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COMPLIANCE INFO_2017
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MICKE GROVE
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1600 - Food Program
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PR0161935
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COMPLIANCE INFO_2017
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Entry Properties
Last modified
4/20/2020 9:30:56 AM
Creation date
4/20/2020 9:30:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2017
RECORD_ID
PR0161935
PE
1635
FACILITY_ID
FA0000284
FACILITY_NAME
FUN TOWN AT MICKE GROVE #4FU5813
STREET_NUMBER
11707
Direction
N
STREET_NAME
MICKE GROVE
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05910002
CURRENT_STATUS
01
SITE_LOCATION
11707 N MICKE GROVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SShih
Tags
EHD - Public
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SAN JOAQUIN COUNT <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjcpv.orci/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility:' - i 11A- (: k-Ci -'.,,) G '-(- Date: / t <br />Address: <br />I ( 7 / I i 1 (--L tAC:.( 4 -1, 4 City: Zip Code: <br />Owner/Operator: t_ ) ' 4 7e( yl---1_4A--,ei---Li Telephone: <br />Program Element: is - .• ( Program Record: e, /.(, (, 3 j- Inspection Type:/.( - ,: <br />' SB180 Posted s No Permit Posted )(Yes No Re-Inspection on or After: <br />IN = In Compliance N/O = Not Observed N/A = Not Applicable COS = Corrected on-site MAJ = Major Violation OUT = Not in Compliance <br />See reverse side for code sections and general requirements that correspond to each violation listed below. <br />Ma'or violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility <br />ts, VO VA Demonstration of Knowledge 1 I OUT. COS , Supervision <br />1 1. Demonstration of knowledge; food safety certificate 24 Person In Charge is present and performs duties <br />Employee Health and Hygiene Personal Cleanliness ',,' • <br />. Communicable disease; reporting, restrictions & exclusions 25. Personal cleanliness and hair restraints <br />. No discharge from eyes, nose, or mouth; no open wounds General Food Safety Requirements <br />4. Proper eating, tasting, drinking, or tobacco use 1 ' 26. Approved thawing methods used <br />Preventing Contamination by Hands 27. Food protected from contamination during storage <br />'')( li.5. Hands clean and properly washed; proper glove use 28. Washing fruits and vegetables before use <br />6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified, stored, and used <br />Time and Temperature Relationship Food Storage/Display/Service <br />7. Proper hot and cold holding temperatures 30. Food storage; food storage containers labeled <br />8. Proper use of time as a public health control 31. Customer self-service food protected; individual utensils provided <br />Np. Proper cooling methods 32 Food properly labeled and honestly presented <br />Proper cooking time and temperatures Equipment / Utensils / Linens <br />Proper reheating procedures for hot holding .,... 33 Nonfood contact surfaces clean <br />-• Protection From Contamination 34. Warewashing facilities maintained; test strips available <br />12. No re-service of returned food 35. Equipment/utensils approved; installed; clean; good repair <br />jj13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use <br />14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br />Food From Approved Source 38. Approved and sufficient ventilation and lighting <br />15. Food obtained from approved source 39. Thermometers provided, accurate, and easily visible <br />16. Compliance with shell stock regulations; tags/display 40 Proper use and storage of wiping cloths <br />. .17. Compliance with Gulf oyster regulations Physical Facilities . <br />Conformance With Approved Procedures Plumbing maintained; proper back flow prevention <br />8. Compliance with HACCP plan or variance conditions Garbage and refuse properly disposed <br />Consumer Advisory Toilet facilities clean, supplied, and maintained <br />' Advisory provided for raw or undercooked food 44 Premises; personal/cleaning items; vermin-proofing <br />. Highly Susceptible Populations Permanent Food Facilities ' <br />Prohibited foods not offered at high risk facilities Floors, walls and ceiling are maintained and kept clean <br />Water / Hot Water No living or sleeping quarters inside facility <br />gl. Hot and cold potable water available. - Compliance and Enforcement <br />Liquid Waste Disposal Signs posted; last inspection report available <br />22. Sewage/wastewater properly disposed; toilet facility useable 48 Compliance with plan review requirements <br />Vermin 49. Facility operating with a valid health permit <br />23. No rodents, insects, birds or animals inside facility 50. Impoundment <br />51 Permit Suspension <br />Received By/Title: <br /> a tellifisi <br />EH Specialist: jl <br /> Phone: cAr", _,..7 p....57 Page 1 of • <br />..i <br />EHD 16-23 (1s1 pg) 4/9/12 FOOD PROGRAM 019
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