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SAN J a A Q U I N Environmental Health Department <br /> COUNTY <br /> Food Program Official Inspection Report <br /> Facility Name and Address: VILLAGE COFFEE SHOP INC, 416 W LODI AVE, LODI 95240 <br /> #30 Food Storage/Display Properly Labeled <br /> OBSERVATIONS:Observed boxes of pie crust stored on the same shelf as raw meat in 2 door upright ev Air refrigerator in <br /> dry storage room. <br /> Store ready to eat food items separate from raw food items,with ready to eat foods on racks above raw food items <br /> CALCODE DESCRIPTION:Food shall be stored in approved containers and labeled as to contents. Food shall be stored at least 6" <br /> above the floor on approved shelving. (114047, 114049, 114051, 114053, 114055, 114067(h), 114069(b)) <br /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:Observed overhead pipes(near plate storage shelf near cooking area)and electrical receptor over <br /> refrigerator that have dust accumulation. <br /> Detail clean. <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: Debra Roberson Expiration Date:October 03,2024 <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 130°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 130°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door upright Blue air dry storage room--41.00°F pie case--48.00°F <br /> 2 door reach-in--under prep(cook's station)--47.00°F hand sink--restroom--109.00°F <br /> small 3 comp--120.00°F 3 comp/hand sink--130.00°F <br /> 2 door upright Blue air--kitchen--41.00°F country gravy--hot hold--170.00°F <br /> 1 door reach-in--next to griddle--41.00°F <br /> NOTES <br /> sanitizer bucket 100ppm (chlorine) <br /> Signature not captured due to COVID <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: Debra Roberson, <br /> EH Specialist: STEPHANIE RAMIREZ Phone: <br /> FA0001042 PRO160081 SCO01 05/24/2021 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />