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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0527301
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Entry Properties
Last modified
4/22/2020 1:57:30 PM
Creation date
3/21/2019 2:21:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0527301
PE
1628
FACILITY_ID
FA0018492
FACILITY_NAME
GOOD SAMARITAN REHAB & CARE
STREET_NUMBER
1630
Direction
N
STREET_NAME
EDISON
STREET_TYPE
ST
City
STOCKTON
Zip
95204
APN
13705001
CURRENT_STATUS
01
SITE_LOCATION
1630 N EDISON ST
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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Pa"f" SAN JOAQUIN COUP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �;.. <br /> '5 . Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.segov.orq/ehd <br /> �iFoa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �OOd r'1 ,i 4a,-) {CCI'" It Car¢., Date: _/7 <br /> Address: t(o 30 f-) C di Son 6>+, City: S+Q C.V_+-0 Zip Code: 5 20 4 <br /> Owner/Operator: 5/A Telephone: <4'4 _ 87 0 2 <br /> Program Element: 11602-8 Program Record: P(2-©5 -A-7 3 O t Inspection Type: '¢p v f-j he, <br /> B180 Poste Yes No Permit Posted(- Yes No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility <br /> N wo wA Demonstration of KnowledgennA our cos Supervision uu� <br /> 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> PT15. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship Food Storage/Display/Service <br /> 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment/Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> Protection From Contamination 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized'warewashing procedures 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> Advisory provided for raw or undercooked food 44. Premises:personalicleaning items:vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 120. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> F <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> 21.Hot and cold potable water available. Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 22. Sewage/wastewater properly disposed:toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> EH S <br /> p <br /> eci <br /> alist: Phone: ,, J Page 1 of <br /> EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR <br />
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