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<br /> Time Out: 12:12 pm
<br /> Food Program Official Inspection Report
<br /> Name of Facility: COLLIERVILLE COUNTRY STORE Date: 09/26/2022
<br /> Address: 3706 E COLLIER RD,ACAMPO 95220
<br /> Owner/Operator: SINGH, HARI Telephone: (209)369-6375
<br /> Program Element: 1617-RETAIL MARKET> 1000 SQ FT W/FOOD PREP
<br /> Inspection Type: INSPECTION/REINSPECTION (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 /> #27 Food Protected from Contamination
<br /> OBSERVATIONS:Observed debris on ice machine deflector plate. Clean today and maintain clean.
<br /> CALCODE DESCRIPTION:All food shall be separated and protected from contamination. (113984(a, b, c,d, t), 113986, 114060,
<br /> 114067(a, d, e,j), 114069(a,b), 114077, 114089.1 (c), 114143(c))
<br /> #32 Food Properly Labeled and Honestly Presented
<br /> OBSERVATIONS:Ice is made and bagged on site. Provide sign on ice display freezer or each individual bag that states ice
<br /> is made on site with the name and address of the facility included. Correct today and email evidence of correction to
<br /> dafonskaia@sjgov.org within 1 week.
<br /> CALCODE DESCRIPTION:Any food is misbranded if its labeling is false or misleading,if it is offered for sale under the name of another
<br /> food, or if it is an imitation of another food for which a definition and standard of identity has been established by regulation. Food facilities
<br /> with 19 or more chains in the state shall disclose nutritional information. (114087, 114089, 114089.1(a, b), 114090, 114093.1, 114094)
<br /> #35 Equipment/Utensils Approved and in Good Repair
<br /> OBSERVATIONS:Observed cardboard on shelves in 5 dr display and market walk-in cooler. Remove cardboard and
<br /> provide cleanable surface today.
<br /> The market walk-in cooler door was repaired with a wood board. Paint wood to provide cleanable surface. Correct within 2
<br /> weeks.
<br /> The deflector plate in the ice machine was damaged. Replace within 3 weeks.
<br /> CALCODE DESCRIPTION:All utensils and equipment shall be fully operative and in good repair. (114175).All utensils and equipment
<br /> shall be approved,installed properly,and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5,
<br /> 114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114172, 114177, 114180, 114182)
<br /> FA0000238 PRO161892 SC333 09/26/2022
<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
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