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SA NUJ OAHU I N Environmental Health Department <br /> L■ COUNT Y-- <br /> c/ p, Greotrless grows hey,. Time In:�Apm <br /> Time Out: 1:26 om <br /> Food Program Official Inspection Report <br /> Name of Facility: NIGHTINGALE COFFEE&TEA Date: 02/28/2020 <br /> Address: 1505 MOFFAT BLVD, MANTECA 95336 <br /> Owner/Operator: MONTANDON, SARA Telephone: <br /> Program Element: 1624-RESTAURANT/BAR 21-50 SEATS <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 /> #21 Hot and Cold Potable Water Not Available <br /> OBSERVATIONS:3 comp sink has temp at 111 F. Provide 120F or above in 1 week. <br /> CALCODE DESCRIPTION:An adequate,protected,pressurized,potable supply of hot water and cold water shall be provided at all times. <br /> (113953(c), 114099.2(b) 114101(a), 114189, 114192, 114192.1, 114195) <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:Pipe, draining the coffee machine, is lacking air gap. Provide air gap 1 inch minimum off the floor sink in <br /> 1 week. <br /> CALCODE DESCRIPTION: The potable water supply shall be protected with a backflow or back siphonage protection device,as required <br /> by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing <br /> ordinances, shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose <br /> used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, <br /> 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Douglas Montandon Expiration Date: November 14,2024 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 111 OF <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 112°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Hand sink--Rest room--105.00°F 1 D True cooler--41.00°F <br /> NOTES <br /> Coffee shop inside Crossroads Church. <br /> Facility will be open only on Thursdays 6pm-7:30pm and on Sundays 7:45am- 12 pm. <br /> QUAT tablets and test strips are available. <br /> FA0017681 PR0526131 SCO01 02/28/2020 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 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 />