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t "` °• ►I �� Illlr<I Environmental Health Department <br /> �1 <br /> U 111 <br /> -COUNTY— <br /> Time <br /> Gf$oLIS@SS f wS hem Time <br /> In: 9.41 am <br /> Time Out: 10:00 am <br /> Food Program Official Inspection Report <br /> Name of Facility: KAY'S CREATIONS Date: 04/21/2021 <br /> Address: 535 W CANCION CT, MOUNTAIN HOUSE 95391 <br /> Owner/Operator: TABAR, KAREN R Telephone: <br /> Program Element: 1609-CLASS B COTTAGE FOOD-INDIRECT SALES <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 /> 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: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door reach-in refrigerator--40.00°F restroom hand sink-- 113.00°F <br /> NOTES <br /> In home Class B CFO inspection <br /> No signature obtained/COVID-19 <br /> permit handed to operator <br /> Report typed at the office 2:38-2:43pm <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/Karen Tabar, owner <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0022345 PR0538891 SCO01 04/21/2021 <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 />