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Time In: 11:25 am <br /> Time Out: 12:05 pm <br /> oPq�IM. San Joaquin County <br /> Environmental Health Department <br /> _ J. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> 9GIFoµc� <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-ANSELADAMS ELEMENTARY Date: 10/20/2015 <br /> Address: 9275 GLACIER POINT DR, STOCKTON 95212 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209) 331-7000 <br /> Program Element: 1632 - EXEMPT FOOD <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 /> #40 Proper Use and Storage of Wiping Cloths <br /> OBSERVATIONS:Wipe cloth on table and on 3-comp sink drain board not in sanitizer bucket. Store wipe cloth in sanitizer <br /> bucket. <br /> CAL CODE DESCRIPTION: Wiping cloths used to wipe service counters, scales or other surfaces that may come into contact with food <br /> shall be used only once unless kept in clean water with sanitizer. (114135, 114185.1 114185.3(d-e)) <br /> #45 Floors,Walls, Ceilings; Clean and Maintained <br /> OBSERVATIONS: Floor behind oven has some build up, and water/debris under dishwasher. Clean. <br /> CALCODE DESCRIPTION: The walls/ceilings shall have durable, smooth, nonabsorbent, light-colored, and washable surfaces. All floor <br /> surfaces, other than the customer service areas, shall be approved, smooth, durable and made of nonabsorbent material that is easily <br /> cleanable. Approved base coving shall be provided in all areas, except customer service areas and where food is stored in original <br /> unopened containers. Food facilities shall be fully enclosed. All food facilities shall be kept clean and in good repair. (114143(d), <br /> 114266, 114268, 114268.1, 114271, 114272) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Mary Patterson Expiration Date:June 02,2020 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 133°F <br /> Quaternary Ammonia(QA): 300 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM --LOCATION --TEMP° F--COMMENTS <br /> Prep Sink-- Kitchen-- 120.00° F Walk In--Kitchen--41.00°F <br /> Metro C200-- Kitchen-- 146.00°F Cres Cor Hot Hold--dining-- 154.00°F <br /> Beverage Air Milk Box Ift--dining--29.00°F Handwash-- Kitchen-- 100.00°F <br /> Metro C200--dining-- 148.00°F Beverage Air Milk Box rt--dining--40.00°F <br /> RR-- 100.00°F 3-comp-- Kitchen-- 133.00°F <br /> 71 � 160 <br /> NOTES <br /> 'C 'F <br /> It center Is black <br /> at <br /> m <br /> e <br /> Sanitizer bucket at 160 F. In.n correct temperature <br /> has been achtem a ed <br /> rat <br /> Lunch is served from 10 am to 12:30am. Salad is placed out in reach-in directly from Walk In at 9:45am. Document <br /> available. <br /> FA0015582 PR0523085 SCO01 10/20/2015 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program OR <br />