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i ,71e,d O A Q U I iII4,f1, Environmental Health Department <br /> —IhCOU NTS <br /> Food Program Official Inspection Report <br /> Facility Name and Address: LARCH CLOVER CENTER, 11157 W LARCH RD,TRACY 95376 <br /> 1 door True- 41.00°F 2 door Maytag--44.00°F--unopened cheese <br /> 2 door True- 27.00°F <br /> NOTES <br /> Currently: Brown Bag only(1st and 3rd Wed of the month 11a-2p) <br /> No hot food/no communal dining: may be resumed mid-July(when resumed, one person shall obtain the 5 year Food Safety <br /> Certificate, also called the 5 year Food Manager). <br /> No signature obtained/COVID-19 <br /> Report typed up at the office 2:57pm-3:07pm <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/Ron Munoz, CSS Direc <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0003115 PRO163211 SCO01 06/02/2021 <br /> EHD 16-23 Rev.09/16/2020 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.sjgov.org/EHD <br />