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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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PR0547371
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COMPLIANCE INFO_2021
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Last modified
3/7/2022 11:54:29 AM
Creation date
1/12/2022 2:05:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0547371
PE
1613
FACILITY_ID
FA0026924
FACILITY_NAME
CLUB DEMONSTRATION SERVICES INC
STREET_NUMBER
1616
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95210
CURRENT_STATUS
01
SITE_LOCATION
1616 E HAMMER LN
P_LOCATION
01
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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Environmental Health Department <br /> SAN-6-JOAQUIN <br /> �M COUNTY <br /> r'�JFOSx'tYY r Greotness grows here. <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: CLUB DEMONSTRATION SERVICES INC., 1616 E HAMMER LN , STOCKTON <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Amber R Olmos Expiration Date:January 17,2023 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 comp sink--CDS office--112.00°F 2 comp sink--CDS office--120.00°F <br /> nonadjustable hand sink--female restroom--106.00°F nonadjustable hand sink--male restroom 101.00°F <br /> hand sink- breakroom next to CDS office--100.00°F meatball--demo--119.00°F <br /> hand sink- employee restroom--100.00°F hand sink--deli--101.00°F <br /> prep sink deli--121.00°F <br /> NOTES <br /> Consultation inspection. <br /> CDS office is located next to costco breakroom. <br /> A 2 comp sink and 1 comp sink side by side are used to wash, rinse, and sanitize equipment/utensils. <br /> Quat test strips available. <br /> Demo stations are reheating food only. <br /> The deli prep sink and hand sink may be used if required for a food item. <br /> Potentially hazardous foods are kept in ice chests at each station with a thermometer inside. <br /> Sanispray bottles are available at each demo station and they are replaced every Tuesday. <br /> Sanispray bottle-200 ppm quat. <br /> Will have between 5-12 demo stations inside facility. <br /> Demo stations keep temp logs for food items. <br /> Employees undergo Pathway Food Safety I training. <br /> Discussed report with Vang Thor and Amber Olmos <br /> No signature captured. <br /> Okay to permit once permit fee is paid and pink and green forms are submitted. <br /> PE 1613,fee$350 <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: DARIA AFONSKAIA Phone: (209)616-3035 <br /> SR0084514 SC061 12/16/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 2 of 2 Food Program Service Request Inspection Report <br />
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