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Time In: 11-00 am <br /> Time Out: 11:36 am <br /> PgvItY San Joaquin County <br /> �Q.��•cGG <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... _ p• Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �L�PORN; <br /> Food Program Complaint Inspection Report <br /> Name of Facility: MASA JAPANESE DELI Date: 01/12/2018 <br /> Address: 2819 W MARCH LN, STOCKTON 95219 <br /> Owner/Operator: KIM, JENNIFER&JIN Telephone: (209)473-1255 <br /> Program Element: 1600-FOOD PROGRAM Complaint#: C00045400 <br /> DESCRIPTION OF COMPLAINT ALLEGATIONS <br /> The San Joaquin County Environmental Health Department received the following complaint: <br /> STAFF NOT NOTIFIED. FOOD POISONING.THURSDAY, JANUARY 4, 2018 AT 8PM. DIARRHEA, FEVER AND BODY <br /> ACHES EXPERIENCED A COUPLE OF HOURS AFTER DINING AT RESTAURANT. COMPLAINANT HAD CHICKEN <br /> DUMPLINGS. NO DOCTOR VISIT.40 YEAR OLD FEMALE. <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 /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> Went to facility and informed the owner about the complaint. The owner stated they do not sell chicken dumplings.When i <br /> asked if they have any food similar to chicken dumplings, she stated they have shrimp dumplings. No employees reported <br /> being ill a week before the alleging complaint. Unknown whether employees work at other food facilities. No travel outside the <br /> country. <br /> Hand wash provided,did not observe cleaning of utensils but sink is provided for the proper cleaning of utensils. <br /> The shrimp dumplings are received once per month. Shrimp dumplings are received frozen and stored in freezer at-4 F.The <br /> dumplings are microwaved when order. <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: Jin Kim, owner <br /> EH Specialist: VIDAL PEDRAZA Phone: (209)468-0334 <br /> FA0017620 C00045400 SCO04 01/12/2018 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program Complaint Inspection Report <br />