposes with the intent to sell or distribute outside the boundaries of Salem. 4. The Salem Board of Health may adjust from time to time the amounts specified in this Section to reflect changes in the applicable Consumer Price Index by amendment of this regulation. G. Prohibition of the Sale of Blunt Wraps No person or entity shall sell or distribute blunt wraps within the City of Salem. H. Free Distribution and Coupon Redemption: SNo person shall distribute, or cause to be distributed, any free samples of tobacco products. No means, instruments or devices that allow for the redemption of tobacco products for free or at a reduced price below the minimum retail price determined by the Massachusetts Department of Revenue shall be accepted by any permittee. 1. Out-of-Package Sales: No person may sell or cause to be sold or distribute or cause to be distributed, any cigarette package that contains fewer than twenty(20) cigarettes, including single cigarettes. J. Self-Service Displays: All self-service displays of tobacco products are prohibited. All humidors including, but not limited to, walk-in humidors must be locked. K. Vending Machines: All tobacco product vending machines are prohibited. L. Commercial Roll-Your-Own Machines • All commercial Roll-Your-Own machines are prohibited. • M. Prohibition of the Sale of Tobacco by Health Care Institutions: 7 No health care institution located in City of Salem shall sell or cause to be sold tobacco products. No retail establishment that operates or has a health care institution within it, 40 0 such as a pharmacy or drug store, shall sell or cause to be sold tobacco products. N. Prohibition of the Sale of Tobacco Products by Educational Institutions: No educational institution located in City of Salem shall sell or cause to be sold tobacco products. This includes all educational institutions as well as any retail establishments that operate on the property of an educational institution. O. E-Cigarette Use: The use of e-cigarettes is prohibited wherever smoking is prohibited per M.G.L. Ch.270, §22 and the Salem Environmental Tobacco Smoke (ETS)regulation. P. Sale of Flavored Tobacco Products Prohibited: No person shall sell or distribute or cause to be sold or distributed any flavored tobacco.'. product, except in smoking bars and adult-only retail tobacco stores.' Q. Violations: 1. It shall be the responsibility of the establishment, permit holder and/or his or her business agent to ensure compliance with all sections of this regulation pertaining to his or her distribution of tobacco products. The violator shall receive: a. In the case of initial violations observed at an inspection within a 36-month period, a fine of one hundred dollars ($100.00) per violation. b. In the case of violations observed at the second inspection within 36 months of the date of a current violation, a fine of two hundred dollars ($200.00) per violation and the Tobacco Product Sales Permit shall be suspended for seven (7) consecutive business days. c. In the case of violations observed at the three or more inspections within a 36 months of a current violation, a fine of three hundred dollars ($300.00) and the Tobacco Product Sales Permit shall be suspended for thirty(30) consecutive business days or the City of Salem Board of Health may revoke the Tobacco Product Sales Permit. 2. Refusal to cooperate with inspections pursuant to this regulation shall result in the suspension of the Tobacco Product Sales Permit for thirty(30) consecutive business days. 3. In addition to the monetary fines set above, any permit holder who engages in the sale or distribution of tobacco products directly to a consumer while his or her permit is suspended shall be subject to the suspension of all board of health issued permits for thirty(30) consecutive business days. 8 4. Suspensions; a. The Salem Board of Health shall notify the permit holder of its intention to:,. suspend a Tobacco Product Sales Permit and such notice shall contain the reasons for the suspension, the length of the suspension, the date that the suspension period shall begin and that the permit holder has twenty-one (21) days from the' date of this notice to request a hearing before the Board of Health. b. The Salem Board of Health shall provide notice of the intent to revoke a Tobacco Product Sales Permit, which notice shall contain the reasons therefor and establish a time and date for a hearing which date shall be no earlier than seven(7) days after the date of said notice. The permit holder or its business agent shall have an ,opportunity to be heard at such hearing and shall be notified of the Board of Health's decision and the reasons therefor in writing. After a hearing, the Salem Board of Health may revoke the Tobacco Product Sales Permit if the Board of Health finds that a violation of this regulation occurred_; c. For purposes of such suspensions or revocations, the Board shall make the determination notwithstanding any separate criminal or non-criminal proceedings brought in court hereunder or under the Massachusetts General Laws for the same' ,offense. All tobacco products, as defined herein, shall be removed from the retail establishment upon suspension or revocation of the Tobacco Product Sales Permit. Failure to remove all tobacco products, as defined herein, shall constitute a separate violation of this regulation. R. Non-Criminal Disposition: Whoever violates any provision of this regulation may be penalized by the non-criminal method of disposition as provided in General Laws, Chapter 40, Section 21 D or by filing a criminal complaint at the appropriate venue. Each day any violation exists shall be deemed to be a separate offense. S. Enforcement: Enforcement of this regulation shall be by the City of Salem Board of Health of or its designated agent(s). Any citizen who desires to register a complaint pursuant to the regulation may do so by contacting the City of Salem Board of Health or its designated agent(s) and the Board shall investigate. T. Severability: If any provision of these regulations is declared invalid or unenforceable, the other provisions shall not be affected thereby but shall continue in full force and effect. U. Effective Date: 9 . This regulation shall take effect on September 1, 2012, with the exception of Section F (Cigar Sales Regulated) which shall take effect on February 4, 2013. Amended August 7, 2014 The amendments to Regulation 24: Restricting the Sale and Use of Tobacco Products & Nicotine Delivery Products will become effective January 1 of 2015. After a vote of the Board of Health at a special meeting held on August 7, 2014 the amendments passed: 3 affirmative 2 negative Pursuant to MGL Chap. 111 § 31, a summary of the regulation was posted in the Salem Evening News on September 5, 2014 Vote reaffirmed on September 24, 2014: 3 Affirmative 1 negative, 1 abstain City of Salem Board of Health 120 Washington