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CO0055409 (2)
EnvironmentalHealth
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1600 - Food Program
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CO0055409 (2)
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Entry Properties
Last modified
1/20/2023 1:44:19 PM
Creation date
1/20/2023 1:42:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
RECORD_ID
CO0055409
PE
1600
FACILITY_ID
FA0000545
STREET_NUMBER
841
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04931058
ENTERED_DATE
12/6/2022 12:00:00 AM
SITE_LOCATION
841 E KETTLEMAN LN
RECEIVED_DATE
12/6/2022 12:00:00 AM
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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Complaint Investigation Summary Report #: 5105 <br />COMPLAINT ID: C00055409 <br /> <br />Site Location: 841 E KETTLEMAN LN <br /> <br />Received by: EE0000467 CARRUESCO <br /> Received Date: 12/6/2022 Complaint Received Via: INTERNET! EMAIL <br />Assigned To: EE0009825 AFONSKAIA <br /> Assigned Date: 12/6/2022 <br />Program/Element Code 1600- FOOD PROGRAM <br />Nature of complaint: <br />CUSTOMER ATE A BIG MAC COMBO WITH CHEESE, MAYO, LETTUCE, AND TOMATO AT FACILITY ON 12/03/22. HE FELT ILL THAT NIGHT <br />WITH SYMPTOMS OF DIARRHEA (STARTED AT 5AM ON 12/4/22) CHILLS, VOMITING, FEVER (101.3 F) AND LIGHT HEADEDNESS. HE WENT <br />TO THE ER ON 12/4/22 AND WAS ADMITTED FOR GI SEPSIS. <br />PROPERTY INFORMATION <br />Facility: FA0000545 - MCDONALDS #10555 <br />Site Location 841 E KETTLEMAN LN <br /> District <br />004 - WINN, CHARLES <br />LODI, CA 95240 <br /> Location Code 02 - LODI <br />Cross Street BUSINESS PARK <br /> APN <br />04931058 <br />Complaint Status: <br /> <br />Mon.514- <br /> <br />Date Abated: /2,-d_a Abated By: <br /> <br />Activity Summary <br />Activity Date Recorded by <br />12/06/2022 Complaint inspection. No major violations, some minor. No re-inspection Report AFONSKAIA <br />emailed to griseldab@mcdgs.org <br />5105 rpt Page 1 of 1
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