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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: 9:40 am <br /> Time Out: 10:22 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-ANSEL ADAMS ELEMENTARY Date: 04/20/2022 <br /> Address: 9275 GLACIER POINT DR, STOCKTON 95212 <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 staff restroom toilet paper dispenser was empty, observed toilet paper roll on top of hand rail. <br /> Provide toilet paper in dispenser today. <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 /> #45 Floors,Walls, Ceilings; Clean and Maintained <br /> OBSERVATIONS:Observed peeling coving on left and back side of staff restroom. Repair/replace coving within 1 month. <br /> CALCODE DESCRIPTION: The walls/ceilings shall have durable,smooth,nonabsorbent,light-colored,and washable surfaces. All floor <br /> surfaces, other than the customer service areas, shall be approved, smooth, durable and made of nonabsorbent material that is easily <br /> cleanable.Approved base coving shall be provided in all areas,except customer service areas and where food is stored in original <br /> unopened containers. Food facilities shall be fully enclosed. All food facilities shall be kept clean and in good repair. (114143(d), <br /> 114266, 114268, 114268.1, 114271, 114272) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Leanna Nava Expiration Date:July 19,2023 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 126°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Beverage Air milk cooler#1 --cafeteria--41.00°F 2 dr Metro C200 warmer--kitchen--147.00°F <br /> 2 dr Crescor warmer--cafeteria--185.00°F Beverage Air milk cooler#2--cafeteria--38.00°F <br /> hand sink- staff restroom--108.00°F walk-in--36.00°F <br /> prep sink 127.00°F <br /> NOTES <br /> FA0015582 PR0523085 SC101 04/20/2022 <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 />