Street, 4th Floor Salem MA, 01970 Dr. Barbara Poremba Ed. D MPH Chair Gayle Sullivan Dr. Shama Alam, MD Dr. Danielle Ledoux M.D. Paul Kirby Larry Ramdin Health Agent Heather Lyons- Paul- Clerk of the Board • i 10 i Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,40'Floor Salem,MA 01970-3523 Tel. (978)741-1800 Fax (978)745-0343 I City/Town of Address: FOOD ESTABLISHMENT INSPECTION REPORT Tel. Name Oat T pe of perotion(s) Type of inspection V t+ c1 G c-Q -�t J ^h J Service ine Address Z 2 Risk ❑ Retail Re-inspection 3 S Level ❑ Residential Kitchen Previous Inspection Telephone C1�1 _ -�N L j M _.7 Z ❑ Mobile Date: ❑ Temporary ❑Pre-operation Owner V nfy) NN HACCP Y ❑ Caterer ❑Suspect Illness Person-in-Charge(PIC) Time ❑ Bed 8 Breakfast ❑General Complaint Inspector In:t 1- 1-5 El ermlt No. ❑H heCP 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 Poodborne Illness interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) 161 Violations marked may se an imminent health hazard and require immediate tobacco 90.009(F) ❑ y pose � 6 Allergen Awareness 90.009(G) ❑ corrective action as determined by the Board of Health. F00 ROTECTION MANAGEMENT ❑ 12. Prevention of Contamination from Hands r 1 PiC ASSignedlKnowtedgeabte/buties ❑ 13 Handwash Facilities EMPLOYEE HEALTH ❑ 2. Reporting of Diseases by Food Employee and PiC PROTECTION FROM CHEMICALS ❑ 1 ❑ 3. Personnel with Infections Restricted/Excluded Approved Food or Color Additives 15.Toxic Chemicals F000 FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4. Food and Water from Approved Source ❑ 5 Receiving/Condition ❑ 16.Cooking Temperatures Tags/RecordslAccuracy of Ingredient Statements ❑ 17,Reheating ❑ 7.e-T nformanco with Approved Procedures/HACCP Plans ❑ 18.Cooling PROION FROM CONTAMINATION 18.Hot and Cold Holding 8, epa ❑20.Time as a Public Health Control Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HiGHLYSUSCEPTIBLE-POPULATIONS(HSP) ❑21.Food and food Preparation for HSP ❑10,Proper Adequate Handwashing ❑11.Good Hygienic Practices &22. SUMER ADVISORY Pasting of Consumer Advisories Violations Related to Good Retail Practices.(Blue Number of Violated Provisions Related items) Critical(C)violations marked must be corrected To Foodborne illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red 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 by a Board of Health member or its agent constitutes an Management and Personnel (Fc•2x59o.o03) order of the Board of Health. Failure to correct violations Food and Food Protection (FC-3)(590.004) cited in this report may result in suspension or revocation of 87 4Equipment and Utensils (FC-4)(5W.005) the food establishment permit and cessation of food 6.6.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-7X590.006) and submitted to the Board of Health at the above address 29. Special Requirements (590.000) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION. S n abc Inspector's Signs Print: , PICs Signature: Print: Page ! of Pages I CITY OF SALEM lc� BO RO OF EALTH Establishment Name: �'��-�G , Vl �� C K 'T```'«�► Date: s 2 Page:9 of fA Referonce R—Red Item Item Code C- to m hem DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Deis PUME PRINT CLEARLY A Vertfled l I 3-3oL�►� on o-(N Cour 7 r�i orr"e C& s On r rag.6to,I M �e �tc�C n *I 217 Ell 3 ,I 'J Q I �i � 1,'s a 's Discussion With Person in Charge: Corrective Action Required: o No I have read this report, have had the opportunity to ask questions and agree to correct all 0 Voluntary Compliance ❑ Employee Restriction violations before the next inspection, to observe all conditions as described, and to Exclusion comply with all mandates of the Mass/Federal Food Code. I understand that 0 Re-inspection Scheduled 0 Emergency Suspension noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of 0 Embargo U Emergency Closure your food permit. -� ❑ Voluntary Disposal 0 Other: CITY OF SALEM T BOARD OF HEALTH Establishment Name: �t-�-i:,;n -Y�Gc e � ✓r�. r 4- Date: S 2 Ll to Item Code C—Critical Item Page:�Of No. Reference R—Red item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION pie P e Pm CLEAR Y Verlfled `4 ICor 0.0 bl In S uj c S r Gc o ti . t lC? b . me Crtoo :,- . '�SlSt l r t° ch ct y) � C' V- CC mile 1 Y1 I i C. CcA LO CL +f Gl ✓2c17d G `e n, r z r tr o� A04- o rh Discussion With Person in Charge: Corrective Action Required: a No Yes I have read this report, have had the opportunity to ask questions and agree to correct all O Voluntary Compliance O Employee Restriction violations before the next inspection, to observe all conditions as described, and to Exclusion comply with all mandates of the Mass/Federal Food Code. I understand that `e inspection Scheduled t7 Emergency Suspension noncompliance may result in daily fines of twenty-five d rs or suspea§ion/revocation of your food permit. O Embargo ❑ Emergency Closure �� a voluntary Disposal 0 Other: CITY OF SALEM v BOARD OF HEALTH ) Establishment Name:_�p��n- ,lei G _,0 �e5' ✓ Date: 7- I Page: of Item Code C Critical ttem DESCRIPTION OF VIOLATION/P O CORRECTION No. Reference R-Red Item fate r PLIFASE PRI EARLY Verified 21<1 t, Lar- n, �—fL_1D ot zi. rc(o C . 4-� c of rJ v / Discussion With Person in Charge: Corrective7Ac7nRequi7dd:To�No ..-- I have read this report, have had the opportunity to ask questions and agree to correct all ❑ voluntary Comajiance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion 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 dollar or su�nsion/revocation of o Embargo ❑ Emergency Closure your food permit. '� ❑ Voluntary Disposal 0 Other: CITY OF SALEM J_ BOARD OF HEALTH Establishment Name: un T l Gam_ )ee S k-y n Date: , "Z Page: 9 _ of Item Code C-Critical Item DESCRIPTION OF VIOLATION/1 LAN OF CORRECTION Date No. Reference R-Red Item PLEAS PLEASR PRINT CLEARLY Verified ' s Lk and s- ry .09(0 _ CqS Ln S Cw 5• b-5Dt Cp use, ok- e yen i S ra (�0 0,-Lt c7�-i I�� r^z�ca�s a r Discussion With Person in Charge: Corrective Action Required: o No c�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 comply with all mandates of the Mass/Federal Food Code. I understand that e-inspection Scheduled ❑ Emergency Suspension noncompliance may result in daily fines of twenty-five dollars r suspeo}siQn/revocation of ❑ Embargo ❑ Emergency Closure your food permit. U Voluntary Disposal 0 Other: 0 . CITY OF SALEM y� BOA D OF HE LTH Establishment Name: �1"-�?�-n � _- -2Cc,"'N Date: Page:______of Item Code c- l Item No. Reference R-Red Red Rom DESCRIPTION OF VIOLATION/P OF ate CORRECTION D WASPE PRINT L ARIY Verified C V vm _ � lo__ 00( LD o e r1 J(::A E r uI-sv c-Y-\cA DO x car i s n < v�- 14-s n 4a' a'k j C' 1 1 n rb t> ` I � . �t✓ "`� hod- 2.� Discussion With Person in Charge: .r), Z itla Corrective Action Required: I t] No s 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 W-- � Exclusion comply with all mandates of the Mass/Federal Food Code. I understand that ^"''nsp°ciion Scheduled O Emergency Suspension noncompliance may result in daily fines of twenty-f' 11 rs or suspension/revocation of ❑ Embargo D Emergency Closure your food permit. 