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SANOAQU I N Environmental Health Department <br /> COUNT -( IY <br /> { put' <br /> �1f flCri 3S grows here, <br /> Time In: 10:50 am <br /> tlp <br /> Time Out: 11:34 am <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 foodborne 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: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°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 C00051686 SCO04 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 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />