Boston Medical Center
PASS W/ CONDITIONSFriday, June 27, 2008 at 4:30 PM
Violations Cited
03-3-501.16(A)
Cold Holding
Seafood roll up 51F. Prepped foods not chilled to 41F or below before serving. PHF's stored in refrigerated between 41 - 47F. Store cold at 41F or below. Manager to review flow of foods and chilling after preparation. Milk and juice above 45F in home style unit. Unit reading 46F. Must be at below 41F. Bleu cheese dressing in dry storage states must refrigerate- Address. Removed by manager.
Why This Matters
THE DANGER ZONE KILLS: Between 41°F-135°F bacteria double every 20 minutes. At 70°F, 10 bacteria become 10,000 in 2 hours, 10 million in 4 hours. Staphylococcus aureus produces heat-stable toxins that cooking cannot destroy. Clostridium perfringens causes 1 million illnesses yearly from temperature abuse. Listeria grows even under refrigeration, killing 20% of victims including pregnant women and newborns.
Code Requirements
ALL TCS foods MUST be held at 41°F or below at ALL times. This includes: All meat, poultry, seafood; Dairy products; Cut melons, tomatoes, leafy greens; Cooked rice, pasta, potatoes; Tofu, soy products; Sprouts; Garlic in oil. Check temperatures every 2 hours (4 hours maximum). If above 41°F for less than 2 hours, rapidly cool. If above 41°F for 2-4 hours, use immediately. If above 41°F for over 4 hours, DISCARD.
Corrective Actions
IMMEDIATE: Check ALL refrigerated foods NOW; Discard any food above 41°F for >4 hours; Rapidly cool foods 41-70°F if <4 hours; Repair/adjust all refrigeration immediately; Reduce inventory to prevent overstocking; Install thermometers in warmest part of all coolers; Implement 2-hour temperature checks; Create power outage procedure
M-2-103.11
PIC Performing Duties
No illness policy. Provide and train staff. Monitor cold holding flow of foods during preparation glove use and cooling methods.
Why This Matters
EXTREME RISK: Without active management, ALL five CDC risk factors go unchecked. Studies show restaurants without certified managers have 2.5 times more critical violations. Lack of supervision leads to: temperature abuse (bacteria double every 20 minutes), cross-contamination spreading pathogens, sick employees working with food, improper cooking allowing pathogen survival. This single violation enables conditions for major outbreaks.
Code Requirements
PIC MUST: Be present during ALL operating hours; Hold valid food safety certification; Actively monitor employee health and hygiene; Ensure proper cooking, cooling, and holding temperatures; Verify foods from approved sources; Monitor handwashing compliance; Ensure equipment properly sanitized; Take immediate corrective actions for violations; Demonstrate knowledge to health inspector; Train and supervise all food employees.
Corrective Actions
IMMEDIATE: Designate qualified PIC immediately; If no certified manager available, cease operations; Implement active managerial control system; Create monitoring logs for all CDC risk factors; Retrain management on responsibilities; Post PIC duties checklist
22-4-601/602.11
Food Contact Surfaces Clean
Can opener soiled. Utensils in soiled drawer.
Why This Matters
BIOFILM FORMATION: Visible soil indicates biofilms - communities of bacteria protected by slime layers that resist sanitizers. Biofilms on slicers have caused Listeria outbreaks killing 30% of victims. Meat slicer contamination sickened 300 across 6 states. Grease harbors Listeria which grows at refrigeration temperatures.
Code Requirements
Food contact surfaces must be: Visibly clean with no food debris; Free of grease accumulation; Smooth and cleanable; Cleaned and sanitized after each use; Cleaned every 4 hours if in continuous use; Equipment must be disassembled for cleaning when necessary.
Corrective Actions
Clean and sanitize ALL equipment immediately; Disassemble equipment for thorough cleaning; Establish cleaning schedule with assigned responsibilities; Use cleaning checklist; Train on proper disassembly; Increase cleaning frequency
30-5-203.14
Cross Connection Back Siphonage Backflow
Provide a back flow preventor for the rinse station with a submerged inlet.
Why This Matters
This violation supports conditions that may lead to foodborne illness
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
04-3-501.15/4-301.11
Inadequate Facilities/Cooling Methods
Foods cooling in tightly wrapped and / or deep pans. Use proper cooling methods- shallow pans lightly wrapped.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
08-3-302.15
Washing fruits and veg's.
Deli Prep - Discontinue use of Victor wash for fruits / vegetables until test kit requirements addressed with company.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
08-3-305-307.11
Food Protection
Prep areas near hand sink subject to contamination from soap dispensers.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
13-2-304/402.11
Clean Cloths Hair Restraint
Some staff with soiled aprons.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper cleaning & sanitization procedures. Train all staff. Document corrective actions taken.
14-4-202.11
Food Contact Surfaces Design
Clean soiled utensil drawers.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
15-4-202.16
Non-Food Contact Surfaces
Repair refrigeration with frost build up and ensure cold holding units NSF 7 for storing in kitchen and on patient unit.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
15-4-202.16
Non-Food Contact Surfaces
Clean sides backs of soiled cooking line equipment. Clean soiled handles on all food storage. Defrost ice cream chests.Clean exteriors of spice containers. Clean soils from chemical storage cabinets dry storage shelves.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
16-4-501.11/.15
Dishwashng Facilities
Repair leak below machine. Wash 160 F / Rinse 190F ok.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
21-3-304.14
Wiping Cloths Clean Sanitize
Soiled cloths not stored in sanitizer solution. Solution checked ok
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper cleaning & sanitization procedures. Train all staff. Document corrective actions taken.
29-5-201/02.11
Installed and Maintained
Replace missing handles on rinse station next to dishmachine.
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper food safety procedures. Train all staff. Document corrective actions taken.
32-6-301.11-02.11
Hand Cleaner Drying Tissue Signage
Promote signage for cafe restrooms and a covered receptacle in ladies room
Why This Matters
This violation affects overall sanitation and food safety
Code Requirements
Immediate correction required. Follow health code section . Implement proper personal hygiene procedures. Train all staff. Document corrective actions taken.
37-6-201.11
Walls/Ceilings Designed Constructed Installed
Hood at grill Hook line dripping grease. Clean. Contacted Company. Clean dish room walls of drips. Address ceiling leak.
Why This Matters
Poor facility maintenance can harbor pests and prevent proper cleaning
Code Requirements
Smooth, washable surfaces; No holes or damage; Light-colored in food areas; Clean condition