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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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pq.o�rN.. <br /> SAN JOAQUIN COUNTY <br /> . .... .0 <br /> � •.pG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Cq�IFO•na�Q' Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:.www.siqov.orq/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: DD Mq K1, <br /> P1 u.h Date: <br /> Address: L�� ✓-Z /2 <br /> �� Aj O n City: TU ��, Zip Code: 2� <br /> � TU � 5 <br /> Owner/Operator: -4/4 <br /> Telephone: L� , <br /> Program Element: Gj 2- Program Record: A D '5 22 7 Inspection Type: . <br /> SB180 Posted--.rYes No Permit Posted`f 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 immediatel . Non-compliance may warrant closure of the food focilit <br /> IN N/o NVA Demonstration of Knowledge MAJ our Cos Supervision ovr <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 /> ✓ 2. Communicable disease;reporting,restrictions&exclusions 2S. Personal cleanliness and hair restraints <br /> ✓ 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> 4. 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 /> V" :[ <br /> 5. 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 /> 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> 9. Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment/Utensils l 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 /> V 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> �_-t9. Advisory provided for raw or undercooked food 44. Premises:personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> L 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 /> 23. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/ itle: <br /> EH J, C. <br /> Phone: _ / Page 1 ofd <br /> EHD 16-23 (1st pg) 12/15/09 7 FOOD PROGRAM OR <br />
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