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SA IIIc J UHQ U I N Environmental Health Department <br /> ._ COUNTY <br /> Tl : 10:30 am <br /> .- <br /> 7FOpt�� Greotness grows here, <br /> Timee OOutut: 12:00 Pm <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-HENDERSON SCHOOL Date: 04/15/2019 <br /> Address: 13451 N EXTENSION RD, LODI 95240 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <br /> Program Element: 1632-EXEMPT FOOD <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;113700.All <br /> violations must be corrected within specified timeframe. Violations that are classified as"MAJOR"pose an immediate threat to public health and have the <br /> potential to cause foodborne illness.All major violations must be corrected immediately.Non-compliance may warrant immediate closure of the food facility. <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Doreen Roe Expiration Date:June 02,2020 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 D Traulsen cooler--40.00°F 2 D Cres Cor warmer--162.00°F <br /> Milk box--42.00°F Hand sink--Staff rest room--100.00°F <br /> NOTES <br /> Food is delivered from the central kitchen Lodi unified. <br /> Food delivery log is maintained with hot food at 135F or above and cold food at 41 F or below. <br /> No major violations observed. <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 Safety <br /> Code.If a reinspection is required,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: Dr. Dominee S. Muller-Kimball, Princip <br /> EH Specialist: GEHANE FAHMY Phone: (209)953-7698 <br /> FA0000447 PRO162146 SCO01 04/15/2019 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />