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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0527564
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COMPLIANCE INFO_2021
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Last modified
5/5/2021 4:10:02 PM
Creation date
5/5/2021 4:07:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0527564
PE
1632
FACILITY_ID
FA0018673
FACILITY_NAME
HIS PLACE
STREET_NUMBER
17238
Direction
N
STREET_NAME
BRUELLA
STREET_TYPE
RD
City
VICTOR
Zip
95253
APN
05109020
CURRENT_STATUS
01
SITE_LOCATION
17238 N BRUELLA RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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Environmental Health Department <br />Time In: <br /> 3:00 pm <br /> 1:57 pm <br />Time Out: <br />Program Element: 1632 - EXEMPT FOOD <br />Telephone: Owner/Operator: OUTREACH MINISTRIES INTERN'L <br />Inspection Type: ROUTINE INSPECTION - Operating Permit <br />Address: 17238 N BRUELLA RD, VICTOR 95253 <br />Date: 04/23/2021Name of Facility: HIS PLACE <br />Food Program Official Inspection Report <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 />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br /> 100 <br />N/A <br />OVERALL INSPECTION NOTES AND COMMENTS <br />Mop sink -- 120.00º F Hand washing sink -- Women's restroom -- 100.00º F <br />Hand washing sink -- Men's restroom -- 100.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />Routine inspection. <br />Facility distributes donated dry food items at this time. <br />No ware-washing occurs on site. <br />All food items are stored on metal shelving inside of the "warehouse" portion of the facility. <br />Restrooms and mop sink are located adjacent to the warehouse. <br />Observed no violations at this time. <br />Official inspection report emailed. <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: <br />EH Specialist:Phone:(209) 616-3023 <br />Kathy McClelland, Site manager <br />VICTOR ACEVEDO <br />Page 1 of 1EHD 16-23 Rev. 09/16/2020 Food Program OIR <br />FA0018673 PR0527564 SC001 04/23/2021 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD
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