0 Voluntary Disposal 0 Other: w CITY OF SALEM B RD OF HEALTH Establishment Name: 7:;�vrlkl`a 210"—Lf . Jrti Date: 2 * // (0 Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/PU&OF C RRECTION Date No. Reference R-Red Item PLEASE PRINT CLEARLY VerMied 1 {P b nurlS - lc` -YO,2- - n +a >t cd e.<A ?n © s 44 tI? - - 13U �vvlt '5het�:' ` ( t, ') � z s - cA t010 Vic 5e . , - a\ �Q e_n ' -soy cQ - 4330 F reach t`n n - o ro & b en ` -30Z ,2 of r(' CDi SS — inW ey-cJ -y Discussion With Person in Charge!` t7Iget Corrective Action Required: n No ❑ I have read this report, DLJ CJ ❑ Voluntary Compliance o p , have had th opportunity to ask questions and agree to correct all n` p Employee Restriction violations before the next inspection, to observe all conditions as described, and to e-in Exclusion comply with all mandates of the Mass/Federal Food Code. I understand that 0 spection Scheduled 0 Emergency Suspension noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo a Emergency Closure your food permit. "\ - _�� ❑ Voluntary Disposal 0 Other: Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,40'Floor Salem,MA 01970-3523 Tel. (978)741-1800 Fax (978) 745-0343 6 City/Town of ,a �ie4-r'1 Address: FOOD ESTABLISHMENT INSPECTION REPORT Tel Name �n i Date Ty of Operations) T pe of Inspection 1" 0 Food Service []Routine Address + �i Risk Retail e-inspection Telephone t ? i Level El Residential Kitchen revious Inspection Owner ,� � � � � 7 N ❑ Temporary [I Pre-operation �.1, 11 /<' U� HACCP �� ❑ Caterer ❑Suspect Illness Person-in-Charge(PIC) Time ❑ Bed a Breakfast ❑General Complaint In:Z.°tS. ❑HACCP Inspector f,,,K0 Out: Permit No. ❑Other Each violation checked requires an explanation on the narrative pages and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Non•compl/ance with: Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate Tobacco 590.009(F) p corrective action as determined by the Board of Health. Allergen awareness $90.0o9(G) ❑ F090 PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands SY 1. PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH [12. Reporting of Diseases by Food Employee and PIC PROTECTION FROM CHEMICALS ❑❑ 3. Personnel with Infections Restricted/Excluded 14.Approved Food or Color Additives FOOD FROM APPROVED SOURCE ❑ 1 S..Toxic Chemicals (34. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 1&Cooking Temperatures ❑ 6. Tags/Records/Accuracy of ingredient Statements ❑ 17:Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 10.Cooling PROTECTION FROM CONTAMINATION � 9_Hot and Cold Holding ❑ Separation/Segregation/Protection ❑20,Time as a Public Health Control 9.Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE•POPULATIONS(HSP) ❑10.Proper Adequate Handwashng ❑21. Food and Food Preparation for HSP ❑11.Good Hygienic Practices CONSUMER ADVISORY [122.Posting of Consumer Advisories Vialatigns Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical(C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red items 1-22): of Health. Non-critical(N)violations must be corrected Official Order for Correction:Based on an inspection immediately or within 90 days as determined by the Board of Health. today,the items checked indicate violations of 105 CMR C n 590.000ffederal Food Code.This report,when signed below 23. Management and Personnel (FC-2X590.003) 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)(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►ight to a hearing. Your request must be in writing 28. Poisonous or Toxic Materials (FCJX590,00e) and submitted to the Board of Health at the above address 29. Special Requirements (590,009) within 10 days of receipt of this order. s 30 Other DATE OF RE-INSPECTION: { V I lnipector's Signature Prink I PICs Signature: Print; age of Pages w � � CITY OF SALEM .� 11 "� BOARD OF HEALTH Establishment Name: ; &k() 1e•t 0 9161C-f— ��S ,y�� Date:. li Page: 2 of # Item code c-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red Item Vedfled P PRINT CLEARLY I PIctc� 1^ r r G D7? /' C; - ! v aJI Y IL to 1 P h .''1 f�l�,t :s _0 is 0 P e ct5 47 C(D( eC L z� to Discussion With Person in Charge: Corrective Action Required: ❑ No T 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 comply with all mandates of the Mass/Federal Food Code. t understand that O Re-inspection Scheduled ❑ Emergency Suspension noncompliance may result in daily fines of twenty-five;dollars r suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. U Voluntary Disposal 0 Other M � ! CITY OF SALEM BOARD OF HEALTH Establishment Name: t n Z C�.L-:Q K r Date:-S �_ Page:-Z �of Item Cate C-Critical Item DESCRIPTION OF VIOLATION/PLAN O CORRECTION Date No. Refereeoe R-Red Item PLEASE PRINTCLEARLY Verified TT 'c Ch v - oK I rl e4) i ts 445 t hold a a f °F- Cr - Ur)( dj L4-) t?I t e� �ncf ;\n Q I^ v t C-6) " 2 of � 03, Discussion With Person in Charge: Corrective Action Requilretr I o No o 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 comply with all mandates of the Mass/Federal Food Code. I understand that ❑ Re-inspection Scheduled O Emergency Suspension noncompliance may result in daily fines of twenty-five doila spension/rev ation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal 0 Other: CITY OF SALEM BOARD OF HEALTH Establishment Name: (�-�P�i r7 Pn f.p iCe- ZY .1" % Date: P2 1 Page: of Item cove C-Critical ttem DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R—Red item Verified P INT CLEARLY kX)Wr V rrrt fi , u P a. 1, S g u Ir 01 rQ d' -5 - . i '_. e in fc, (n . to 1 11- -Z cl c c�t,J ' Cj cite (� �^es. Discussion With Person In Charge: Corrective Action Required: ❑ No es I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Exclusion fieslrlction violations before the next inspection, to observe all conditions as described, and to Exclusion 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 suspeption/rev cation of ❑ Embargo ❑ Emergency Closure your food permit. ❑ Voluntary Disposal 0 Other: i Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,4111 Floor Salem,MA 01970-3523 Tel. (978)741-1800 Fax(978)745-0343 City/Town of S, i-e>ri Address: FOOD ESTABLISHMENT INSPECTION REPORT Tel. 9 7 ham-- $3 CQ -- i 1 ;3 23� CCe-c!� Name - Dat Type of Operation(s) Type of Inspection ood Service B;R;!utirve Addressj Risk ❑ Retail inspection Telephone q Level ❑ Residential Kitchen Previous Inspection 7 7 4-1 ~ -7 ❑ Mobile Date: CP Y Owner ❑ Temporary ❑Pre-operation Uri r'Y\ 1 HAC ❑ Caterer ❑Suspect Illness Person-in-Charge(PIC) Tim< ❑ Bed 8 Breakfast ❑General Complaint In: "/t�ft'1 ❑HACCP Inspector S'4-e. hexn 1,p ITVII-okn Out: •',�r04 ermit No. ❑Other Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Non-compliance with: Items) Anti-Choking $90.009(E) ❑ Violations marked may [3y pose an imminent health hazard and require immediate Tobacco $90,009(F) corrective action as determined by the Board of Health. Allergen Awareness 590.009(G) [3 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS [32. Reporting of Diseases by Food Employee and PIC ❑ t 4.