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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> .r{ � 7fa�pl r+fSS grows hire, Time In: 11.00 am <br /> Time Out: 12:00 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-ANSEL ADAMS ELEMENTARY Date: 10/21/2021 <br /> Address: 9275 GLACIER POINT DR, STOCKTON 95212 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <br /> Program Element: 1632-EXEMPT FOOD <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 /> #21 Hot and Cold Potable Water Not Available <br /> OBSERVATIONS:The water at the hand sinks in the male and female restrooms was 81 F. Provide warm and cold water <br /> with warm water at 100 F minimum at these sinks today. <br /> CALCODE DESCRIPTION:An adequate,protected,pressurized,potable supply of hot water and cold water shall be provided at all times. <br /> (113953(c), 114099.2(b) 114101(a), 114189, 114192, 114192.1, 114195) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Leanna Nava Expiration Date:July 19,2023 <br /> Warewash Chlorine(Cl): ppm Heat: 160°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 /> hand sink--kitchen--100.00°F walk-in--40.00°F <br /> Beverage Air milk cooler#1 --cafeteria--39.00°F Beverage Air milk cooler#2--cafeteria--41.00°F <br /> prep sink--120.00°F hand sink--male restroom--81.00°F <br /> hand sink--female restroom--81.00°F 2 dr Cres Cor warner--cafeteria--170.00°F <br /> 3 comp sink--120.00°F 2 dr Metro C200 warmer--kitchen--166.00°F <br /> NOTES <br /> Routine inspection. <br /> Sanitizer bucket-200 ppm quat. <br /> Quat and thermal test strips available. <br /> Facility prepares hot and cold lunches on site. Lunch occurs between 10:40 AM- 12:40 PM. <br /> Facility receives their food items from SYSCO and Lodi Unified School District warehouse every Wednesday. <br /> Facility receives their produce from DOD every Monday and Thursday. <br /> Facility receives their milk from Crystal Creamery every Monday, Wednesday, and Friday. <br /> The 2 dr Metro C200 warmer in the cafeteria and the steam tables in the kitchen were off during the inspection. <br /> Discussed report with Leanna Nava. <br /> No signature captured. <br /> FA0015582 PR0523085 SCO01 10/21/2021 <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 />