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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> 7fa�p[r+85S grows here. Time In: 9:50 am <br /> Time Out: 10:50 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-VICTOR SCHOOL Date: 04/21/2022 <br /> Address: 17670 BRUELLA RD, VICTOR 95253 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <br /> Program Element: 1632-EXEMPT FOOD <br /> Inspection Type: ROUTINE INSPECTION (Chargeable) <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 /> #43 Toilet Facilites Clean/Supplied/Maintained <br /> OBSERVATIONS:The men's restroom did not have a toilet paper dispenser, observed toilet paper roll on top of hand rail. <br /> Provide toilet paper dispenser within 1 week. <br /> CALCODE DESCRIPTION:Toilet facilities shall be maintained clean, sanitary and in good repair. Toilet rooms shall be separated by a <br /> well-fitting self-closing door. Toilet tissue shall be provided in a permanently installed dispenser at each toilet. The number of toilet <br /> facilities shall be in accordance with local building and plumbing ordinances. Toilet facilities shall be provided for patrons:in <br /> establishments with more than 20,000 sq ft. establishments offering on-site liquor consumption. (114250, 114250.1, 114276) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Faith McKinnon Expiration Date:June 05,2024 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> hand sink--staff restrooms--100.00°F 1 dr Crescor warmer--cafeteria--142.00°F <br /> Norlake milk cooler--cafeteria--31.00°F 2 dr Traulsen--cafeteria--40.00°F <br /> NOTES <br /> Routine inspection. <br /> Facility serves hot and cold premade/packaged food items that are delivered by Lodi USD Central Kitchen. <br /> Lunch is provided between 11:00 AM - 12:40 PM. <br /> SYSCO Surface Clean Sanitizer RTU spray bottle is used to sanitize surfaces, it has 3010 ppm lactic acid. <br /> Discussed report with Faith McKinnon. <br /> No signature captured. <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 /> FA0006502 PR0505059 SC101 04/21/2022 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 1 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 />