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded El 15.Toxic:Chemicals FOOD FROM APPROVED SOURCE ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures El 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17.Reheating ❑ 7. Conformance with Approved Proeedures/HACCP Plans ❑ 18,Cooling PROTECTION FROM CONTAMINATION ❑ 19. Hot and Cold Holding ❑ 8.Separation/Segregation/Protection ❑20.Time as a Public Health Control ❑ 9.Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP) 10,Proper Adequate Handwashing [321.Food and Food Preparation for HSP ❑ ❑11,Good Hygienic Practices CONSUMER ADVISORY ❑22.Posting of Consumer Advisories X:�SCA4 S S i Cyfl- �5e>1.. Nth Violations Related to Good Retail Practices-(Blue Number of Violated Provisions Related Items) Critical(C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Red 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 HeaNth. 590.000ffederal Food Code.This report,when signed below 23. Management and Personnel (FC-2x690.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC,3)(590,004) order of the Board of Health. Failure to correct violations 25. Equipment and Utensils cited in this report may result in suspension or revocation of (FC;4)(590.005) the food establishment permit and cessation of food 26,Water, Plumbing and Waste (FG5)(590:008) establishment operations. If aggrieved by this order, you 27. Physical Facility (FG$)(590.007) have a right to a hearing. Your request must be in writing 28, Poisonous or Toxic Materials (FC-7)SW.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. f /� s 30. Other DATE OF RE-INSPECTION: UdG� I e "e- cr.O,Y A 777 Inspector's Signatu Print Lci r/"a /n P1Cs Signature: Print: d Pag�ofPagts CITY OF SALEM r- BOARD OF HEALTH Establishment Name: I�uvn tat,n p14L� steS4q,n-i- Date: Page: 2- of No. Reference R Item Coke -Red Red It- Item l Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION pets PL E RINT CL ARLY Verified To m YY)0 U (e - of 7 - z3%S 2'0 12 ' 8rn��- 1 e777 Z. -CPU/S Q lef'rn D L�1/f ( v m hem '7l1lZ 4-7-4 cam. " 0/1 V Le t G cz- t �D� <Z- o-?7 r� '1�.5cLtS51 N-.e-el / U rea 40 PKZ Inch t. r c- 'sta rnes t (' 25 t- $�cc�5 n P ec1 C scZl� eL v f Discussion With Person in Charge: Corrective Action Required: ❑ No $ I have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance O Employee Restriction! * violations before the next inspection, to observe all conditions as described, and to Exclusion comply with all mandates of the Mass/Federal Fo . l understand that X Re-inspection Scheduled D Emergency Suspension noncompliance may result in daily fines o ent - dollar or suspension/revocation of ❑ Embargo o Emergency Closure your food permit. u Voluntary Disposal 13 Other: CITY OF SALEM BOARD OF HEALTH Establishment Name: -1:0_0n4y t' Pla.c e R e5}&j -C Date: 5"L,2_4a h (o Page: Of Item Cods - el Item No. Reference -Red Red(tern DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date P EASE PRINT EARLY Verified C'one-ay-n3 OboC.-t cad /'r) !(vV It . -' tcem bl'n lhvoic{e r r+ [,9Cybr,,p cL h (T)6-C I`✓1 S 2 i%1✓t�,'c le c� /7,scuss� S of,<,e aboit� - duo tJs tht s rn en �uf ea. K4. i a eloors CI -5 ' - N 040 �4Q5 vr'� _ I Ic�SG? cq- S 2t.o •{ter i 7_�>I scvs'SIa7 - S 01_.j e u a Cl e,�n M� v cl YY7 f / o r- ,e!o r,J e Fore 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 O Voluntary Compliance ❑ Employee Restriction violations before the next inspection, to observe all conditions as described, and to Re-inspection Scheduled ❑ Emergency Suspension Exclusion ` comply with all mandates of the Mass/FederaLFood-Code I understand that noncompliance may result in daily fines f-tw doll~` or suspension/revocation of ❑ Embargo ❑ Emergency Closure . your food permit. 0 Voluntary Disposal 0 Other: CITY OF SALEM BOARD OF HEALTH Establishment Name: z` u tl lG �� ( G G�' (�e5 � (.�� Date: S 2Is� ' to Page: of Item Code C-Critical Item DESCRIPTION OF VIOLATION/P OF tORRECTIOW Date No. Reference R-Red Item Verified /± -PLEASE PRINT CLEARLY LEARN �® / n i f a � mil' od s c& be, G bU L�e'a CC el- j. C� Inp- ` N G. c ,o Olt ea-C.' P O� Q Cf rr 6`1 00 5--e-M le 3(g - t t z33 W he cc l o, r,S a r e YY)a J- C a n rto� v v 't �� v►� !.s �,e Vie( �✓� �, v , 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 ` comply with all mandates of the Mass/Federaj.Goo-d"Oode 1--u derstand that Re-inspection Scheduled ❑ Emergency Suspension noncompliance may result in daily fines t'w - ive lays or uspension/revocation of o Embargo U Emergency Closure your food permit. _ ❑ Voluntary Disposal ❑ Other: Massachusetts Department of Public Health Salem Board of Health Division of Food and Drugs 120 Washington Street,4th Floor Salem,MA 01970-3523 Tel. (978)741-1800 Fax (978)745-0343 City/Town of c7, a 1-e-(Y1 Address: — _ FOOD ESTABLISHMENT INSPECTION REPORT Tel. 9 7$— b 3(fl I t Z33 Name�LA n�.i PI Dat T of Operation s T Ci C v r-q h 5 � 10 - p () pe of Inspection NJ Food Service U Routine Address/�32 Z 35(L 4reet- Risk ❑ Retail 04e-inspection Telephone //�� _ Level ❑ Residential Kitchen Previous Inspection "I 7 - 4-4 Z- -- Cl `J -1 ❑ Mobile Date: Owner 9((VA � I�C HACCP Y Q Temporary ❑Pre-operation ❑Suspect Illness Person-in-Charge(PIC) Time ❑ Bed&Breakfast ❑General Complaint Inspector Intl f 38 ❑HACCP S hC`n' Qi f o Out:2% Permit No, 0 Other Each violation checked requires an explanation on the narrative pages)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Non-compfiance with: Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate Tobacco 590.009(F) ❑ corrective action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12,Prevention of Contamination from Hands �W'• PIC Assigned/Knowledgeable/Dutiies EMPLOYEE HEALTH ❑ 13. Handwash Facilities ❑ 2. Reporting of Diseases by Employee Food Ern 1 and PIC PROTECTION FROM CHEMICALS ❑ 3. Personnel with Infections RestrictRestricted/Excluded ❑ 14:.Approved Food or Color Additives FOOD FROM APPROVED SOURCE ❑ 15•Toxic Chemicals ❑ 4. Food and Water from Approved Source TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 5. Receiving/Condition ❑ 16.Cooking Temperatures ❑ 8. Tags/Reoords/Accuracy of Ingredient Statements ❑ 17, Reheating ❑ 7, Conformance with Approved Procedures/HACCP Plans ❑ 18,Cooling PROTECTION FROM CONTAMINATION W9.Hot and Cold Holding W8.Separation/Segregation/Protection ❑20.Time as a Public Health Control 12'9.Food Contact Surfaces Cleaning and Sanitizing REQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS(HSP) ❑10.Proper Adequate Handwashing ❑21.Food and Food Preparation for HSP ❑11.Good Hygienic Practices CONSUMER ADVISORY [122, Posting of Consumer Advisories Violations Related to Good Retail Practices (Blue Number of Violated Provisions Related Items) Critical(C)violations marked must be corrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors (Red Items 1-22): of Health. Non-critical(N)violations must be corrected Official Order for Correction:Based on an inspection immediately or within 90 days as determined by the Board of Health. today,the items checked indicate violations of 105 CMR c N 590.000/federal Food Code.This report,when signed below 23.Management and Personnel (FC-2X590.003) by a Board of Health member or its agent constitutes an 24. Food and Food Protection (FC-3)(590,0004) 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-7X590.008) and submitted to the Board of Health at the above address 29. Special Requirements (690.000) within 10 days of receipt of this order. S 30 Other DATE OF RE-INSPECTION: Inspector's Signature: r Print: Nowh oLn i e (j PICs Signature: Print: Page L ofages CITY OF SALEM 'G � n BOARD OF HEALTH Establishment C I^P Date: Z tQ { �_ Page: ,2 c� Item Code C-Crftical Item ---_of No. Reference Ft-Red Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date P 8 PRINT Cl ARLV VerMed 42 m C�t'YIQ,_ ct cxx TV 3 -'COI (D � � mCc.l 1 n m C.` r l' _ toyr .ei^ o f �, S O i I►'� P SmG-1 ( OC)e Ct�cDC- Y7106 n marl'0 �°F ' `Cl\ O 5 - v I� � 30 c��lo I f OI Sot,I 0 s -`PIC 4v rrn e d h e YN eyt� 2 e ea Discussion With Person in Charge: ��( � n Cold V1 cat CJ l'r�� m us� Corrective Action Required: o No �tYl C I'YI+Cis n �cYYes G Cn1 p?r,I r r co or\ Li I* i= yr 6e I Ot,� I have read this report, have had the opportunity to ask questions and agree to correct all 0 Voluntary Compliance 0 Employee Restriction violations before the next inspection, to observe all conditions as described, and to Exclusion comply with all mandates of the Mass/Federal Food Code. I understand that t3'Re-inspection Scheduled O Emergency Suspension noncompliance may result in daily fines of twenty-five d s o suspension/rgyocation of t7 Emb your food permit. argo o Emergency Closure fJ Voluntary Disposal a Other: � w CITY OF SALEM '-�'hs (�P`" - BOARD OF HEALTH Establishment Name:.�tt n-�C,-i () (31 CA C e �C�� u�G�i��}— Date: page: of Item code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date No. Reference R-Red Item PLEASE PRI IEARIY Verified o chlorcn42 Wav- eLoc,sh mac toe 1Qc3A--)iD m — t S r 15 n Ck-12 I` Czc(v ' 4 q o ! �`�- -fio l�cl pjose-rvec'l Pi t Fccn t n i lc erg d l i s l5 rl0�- &tl ado Wya N Zc.f t, AJ0 - S ov-e w t' l G , -t-- US ;4- %s `5- �1221t t.ct c ` Discussion With Person in Charge: Corrective Action Required: a No es I have read this report, have had the opportunity to ask questions and agree to correct all o Voluntary Compliance O Employee Restriction violations before the next inspection, to observe all conditions as described, and to Re-inspection Scheduled o Emergency Suspension Exclusion comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars r suspension/revocation of O Embargo D Emergency Closure your food permit. �> U Voluntary Disposal 0 Other: CITY OF SALEM TH DAY t � t YEAR T1A/E CONTROL N0. LOCATION 2 Esse, S+--'0'e - NAME OF OFFENDER ADDRE 2 9 2 SS lx STATE n vvv , /7 ►hereby acknow►ed �' - b 1 9 7D X ge receipt o►the foregoing citation Date: ( )Unable to obtain signature of offender I)Date Maifed_______i_ SCO Postin2Advertisements,Noffm on City Property [)uloga!Signs SCO 4-39 and 4.47 ))Violation Of State Building Code []Removal Of Unslgfafiy Conditions SCO 12-1 SCO 12-56 I)Violation of BOCA Nat.Fire Prev.Code []Keeping of Trailers,Comm.and Rec.Vehicles,eSCO 20-111 SCO 24-21.1 I)Removal of SnewAce from Sidewalks SCO 38-13 and 38.14 00 I]Zoning Ordinance SZO§ �Othertion: GL!Qyn /(� k 14. Signat of Enforoin Perso �� Department P h Amount of Fine: 17 Warning 1�$25.00 I I$100.00 [ ]$200.00 I ]$50.00 �� IIOther__.____ You have the following alternatives in this matter within 21 days of the date of this notice-- I I choose to Pay the fine within 27 days Of the date of this notice. Enclose li check or money order payable to the City of Salem and return tt in this envelope M by delivering in hand to the City Clerks Office City Hall,93 Washington Street,Salem, MA 01970.If delivering In hand,please note the hours of City Hall operation;Monday through Wednesday from 8:00 a.m.to 4,00 p.m„Thursday from 8;00 a.m.t0 7:00 p.m,and Friday from 8:00 a.m.to 12.M p.m, I]choose to contest this matter within 21 days of the date a noncriminal hearing. of this notice and request in writing Enclose a copy of this citation and mail 4 to the Clerk Magistrate,Salem District C 6 Washington Street,Salem,MA 01970.The Court will schedule a court 5 Rearing. FAILURE TO OBEY THIS NOTICE WITHIN 21 DAYS OF THE DATE OF THIS NOTICE WILL RESULT IN THE CITY OF SALEM APPLYING FOR THE ISSUANCE OF A CRIMINAL COMPLAINT AGAINST YOU AND THE DENIAL OR REVOCATION OF ANY CITY OF SALEM PERMITS OR LICENSES INCLUDING BUILDING PERMITS.YOU APPLY FOR OR THAT YOU HAVE BEEN GRANTED, City of Salem,City Clerk's Office,93 Washington Street,Salem,MA 01970 (978)745.9595,ext.5610. SEE OTHER SIDE FOR FURTHER INSTRUCTIONS + ENCLOSE PAYMENT IN THIS ENVELOPE,PEEL AND SEAL It is the Mission of the Salem Police KNOW THE SIGNS OF AN OVERDOSE DRUG ADDICTION Department, in partnership with the Salem Board of Health, to work diligently to strive to Are they breathing? make a positive impact to substance abuse Is their breathing shallow? PROBLEMS problems. Through education, outreach,follow- Are they sleepy? up,police discretion, and care&assistance, we Not responding to you? aim to find appropriate treatment and Blue or gray around mouth? resources for those with substance abuse Snoring or gurgling sounds? additions and for the families of the addicted persons. Provide rescue breathing Tip head back Partnership and Education: Breath short breathes Salem-Peabody Opioid Prevention Task Force 1 every 5 seconds Salem Board of Health,City of Peabody, Healthy Streets, Project Cope, Learn to Cope Stay with the person .