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SA NUJ OAHU I N Environmental Health Department <br /> ■ COUNTY <br /> ^ r1 `p' Greotrless grows Frere, Time In: 1:45 pm <br /> Time Out: 2:35 om <br /> Food Program Official Inspection Report <br /> Name of Facility: 133 CLUB Date: 11/09/2018 <br /> Address: 133 W YOSEMITE AVE, MANTECA 95336 <br /> Owner/Operator: S RAFFO LLC Telephone: (209)823-4877 <br /> Program Element: 1621 -BAR w/o FOOD PREP <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <br /> VIOLATIONS AND CORRECTIVE ACTIONS <br /> Items listed on this report as violations do not meet the requirements set forth in the California Health and Safety Code commencing with section 7; <br /> 113700.All violations must be corrected within specified timeframe. Violations that are classified as"MAJOR"pose an immediate threat to public health <br /> and have the potential to cause foodborne illness.All major violations must be corrected immediately.Non-compliance may warrant immediate closure of <br /> the food facility. <br /> #1 Demonstration of Knowledge <br /> OBSERVATIONS:One person shall possess the 5 year Food Safety Certificate if food service is continued. Provide a copy <br /> of the certificate and change permit to allow food service within 60 days. <br /> Discontinue food service until Food Safety Certificate has been obtained and permit has been changed. <br /> CALCODE DESCRIPTION:All food employees shall have adequate knowledge of and be trained in food safety as it relates to their <br /> assigned duties. (113947)Food facilities that prepare,handle or serve non-prepackaged potentially hazardous food,shall have an <br /> employee who has passed an approved food safety certification examination. (113947-113947.1)Any food handler hired after June 1, <br /> 2011 shall obtain a Food Handler Card within 30 days(113948). <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: n/a Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 108°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hand sink--women's rr--100.00°F hand sink--men's rr--100.00°F <br /> chili--warmer 163.00°F walk in--28.00°F <br /> nacho cheese -warmer--162.00°F hand sink--bar--100.00°F <br /> NOTES <br /> Steramine tablets are used. <br /> During the inspection,tortilla chips, chili, nacho cheese, and salsas were out for customers.The walk in cooler has hot dogs, <br /> tortillas, cheese,tomatoes, buns, butter, sour cream, onions, etc.The facility's current permit is for"bar without food prep." If <br /> facility wants to continue food service, one person shall obtain the Food Safety Certificate and change permit to PE 1624 <br /> ($355)from current PE 1621 ($270). <br /> FA0000890 PRO161119 SCO01 11/09/2018 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />