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1600 - Food Program
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PR0527312
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COMPLIANCE INFO
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Last modified
5/28/2020 1:14:40 PM
Creation date
4/1/2019 9:13:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0527312
PE
1628
FACILITY_ID
FA0009746
FACILITY_NAME
Kindred Transitional Care and Rehabilitation Valley Gardens
STREET_NUMBER
1517
STREET_NAME
KNICKERBOCKER
STREET_TYPE
DR
City
STOCKTON
Zip
95210
APN
09056004
CURRENT_STATUS
01
SITE_LOCATION
1517 KNICKERBOCKER DR
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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Program Element: 1628 - LICENSED HEALTH CARE FACILITY <br />Telephone: (502) 596-7300 Owner/Operator: VENTAS INC <br />Inspection Type: ROUTINE INSPECTION - Operating Permit <br />Address: 1517 KNICKERBOCKER DR, STOCKTON 95210 <br />Date: 12/29/2016Name of Facility: Kindred Transitional Care and Rehabilitation Valley Gardens <br />Food Program Official Inspection Report <br />12:59 pm <br />11:30 am <br />Time Out: <br />Time In: <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <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 />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br /> 50 140 <br /> 101 <br />Analyn Aquino December 11, 2018 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />HW 1 (premixed) -- 101.00º F mashed potatoes -- steam table -- 158.00º F <br />pot pie -- steam table -- 188.00º F 3-comp -- 140.00º F <br />WI -- 38.00º F 3D Traulsen -- 40.00º F <br />soup -- steam table -- 153.00º F coobler -- steam table -- 158.00º F <br />squash -- steam table -- 183.00º F HW 2 -- 108.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Sanitizer bucket 200 ppm quat <br />No violations observed <br />OIR emailed allison.boyd@kindred.com <br />The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br />Safety Code. If a reinspection is required, fees will be assessed at the current hourly rate. <br />Received by: Name and Title: <br />EH Specialist:Phone:(209) 468-0335 <br />Allison L Boyd, Registered Dietitian <br />JEFFREY WONG <br />Page 1 of 1EHD 16-23 Rev. 06/30/15 Food Program OIR <br />FA0009746 PR0527312 SC001 12/29/2016
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