� t Good Samaritan Law Protects you Outreach& Follow-up: from arrest or prosecution for MH Clinician and Criminal Investigation Division simple possession. " makes contact with everyone involved in a medical assist where drugs or an overdose may If you have to leave have occurred to encourage treatment options. Place person on their side We identify&investigate trends of mixing opiates resulting in overdose/death and * . individuals dealing these drugs. Discretionary Initiative Work with Essex County DA Jonathan Blodgett's ` Drug Diversion Program,to seek out treatment n, options pre or post arraignment for any simple If you suspect an Overdose possession of drugs&ECSD Sheriff Frank RECOGNIZE THE SIGNS OF ADDICTION Cousins treatment program in Middleton. CALL - 9-1-1 Pills or medication bottles are missing Care&Assistance All Salem Police Officers carry Naloxone in Excessive use of medication Don't delay, call immediately! order to render immediate life-saving Abrupt changes in finances Mood changes assistance&assure the individual has an g An opioid overdose can result opportunity to take advantage of treatment Missing work or school in death in a matter of minutes. options.Anyone walking into the Salem Police Changes in social life Salem Police,Salem Fire,&Atlantic Ambulance Department seeking assistance,addict or famil, Changes in sleep or appetite carry the life-saving medication= NALOXONE! member will be provided the connections to Loss of concern about appearance ph sical symptoms manifested in— In Partnership the proper resources for assistance, including y Salem Police Department ensuring an in-take is completed aiming to weight loss,fatigue, confusion, speech and locate tre- ent and transportation if needed. changes,dizziness, change in pupil size Salem Board of Health LOCAL RESOURCES FOR TREATMENT ANUL DETOX PROGRAMS Healthy Streets- Office 339-440-5633 Detox programs require some form of picture ID Outreach 339-987-1920 Danvers Detox, Danvers 978-777-2121 100 Willow Street,2"d Floor, Lynn, MA r Tewksbury Detox,Tewksbury 978-259-7000 www.facebook.com/Healthy-Street-Outreach-Program- t Boston Detox, Boston 800-763-5363 Lynn-MA Andrew House/Bridge 2 Recovery 617-479-9600 Tr management,Naloxone and training. titeatment referrals,transportation,medical case Adcare Hospital,Worcester 800-252-6465 1, CHL,Worcester 508-860-1200 North Shore Community Health , L• Brockton High Point, Brockton 800-734-3444 Salem Family Health,47 Congress St.978-744-8388 Dimock Detox, Roxbury 617-442-9661 Peabody Family Hlth 89 Foster St. 978-532-4903 Grosnold, Falmouth 800-444-1554 Gloucester F.H.,302 Washington St. 978-282-8899 Norcap Lodge, Foxboro 800-331-2900#2 Office-Based Opioid Treatment(Suboxone/Vivitrol)for Plymouth High Point, Plymouth 800-233-4478 established primary care patients. Spectrum,Westboro 508-898-1570 ever)I Clinic- 978-921-1190 TAR, Fall River 508-679-5222 ahey Health Behavioral Services 800 Cummings Center,Suite 266T, Beverly Protect Cope DUAL DIAGNOSIS& PSYCHIATRIC FACILITIES www.NebHealth.org 66 Silsbee Street,Lynn, MA 781-581-9720 Dual diagnosis,substance use and mental health Outpatient clinic providing mental health therapy, www.bridgewell.org/proiectcope/ treatment,require an evaluation. The Crisis Team can counseling,Pharmacological care,including Vivitrol. assist with this process. Substance Abuse services,transitional housing,support for Greater Lawrence Family Hlth 978-685-7663 families. Salem Hospital—Psych Unit 978-354-4550 100 Water Street,Lawrence, MA Bayridge Hospital, Lynn 781-599-9200 www.glfhc.org Lahey Health Behavioral Services Balpate Hospital, Georgetown 978-352-2131 Office-based Opioid therapy&treatment Bournewood Hosp, Brookline 800-468-4358 Psychiatric Associates of Lynn 781-268-2211 SECAP,St. Elizabeth's, Brighton 617-789-2574 173 Oxford Street, Lynn Crisis Team 24-hr service Arbour Svstems.Jamaica Plain 800-222-2237 A Vivitrol Recovery&Treatment Center 978-744-1585 Massachusetts Substance Abuse Information LOCAL SUPPORT for FAMILIES and FRIENDS and Education Hotline Learn to Cope 508-738-5148 You should know that Opioids include: www•helpline-online.com 800-327-5050 www.learn2cope heroin,OxyContin,methadone,morphine,Percocet, TTY Line: 800-439-2370 Thursdays,7:00pm,North Shore Medical Center fentanyl,hydrocodone,Vicodin,etc. Free&confidential information and referrals to public and Davenport Conference Rm.102A private treatment programs. Translation available in 140 Peer led support group for families—provides education, languages. support,resources and hope.Naloxone training. Massachusetts Overdose Prevention Resources Healthy Streets 339-440-5633 Office „ www.mass.gov/dph/overdose 800-383-2437 100 Willow Street,2"d Fir.,Lynn,MA THE FZRST STEP www.facebook.com/Healthy-Street-Outreach-Program- "TOWARDS OETTINC: 800-327-5050 Lynn-MA Referrals,support,Naloxone and Training. SOMEWHERE IS'TO Provides recorded information on how to prevent,recognize,& DECIDE THAT YOU ARE spond to an opioid overdose.Naloxone is available free. GRASP—Grief Recovery After Substance Passing NOT GOINC: TO STAY , grasphelp.org Support for people after losing a loved one. NVHERE YOU AIiE_" Please call for Help and Information Salem Hospital—I"Thursday of every month LTv tc:vowar � .M E Highland Hall Auditorium 7:00pm-8:30pm Call in advance 781-593-5224 or 978-354-2660 It is the Mission of the Salem Police KNOW THE SIGNS OF AN OVERDOSE DRUG ADDICTION Department, in partnership with the Salem Board of Health, to work diligently to strive to Are they breathing? make a positive impact to substance abuse Is their breathing shallow? PROBLEMS problems. Through education, outreach,follow- Are they sleepy? up,police discretion, and care& assistance, we Not responding to you? aim to find appropriate treatment and Blue or gray around mouth? resources for those with substance abuse Snoring or gurgling sounds? additions and for the families of the addicted persons. Provide rescue breathing Tip head back Partnership and Education: Breath short breathes Salem-Peabody Opioid Prevention Task Force 1 every 5 seconds Salem Board of Health, City of Peabody, Healthy Streets, Project Cope, Learn to Cope Stay with the person . Good Samaritan Law Protects you Outreach& Follow-up: from arrest or prosecution for EEL MH Clinician and Criminal Investigation Division simple possession. ....�.e. makes contact with everyone involved in a medical assist where drugs or an overdose may If you have to leave have occurred to encourage treatment options. Place person on their side We identify& investigate trends of mixing opiates resulting in overdose/death and individuals dealing these drugs. Discretionary Initiative Work with Essex County DA Jonathan Blodgett's Drug Diversion Program,to seek out treatment ,. options pre or post arraignment for any simple ~- If you suspect an Overdose possession of drugs& ECSD Sheriff Frank RECOGNIZE THE SIGNS OF ADDICTION Cousins treatment program in Middleton. CULL - 9-1-1 Care&Assistance Pills or medication bottles are missing All Salem Police Officers carry Naloxone in Excessive use of medication Don't delay, call immediately! order to render immediate life-saving Abrupt changes in finances assistance&assure the individual has an Mood changes An opioid overdose can result opportunity to take advantage of treatment Missing work or school in death in a matter of minutes. options.Anyone walking into the Salem Police Changes in social life Salem Police,Salem Fire,&Atlantic Ambulance Department seeking assistance,addict or famil Changes in sleep or appetite carry the life-saving medication=NALOXONE! member will be provided the connections to Loss of concern about appearancephysical symptoms manifested in— In Partnership the proper resources for assistance, including Salem Police Department ensuring an in-take is completed aiming