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SAN J O A Q U I N Environmental Health Department <br /> C_U�j N I Y <br /> •- Time In: 1:30 IZ <br /> GrPOCt'ss glows fires <br /> Time Out: 1:50 om <br /> Food Program Official Inspection Report <br /> Name of Facility: BLOOM BAKERY Date: 06/19/2018 <br /> Address: 1835 PIEDMONT DR, MANTECA 95336 <br /> Owner/Operator: RABY, LINDA D Telephone: <br /> Program Element: 1609-CLASS B COTTAGE FOOD-INDIRECT SALES <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 108°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Amana fridge--39.00°F <br /> NOTES <br /> Cottage Food Operation, Class B. <br /> Routine inspection. <br /> Food Handler Card ok(expires 12-28-18) <br /> Food stored in pantry. Bleach available. <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: Linda Raby, owner <br /> EH Specialist: SCOTT SANGALANG Phone: (209)468-3452 <br /> FA0023332 PRO540811 SCO01 06/19/2018 <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 />