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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> .r{ � 7fa�p[r+85S grows here. Time In: 11.00 am <br /> Time Out: 11:30 am <br /> Food Program Official Inspection Report <br /> Name of Facility: BLESSED GLUTENLESS BAKERY Date: 12/07/2022 <br /> Address: 14811 MANZANITA WAY, LOCKEFORD 95237 <br /> Owner/Operator: FUTCH, MICHELLE S 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 /> #34 Warewashing Facilites Maintained <br /> OBSERVATIONS:Lacking chlorine and thermolabel test strips. Provide sanitizer test strips within 1 week. <br /> CALCODE DESCRIPTION:Food facilities that prepare food shall be equipped with warewashing facilities. Testing equipment and <br /> materials shall be provided to measure the applicable sanitization method. (I14067(f,g), 114099, 114099.3, 114099.5, 114101(a), <br /> 114101.1, 114101.2, 114103, 114107, 114125) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 128°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 128°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 comp sink--kitchen--128.00°F 1 D Premium Levella display--33.00°F <br /> hand sink--restroom--122.00°F <br /> NOTES <br /> Routine inspection. <br /> Sanitizer spray bottle-200 ppm chlorine. <br /> The 2 comp sink in the kitchen is also used as a hand sink. <br /> Facility has a Kichenaid dishwasher with a high heat option. <br /> Picture was emailed after inspection showing that the thermolabel test strip registered 160 F on the surface of the utensil. <br /> Discussed report with Michelle Futch, Operator. <br /> No signature captured. <br /> Maintain a copy of this report on site when operating. <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 /> FA0027457 PR0548117 SCO01 12/07/2022 <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 />