to weight loss,fatigue,confusion, speech and locate treatment and transportation if needed. changes, dizziness, change in pupil size Salem Board of Health k cc. -ai ,� FACT SHEET: The Truth about.Opioids Opioids are a class of drugs that are derived from,or simulate the effects,of,compounds found in the opium poppy. They include legitimate prescription painkillers like morphine,codeine(often used in cough syrups), hydrocodone(Vicodin), hydromorphone(Dilaudid), oxycodone(Percocet and OxyContin), meperidine (Dem- erol),methadone,fentanyl, and others.Heroin is also part of the opioid family.All opioids work in different yet fundamentally similar ways,affecting the same parts of the brain and nervous system to produce intense feelings of pleasure,diminished pain,and slowed breathing and heart rate,which can lead to overdose and death.They are also highly addictive. In their various forms,heroin and prescription painkillers have many names,including junk,H,smack, dope,Oxy,OC,hillbilly heroin,purple drank,sizzurp,hydros,or tabs. ■ Opioids affect your brain.In the short Opioids affect your self-control. term,opioids can affect your judgment and Addiction is a powerful force. People who perception of time.Opioids bind to receptors have never stolen,hurt anyone,or sold in your brain that can slow your breathing their body will often find themselves doing and heart rate,leading to an overdose,coma, things they could have never previously and even death with just one use.Long-term imagined in order to obtain drugs or the effects can include tolerance(meaning more money to buy them.While high,people and more of the drug is needed to achieve the may lose control or judgment,leading to same high)flu-like withdrawal symptoms, unprotected sex,driving while impaired, and feeling depressed,slow,or joyless without and other dangerous behaviors. the drug in your system. Opioids can kill you.An overdose can ■ Opioids affect your body.Short-term use result in heart failure, slowed breathing, can lead to reduced blood pressure,slowed and possibly death.Long-term physical breathing and heart rate,constipation,nausea, effects such as heart and lung damage, and vomiting.Long-term use can lead to HIV/AIDS,or other health problems may painful,uncomfortable withdrawal symptoms also kill you.Between 2006 and 2010, (aches,pains,chills,diarrhea,vomiting,and heroin overdose deaths increased by 45 headaches).Additional medical problems percent.The number of emergency room include contracting diseases like HIV/AIDS visits nationwide related to opioids other or hepatitis B and C from sharing needles or than heroin increased by nearly 300 engaging in unsafe sex while high;heart.and percent between 2001 and 2012,while lung problems;abscesses or blood infections; overdose deaths increased from just over collapsed veins;poor self-care,including 4,000 to over 16,500. malnutrition,hygiene,and medical care; and risk of birth defects or stillbirth among pregnant women who abuse these drugs. i �iwp %? 77 f� c f Y � 'S� CarT)p1�g't� Ou �A7 -,? "P «s '`4^ Y-� 'a$" fir; How can you tell if someone is using heroin or misusing prescription painkillers? It may not be easy to tell,but there are some signs you can look for.Signs of use may include the following: ■ a drop in grades or work performance ■ pin-sized pupils or ■ mood changes dark circles under the eyes ■ lack of interest in hobbies or activities ■ finding drug paraphernalia ■ skipping school or frequent tardiness, (lighters,syringes,cotton balls, missing work burnt spoons,bottle caps) ■ changing friendships ■ missing money or valuables ■ sleeping longer than usual, ■ track marks on arms or legs napping more often ■ worsening appearance or hygiene ■ rapid weight loss '�,. t Ac: l�1f f�rornu � r Aefi�ar� i FACT SHEET: Opioid Myths Opioids include prescription painkillers—highly addictive narcotics that can be found in many household medicine cabinets—and heroin that is bought on the street; both can easily destroy lives. Our nation's opioid crisis is making headlines—but some myths persist. Let's separate fact from fiction. MYTH:People are addicted to opioids after only one MYTH: Snorting or smoking heroin or prescription use. painkillers is safer than injecting them. P J g FACT When prescription painkillers are used as pre- FACT There's no "safe" way to abuse a drug. And scribed,under the care of a doctor,they pose a low risk while sharing needles carries specific risks, like of addiction,and these drugs have a legitimate role to exposure to HIV/AIDS or hepatitis C, any method play in medicine.Some people are able to occasionally of opioid abuse can lead to overdose and death: abuse painkillers without developing an addiction. Many people with opioid addictions progress from The same goes for heroin use. Like any other drug, snorting or smoking to injecting as they develop a including alcohol and tobacco,some people can abuse tolerance and seek a more intense high. opioids once and stop, or abuse them occasionally without developing a full-blown addiction. However, opioids can be extremely addictive in a short amount MYTH: Heroin and prescription painkillers are of time because they create such rushes of pleasure Just the latest"fad"drug.Their appeal will eventu- and steep drops into withdrawal,that most who abuse ally fade. them find themselves quickly needing more and more FACT Opium,heroin, and other.opioids have been of the drug just to maintain a feeling of normalcy. used for thousands of years for both legitimate and illegitimate uses. Prescription opioids are some of the most effective painkillers modern medicine can MYTH: Abusing prescription painkillers to get offer,so they're not going away anytime soon. And high is safer and less addictive than using heroin while it's true that many drugs come and go as the. because they're made by a pharmaceutical com- "drug of the moment,"what communities are expe- . pany and doctors prescribe them all the time. riencing today with opioid abuse is unprecedented FACT: Using a prescription painkiller without a and people are dying.at epidemic levels. prescription, for reasons other than prescribed, in higher amounts than intended, or using methods that are not prescribed(such as crushing,snorting, or injecting),is just as dangerous and can be just as addictive as shooting heroin into your veins. On a biological level,the brain and body treat heroin and prescription opioid painkillers identically. I� i �'_' y"` ..^` m„'.2xt^ r.