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rr 1 <br /> Complaint Investigation Form Report#:5104 <br /> COMPLAINT ID: C00050651 Site Location: 4450 E WATERLOO RD Account ID: AR0023837 <br /> Received by: FE0009846 BALLWAHN Received Date: 10/9/2019 Print Date: 10/9/2019 2:09:42PM <br /> Assigned To: EE0009832 ACEVEDO Assigned Date: 10/9/2019 <br /> Prooram/Element Code 1600-FOOD PROGRAM <br /> <br /> <br /> <br /> Nature of complaint: <br /> ON 8-27-19,AT AROUND 6PM,COMPLAINANT PURCHASED 2 LARGE BUCKETS OF HOT CHICKEN WINGS FROM KFC.AT THE BOTTOM OF <br /> THE BUCKET,THE LAST FEW PIECES OF CHICKEN WERE BLOODY AND RAW.TOOK IT BACK TO RESTAURANT,TOLD MANAGER,AND GOT <br /> A REFUND.CALLED CORPORATE AND GOT NO RESPONSE. RESTAURANT WAS VERY DIRTY.ON THE DAY SHE WAS THERE TO RETURN <br /> THE CHICKEN,SHE SAW AN EMPLOYEE PULL SOMETHING"WORM-SHAPED"OUT OF THE SAUCE AND THREW IT AWAY. (C)SPOKE TO <br /> "JANICE"FROM CORPORATE,AND JANICE TOLD(C)SHE WOULD MAKE A"HIGH-PRIORITY"REPORT AND THAT SOMEONE WOULD BE <br /> CONTACTING HER.OVER THE NEXT FEW WEEKS,SHE NEVER HEARD ANYTHING FROM AN INSPECTOR OR INVESTIGATOR,SO SHE <br /> CALLED BACK AND CORPORATE TOLD HER THE CASE WAS CLOSED. SHE THEN TOLD THEM SHE WAS GOING TO CONTACT <br /> ENVIRONMENTAL HEALTH AND THEY HUNG UP ON HER.*COMPLAINANT WOULD LIKE A CALL BACK FROM INSPECTOR.* <br /> Complaint Mode: P Complaint Mode Codes A-Agency Referral B-Bd of Supervisors/City Council C-Counter F-Fax <br /> E-Code Enforcement M-Mail/Correspondence O-Other EH Unit P-Phone <br /> I-Internet/Email S-Sheriffs Office <br /> ------------------------------------------------- <br /> PROPERTY INFORMATION RESPONSIBLE PARTY INFORMATION <br /> Facility:FA0014100-KFC/A&W#284 RP DBA <br /> Site Location 4450 E WATERLOO RD RP mailing address <br /> STOCKTON,CA 95215--230 <br /> Cross Street WILCOX <br /> Mailing address 1555 Meadowview Road,Suite 150 RP contact <br /> Sacramento,CA 95823 RP contact phone <br /> Phone 209-931-8994 EXT: <br /> Owner: OW0011163-Froilan 284,Inc. <br /> DBA <br /> Owner address 8334 GERBER RD <br /> SACRAMENTO,CA 95828 <br /> Billing Address 1555 Meadowview Road,Suite 150 <br /> Sacramento,CA 95832 <br /> Home Phone 510-429-7925 <br /> Work Phone 916-553-2267 EXT: <br /> District 004-WINN,CHARLES Location Code 99-UNINCORPORATED AREA <br /> APN 10102159 <br /> Date Abated t o A b / '"A Inspector ID#: A��CN) <br /> Send Referral to \ Referral Letter Sent by <br /> Referral Address Date: <br /> Complaint Status Code: ab <br /> Circle appropriate Status Code v <br /> 01-Field Response-Violations Cited and Corrected 29-Alleged FBI-Major Violations Identified <br /> 02-Office Response Only 50-LEAD Assessment Performed-No Abatement Required <br /> 06-Violations Cited-see Linked PROGRAM FACILITY FILE 52-LEAD Abatement Reqired-See Program Record File <br /> 07-Referred to Other Agency 97-Disaster Planning and Response <br /> ®-Unable to Verify Alleged Complaint 99-UNSPECIFIED-Old Complaint-No Original Found <br /> 10-POSTED SUBSTANDARD/UNSECURED-See Housing File MN-EHD Monitoring Status <br /> 11-Multiple Complaints-SEE ACTIVE CASE# PD-Permit Issued-Pending Well Installation <br /> 12-DA Referred Complaint-See Program Enforcement Action Form RS-Resolved-New Well Installed <br /> 15-ACTIVE HOUSING CASE-NEW COMPLAINT see ACTIVE CASE# S1-Tank pumped <br /> 28-Alleged FBI-No Major Violations Identified S2-Hooked up to public sewer <br /> 5104.rpt <br />