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Time In: 2:20 IL <br /> Time Out: 3:20 pm <br /> San Joaquin County <br /> Q. :_� Environmental Health Department <br /> W , A <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.so oq v org/ehd <br /> gc,FORa <br /> Food Program Official Inspection Report <br /> Name of Facility: Kindred Transitional Care and Rehabilitation Valley Gardens Date: 10/12/2015 <br /> Address: 1517 KNICKERBOCKER DR, STOCKTON 95210 <br /> Owner/Operator: VENTAS INC Telephone: (502) 596-7300 <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 /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:- Leak under 1-comp sink by coffee maker, <br /> - Lots of ice build-up on freezer walk in floor. <br /> -gasket of freezer walk in door pulling away/ not tight. <br /> Repair in 2 weeks; remove ice in 1 day. <br /> CALCODE DESCRIPTION. All utensils and equipment shall be fully operative and in good repair. (114175).All utensils and equipment <br /> shall be approved, installed properly, and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5, <br /> 114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114177, 114180, 114182) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Analyn LAquino Expiration Date: December 11,2018 <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: 150°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 144°F <br /> FOOD ITEM --LOCATION --TEMP° F--COMMENTS <br /> 3D Traulen --38.00°F Hand wash by entrance-- 144.00°F <br /> Women staff RR-- 107.00° F 2-COMP PREP-- 144.00°F <br /> 1-comp sink by coffee maker-- 121.00° F Hand wash by chemical room-- 106.00° F <br /> Walk In--37.00°F <br /> NOTES <br /> Sanitizer bucket: 200 ppm quat <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: Allison L Boyd, Registered Dietitian <br /> EH Specialist: JEFFREY WONG Phone: (209) 468-0335 <br /> FA0009746 PR0527312 SCO01 10/12/2015 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />