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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> Vrept�+fSS grows here. Timeln: 1110am <br /> Time Out: 11:50 am <br /> Food Program Official Inspection Report <br /> Name of Facility: CRUMBL COOKIE Date: 10/28/2021 <br /> Address: 864 W BENJAMIN HOLT DR, STOCKTON 95207 <br /> Owner/Operator: BERTILACCHI, KATHERINE Telephone: <br /> Program Element: 1614-FOOD EST>1001 SQ FT W/O SEATING <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 /> #29 Toxic Substances Properly Identified/Stored/Used <br /> OBSERVATIONS:Spray bottle is not labeled. They shall be labeled by 2 days. <br /> CALCODE DESCRIPTION:All poisonous substances, detergents, bleaches, and cleaning compounds shall be stored separate from food, <br /> utensils,packing material and food-contact surfaces. (114254, 114254.1, 114254.2) <br /> #44 Premises: Clean/Litter Free;Vermin-Proof <br /> OBSERVATIONS:Saw a fly strip at food prep area. Remove and install proper fly control device on wall. <br /> Personal items lack proper storage area. Provide designated area that will be used only for employee personal belongings. <br /> CALCODE DESCRIPTION:The premises of each food facility shall be kept clean and free of litter and rubbish all clean and soiled linen <br /> shall be properly stored non-food items shall be stored and displayed separate from food and food-contact surfaces the facility shall be <br /> kept vermin proof. (114067 6), 114123, 114143(a)&(b), 114256, 114256.1, 114256.2, 114256.4, 114257, 114257.1, 114259, 114259.2, <br /> 114259.3, 114279, 114281, 114282) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Katherine Bertilacchi Expiration Date:August 16,2026 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 122°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 120°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door atosa center area-right--40.00°F 2 door atosa center area-left--41.00°F <br /> 2 door atosa--prep area-right--41.00°F 3 door cooler--prep area--40.00°F <br /> 2 door atosa--prep area-left--41.00°F 1 door atosa--prep area--41.00°F <br /> 2 door atosa--back area-left--41.00°F 2 door atosa--back-right--41.00°F <br /> NOTES <br /> No comment entered. <br /> FA0026757 PR0547158 SCO01 10/28/2021 <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 />