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r MJOA(1111 Environmental Health Department <br /> COUNTY I <br /> Gf$oLIS@SS 5rws hemTime In: 11.50 am <br /> Time Out: 12:19 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: PAN-A-CUP KITCHEN USA Date: 08/29/2022 <br /> Address: 1394 YORKSHIRE LOOP , TRACY 95376 <br /> Owner/Operator: FOX, PAMELA Telephone: <br /> Program Element: 1609-CLASS B COTTAGE FOOD-INDIRECT SALES <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 /> #1 Demonstration of Knowledge <br /> OBSERVATIONS:Provide a copy of your baker's 3 year Food Handler Card within 30 days. <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 /> #30 Food Storage/Display Properly Labeled <br /> OBSERVATIONS:Change the sub-ingredients for vegetable shortening on your labels(the sub-ingredients listed are for <br /> regular shortening). <br /> CALCODE DESCRIPTION:Food shall be stored in approved containers and labeled as to contents. Food shall be stored at least 6" <br /> above the floor on approved shelving. (114047, 114049, 114051, 114053, 114055, 114067(h), 114069(b)) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 104°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 door Samsung--41.00°F <br /> NOTES <br /> In home inspection for Class B CFO <br /> No signature obtained <br /> Inspection report typed in the office 3:25p-3:32p <br /> FA0027302 PR0547894 SCO01 08/29/2022 <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 />