�ry�rT .r t YYaa € '*rs` Z ''"k " n arnpa gr� R� oUr � _ - n .. g_ MYTH:Heroin is primarily an inner-city problem. MYTH:Laws making Narcan(naloxone)available, FACT Heroin use is on the rise nationwide, and that give immunity to those who call 911 to including in suburban and rural areas, and the report an overdose, encourage people with addic- prescription painkiller use and misuse that led to tions to use and actually take away their incentive the current crisis was nationwide as well. A great to quit. example is the state of Vermont(certainly not con- FACT: A person addicted to opioids (or any drug, sidered an urban part of the country)where heroin including alcohol)will seek out that drug regardless use has increased 770 percent since 2000. of the consequences.This is the nature of addiction. And a person who dies of an overdose will never have the chance to seek help and enjoy a full life MYTH: If I don't use all of my prescribed painkill- in recovery from their addiction. In overdose situ- ers following an operation or accident, I can save ations, time is critical to survival rates and every them for a"rainy day"when I have minor joint pain step we take to reduce deaths is a wise one. or a toothache. FACT: Many young people are first introduced to opioids by raiding their parents' or grandparents' MYTH: Heroin and prescription painkiller abuse medicine cabinet,or by a friend who did the same.If only hurts those who use the drug. you are prescribed an opioid,talk with your doctor FACT:Opioid abuse hurts everyone.Financially,the about the risks,ask to be prescribed only what you legal,health care, and lost productivity costs total need,and properly discard any unused drugs when in the billions. But the intangible costs are incal- you no longer need them. Talk to your pharmacist culable. Every day parents across the country lose or contact your local city or county government children to overdose deaths, spouses watch their about drug disposal programs in your area. partners throw away their family's future, and friendships are broken due to mistrust. The solu- tion is a complete community and family approach MYTH:A person addicted to heroin or prescription to prevention and treatment. painkillers is a lost cause. FACT: Treatment works. When people seek appro- priate treatment and receive support from their MYTH: Hardworking everyday people don't use family and friends, recovery is possible. Every day heroin or abuse prescription painkillers. I hundreds of thousands of people who were once FACT Any type of person can become addicted to considered a lost cause celebrate one more year of opioids. Research shows wide diversity in users, recovery and live productive,successful,and fulfill- including honor roll students, retired people, ing lives. accountants, mothers, and blue-collar workers. Many people get hooked following a routine surgery or accident,or they experiment at a party and then keep using.These are people you wouldn't ordinar- ily expect to be involved with drugs. And in the case of young people,they don't always understand the dangerous consequences of drug use. __ iPm^-` �t�"a�,,.,�:.gF+�? x"s � .�,,r w, ^:. `�% fi+-,..g t .,w M,::fit ,��.a: ,„ ,• '. F :" wa �°+ "`�'"ask�'�'.�ra„ _ # Date Fatal Narcan Gender Age Race Method Mixing Relapse/U Other 1 1/1/2016 N N MALE 32 WHITE IV YES/ALC 1 MON 2 1/2/2016 N Y FEMALE 29 WHITE Y/ALC 3 1/9/2016 N Y MALE 32 WHITE IV YES/ALC DAILY 4 1/15/2016 N Y MALE 21 WHITE IV Y/KLON 5 1/15/2016 N Y MALE 21 WHITE IV SAME DAY 6 1/22/2016 N Y FEMALE 25 WHITE IV 7 DAYS 7 1/24/2016 N Y FEMALE 33 WHITE IV NO 8 2/8/2016 N Y FEMALE 30 WHITE SNORT FENTANYL? 9 2/12/2016 N Y FEMALE 33 WHITE IV 10 2/20/2016 N Y MALE 33 WHITE 11 2/22/2016 Y Y-6X MALE 30 BLACK SNORT REHAB 12 2/22/2016 N Y-FRIEND FEMALE 25 WHITE 13 2/23/2016 N Y MALE 28 WHITE SNORT 4 YRS 14 2/26/2016 N Y MALE 48 WHITE SNORT Y/COCAINE 15 3/1/2016 N Y MALE 33 WHITE IV 16 3/2/2016 N Y-FRIEND MALE 30 WHITE IV EVERYDAY 17 3/2/2016 N Y FEMALE 30 WHITE IV 18 3/3/2016 Y N FEMALE 47 WHITE IV 19 3/4/2016 N Y MALE 30 WHITE 20 3/5/2016 N Y MALE 33 WHITE 21 3/5/2016 N Y MALE 33 WHITE SAME DAY 22 3/9/2016 N Y MALE 35 WHITE IV NO 23 3/11/2016 N Y FEMALE 24 WHITE 24 3/12/2016 N Y MALE 39 WHITE IV METHADONE 25 3/14/2016 N Y MALE 25 HISPANIC IV 3 WEEKS 26 3/15/2016 Y N MALE 54 WHITE IV MAYBE 27 3/19/2016 N N FEMALE 25 WHITE 28 3/19/2016 N Y FEMALE 23 WHITE SISTER 29 3/19/2016 N Y FEMALE 23 WHITE SISTER 30 3/24/2016 N Y MALE 26 WHITE 31 3/25/2016 N Y MALE 20 WHITE IV NO 6 MONTH 32 3/26/2016 N Y FEMALE 29 WHITE SNORT 33 3/27/2016 N IY MALE 24 WHITE SNORT 34 3/28/2016 N Y MALE 34 WHITE IV SAME PERSON 35 3/29/2016 N Y MALE 34 WHITE IV SAME PERSON 36 2/27/2016 N Y MALE 34 WHITE IV SAME PERSON 37 4/2/2016 N Y MALE 34 WHITE IV 38 4/2/2016 N Y MALE 54 WHITE IV 39 4/3/2016 N Y MALE 32 WHITE IV BENZOS 40 4/4/2016 N Y MALE 37 WHITE IV 1 YEAR 41 4/10/2016 Y N MALE 25 WHITE IV 3 YEAR USE 42 4/10/2016 Y Y MALE 35 WHITE IV 43 4/15/2016 N Y MALE 34 WHITE SNORT 1-2 X PER WEEK 44 4/16/2016 N Y FEMALE 32 WHITE IV 9 YRS-3 MONTHS AGO 45 4/21/2016 N Y MALE 22 WHITE 46 4/22/2016 N Y FEMALE J37 WHITE SNORT BIRTHDAY MIX W/ALC 47 4/28/2016 N Y FEMALE WHITE SNORT PERC 30 48 4/29/2016 N Y MALE HISPANIC 49 4/30/2016 Y N MALE 57 WHITE SNORT 50 5/1/2016 Y Y MALE 44 WHITE IV 51 5/3/2016 N Y MALE 28 WHITE UNCOOPERATIVE 52 5/4/2016 N Y FEMALE 24 WHITE SNORT MIX W/PRESCRIPTION MEDS 53 5/4/2016 N Y FEMALE 36 WHITE 54 5/5/2016 N Y MALE 32 HISPANIC IV VIVITROL 55 5/6/2016 N Y MALE 28 WHITE IV 56 5/6/2016 N Y MALE 33 WHITE IV MUTLIPLE TIMES IN LAST THREE MONTHS 57 5/10/2016 N Y MALE 48 HISPANIC 58 5/13/2016 N Y MALE 33 WHITE 59 5/19/2016 N Y MALE 26 WHITE IV 60 5/19/2016 Y N FEMALE 46 BLACK IV 61 5/20/2016 N jN __ MALE 27 WHITE SNORT 62 5/27/2016 N MALE 56 WHITE IV 63 5/29/2016 N FEMALE 29 WHITE IV 64 5/30/2016 N MALE 32 WHITE SNORT 65 6/2/2016 N MALE 36 WHITE IV 66 6/6/2016 N MALE34 HISPANIC 67 6/8/2016 N FEMALE 25 WHITE IV 00 68 6/9/2016 Y Y MALE 19 WHITE RECENT RELEASE FROM JAIL 69 6/9/2016 N Y MALE 32 HISPANIC SNORT 4X NARCAN 70 6/10/2016 N Y MALE 23 WHITE M 2X NARCAN 71 6/10/2016 N Y FEMALE 42 WHITE 10X NARCAN 72 6/10/2016 N Y FEMALE 36 WHITE 73 6/12/2016 N Y MALE 42 HISPANIC IV 74 6/12/2016 N Y MALE 33 WHITE 75 6/17/2016 N Y MALE 57 WHITE 76 6/20/2016 -N-Y- MALE 32 BLACK 77 6/22/2016 N Y MALE 25 WHITE 78 6/24/2016 N Y MALE 21 WHITE 79 6/24/2016 N Y FEMALE 45 WHITE SNORT 80 6/24/2016 N Y FEMALE 50 BLACK SNORT 81 6/26/2016 N Y MALE 64 HISPANIC 82 6/22/2016 N Y FEMALE 22 WHITE 83 7/1/2016 N Y MALE 33 WHITE 84 7/4/2016 N Y MALE 28 HISPANIC MIGHT BE COCAINE 85 7/8/2016 Y Y FEMALE 45 WHITE OD ON 06/24/16 IV 86 7/8/2016 N N FEMALE 20 BLACK COC/HER MIX IV 87 7/9/2016 N Y FEMALE 52 WHITE 00 0 Overdose variables-Salem Calendar Year 2015 15 fatals 2013 87 2015 123 2016 61 od 8-F 2014 124 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 #Overdoses 7 8 21 13 15 18 5 #Fatal 0 1 2 3 2 1 1 Gender Male 4 5 14 10 11 1 Female 3 3 7 3 4 Age <25 2 5 3 1 25-30 2 4 7 1 3 31-40 3 3 7 7 41 1 41-50 1 1 2 51+ 1 2 Race/Ethnicity White/Non-Hisp 7 7 20 12 13 1 African American 1 1 Hispanic 1 1 1 Asian Narcan 6 7 18 11 13 Unknown Mode of use 11V 6 1 11 7 7 1 Sniffing 4 2 4 3 Mixing* 4 1 VIVITROL Rx Opiates EKLON COC/FENT Relapse/Low tolerance 1 S/D 11 S/D *If indiviudal admits to mixing opiates and other drugs,what were they?