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r �I A (1111 Environmental Health Department <br /> CC)UNTY I <br /> Gf$oLn@SS 5rws hemTime In: 11.35 am <br /> Time Out: 12:00 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: TRACY USD-HIRSCH ELEM SCHOOL Date: 03/26/2021 <br /> Address: 1280 DOVE ST, TRACY 95376 <br /> Owner/Operator: TRACY UNIFIED SCHOOL DISTRICT Telephone: (209)830-3200 <br /> Program Element: 1632-EXEMPT FOOD <br /> Inspection Type: ROUTINE INSPECTION (Chargeable) <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Denise Ramirez Expiration Date:June 05,2023 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door True--41.00°F cheese breadsticks at line--131.00°F--facility uses time as a <br /> temperature control <br /> milk cooler--28.00°F <br /> NOTES <br /> wiping cloth bucket 200 ppm Quat/Quat sanitizer test strips are available <br /> Facility receives food from Williams School/food arrives on site around 10am <br /> Food was all packaged and bagged at the time of the inspection. <br /> Food is distributed from 11a-12:30pm at the cafeteria window. <br /> No signature obtained/COVID-19 <br /> Report typed at the office 2:25-2:30p <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: Discussed w/Ana, Patrina&Alice, FS <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0012292 PR0515697 SC101 03/26/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 1 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />