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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> t.. v•:v COUNTY <br /> 7fep[r+85S grows h$rB, Time In: <br /> Time Out: <br /> Food Program Official Inspection Report <br /> Name of Facility: SUSD-ELMWOOD SCHOOL Date: 10/27/2021 <br /> Address: 840 S CARDINAL AVE, STOCKTON 95202 <br /> Owner/Operator: STOCKTON UNIFIED SCHOOL DIST Telephone: (209)933-7045 <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 /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:Observed ice accumulation on ceiling next to fan in walk-in freezer. Clean with-in 5 days. <br /> CALCODE DESCRIPTION:All utensils and equipment shall be fully operative and in good repair. (114175).All utensils and equipment <br /> shall be approved,installed properly,and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5, <br /> 114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114172, 114177, 114180, 114182) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Brandi Mano Expiration Date: March 16,2024 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 125°F <br /> Quaternary Ammonia(QA): 300 ppm Hand Sink Temp: 106°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Hank sink--Staff restroom--108.00°F Traulsen reach-in#1 --Cafeteria--41.00°F <br /> 3 compartment sink--125.00°F Cres Cor hot hold--150.00°F <br /> Traulsen reach-in#2--Cafeteria--38.00°F Walk in cooler--41.00°F <br /> Hand sink--108.00°F Mop sink--120.00°F <br /> Traulsen reach-in--Kitchen--41.00°F <br /> NOTES <br /> Fall Routine Inspection. No major violations observed.Time was given for the observed minor violation. Re-inspection is not <br /> required. <br /> Verified 5-year Food Manager Certificate during the inspection. Verified proper hot and cold holding temperatures. <br /> Official Inspection report emailed. <br /> Maintain a copy of the official inspection report on-site. <br /> FA0002826 PRO160558 SC101 10/27/2021 <br /> EHD 16-23 Rev.09/16/2020 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.sjgov.org/EHD <br />