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<br />SALM/MIN Environmental Health Department <br />recia,* <br />—COUNTY— <br />Gft0111,13 growl hrfa. Time In 10:50 am <br />Time Out: 11:34 am <br /> <br />Food Program Complaint Inspection Report <br />Name of Facility: 99 Cents Only Stores #177 Date: 03/05/2020 <br />Address: 1120 E Hammer LN, STOCKTON 95210 <br />Owner/Operator: 99 CENTS ONLY STORES Telephone (209) 956-4992 <br />Program Element: 1600- FOOD PROGRAM Complaint #: C00051686 <br />DESCRIPTION OF COMPLAINT ALLEGATIONS <br />The San Joaquin County Environmental Health Department received the following complaint: <br />COMPLAINT INSPECTION CONDUCTED TODAY. COMPLAINANT STATED THAT A BOX OF JIFFY APPLE CINNAMON <br />PANCAKE MIX WAS PURCHASED ON 01/21/20 FROM THE 99 CENT STORE AND FOUND BUGS IN THE MIX AFTER <br />CONSUMING <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 foodbome illness. All major violations must be corrected immediately. Non-compliance may warrant immediate closure of <br />the food facility. <br />#31 Consumer Self-Service Food Protected <br />OBSERVATIONS: Few damaged boxes of prepackage cake mix was observed between the VIP displace case and the <br />wall. Removed these damaged boxes and clean this area today. <br />CALCODE DESCRIPTION: Unpackaged food shall be displayed and dispensed in a manner that protects the food from contamination. <br />(114063, 114065) <br />OVERALL INSPECTION NOTES AND COMMENTS <br />OBSERVATIONS <br />Name on Food Safety Certificate: <br /> <br />Expiration Date: <br /> <br />Warewash Chlorine (CI): ppm Heat: ° F Water/Hot Water Ware Sink Temp: ° F <br /> <br />Quaternary Ammonia (QA): <br />PPm <br /> Hand Sink Temp: 1000 F <br />FOOD ITEM — LOCATION -- TEMP ° F — COMMENTS <br />No Temperature Data Collected <br />NOTES <br />The display case area of Jiffy Apple Cinnamon pancake mix observed to be free of vermin. <br />Complaint can't be verified at this inspection. <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: Marya Yousaf, ASM <br />EH Specialist: STEVEN SHIH Phone: (209) 468-9850 <br />FA0001200 000051686 SC004 03/05/2020 <br />EHD 16-23 Rev. 06/30/15 Page 1 of 1 Food Program Complaint Inspection Report <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com