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Environmental Health Department <br />Time In: <br />11:23 am <br />11:14 am <br />Time Out: <br />Program Element: 1632 - EXEMPT FOOD <br />Telephone: (209) 836-7400 Owner/Operator: LAMMERSVILLE UNIFIED SCHOOL DIST <br />Inspection Type: INSPECTION/REINSPECTION (Chargeable) <br />Address: 1400 S DURANT TER, MOUNTAIN HOUSE 95391 <br />Date: 10/13/2021Name of Facility: PETER HANSEN ELEMENTARY SCHOOL <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 /> #1 Demonstration of Knowledge <br />OBSERVATIONS: One person shall obtain the 5 year Food Safety Certificate within 60 days. Once obtained, e-mail or text <br />a copy to Kadeanne Linhares (klinhares@sjgov.org / 209-616-3025). <br />CALCODE DESCRIPTION: All food employees shall have adequate knowledge of and be trained in food safety as it relates to their <br />assigned duties. (113947) Food facilities that prepare, handle or serve non-prepackaged potentially hazardous food, shall have an <br />employee who has passed an approved food safety certification examination. (113947-113947.1) Any food handler hired after June 1, <br />2011 shall obtain a Food Handler Card within 30 days (113948). <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 /> 160 120 <br /> 100 <br />OVERALL INSPECTION NOTES AND COMMENTS <br />No Temperature Data Collected <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />NOTES <br />This is a re-inspection from the routine inspection conducted 9-14-21 <br />Major violation corrected <br />No signature obtained <br />Inspection report typed up at the office 3:16pm-3:20pm <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) 616-3025 <br />Discussed w/ Ana Duenas, Lead <br />KADEANNE LINHARES <br />Page 1 of 1EHD 16-23 Rev. 09/16/2020 Food Program OIR <br />FA0024795 PR0543643 SC333 10/13/2021 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD