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Time In: 9.50 am <br /> Time Out: 10:40 am <br /> op.. .. San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... _ P• Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> 4�IFO';Rt� <br /> Food Program Official Inspection Report <br /> Name of Facility: GOOD SAMARITAN REHAB&CARE Date: 01/26/2017 <br /> Address: 1630 N EDISON ST, STOCKTON 95204 <br /> Owner/Operator: GOOD SAMARITAN REHAB&CARE Telephone: (209)948-8762 <br /> Program Element: 1628-LICENSED HEALTH CARE FACILITY <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 /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:Saw water puddle behind ice machine. Investigate and make any necessary repairs. <br /> CALCODE DESCRIPTION: The potable water supply shall be protected with a backflow or back siphonage protection device,as required <br /> by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing <br /> ordinances, shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose <br /> used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, <br /> 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) <br /> #43 Toilet Facilites Clean/Supplied/Maintained <br /> OBSERVATIONS:Toilet paper is not inside dispensers. Provide spindles by 1 week. <br /> CALCODE DESCRIPTION: Toilet facilities shall be maintained clean, sanitary and in good repair. Toilet rooms shall be separated by a <br /> well-fitting self-closing door. Toilet tissue shall be provided in a permanently installed dispenser at each toilet. The number of toilet <br /> facilities shall be in accordance with local building and plumbing ordinances. Toilet facilities shall be provided for patrons:in <br /> establishments with more than 20,000 sq ft. establishments offering on-site liquor consumption. (114250, 114250.1, 114276) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Olivia Linayao Expiration Date:October 16,2019 <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: 130°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 115°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> porriege 140.00°F steam tables--160.00°F <br /> walk in--40.00°F eggs--136.00°F <br /> NOTES <br /> No comment entered. <br /> FA0018492 PRO527301 SCO01 01/26/2017 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program OIR <br />