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COMPLAINT INSPECTION REPORT <br />11:34 am <br />10:33 am <br />Time Out: <br />Time In: <br />Environmental Health Department <br />Name of Facility: EPIC ACADEMY Date: 03/10/2023 <br />Address: 2760 PENROSE LN, LATHROP 95330 <br />Owner/Operator: BANTA UNIFIED SCHOOL DISTRICT Telephone: (209) 229-4700 <br />Program Element: 1600 - FOOD PROGRAM Complaint #: CO0055679 <br />Responsible Party Contact: <br />DESCRIPTION OF COMPLAINT ALLEGATIONS <br />The San Joaquin County Environmental Health Department received the following complaint: <br />CO0055679 states: "STUDENT BECAME ILL AFTER EATING A SUN BUTTER SANDWICH. STUDENT WENT TO ER <br />AND WAS TOLD BY ER DOCTOR THAT THEY HAVE FOOD POISONING." <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 />OVERALL INSPECTION NOTES AND COMMENTS <br />Chlorine (Cl): <br />Name on Food Safety Certificate:Expiration Date: <br />ppmQuaternary Ammonia (QA): <br />Heat:ppm º FWarewash Water/Hot Water Ware Sink Temp:º F <br />Hand Sink Temp:º F <br />OBSERVATIONS <br /> 400 <br /> 122 <br /> 100 <br />2 door Traulsen reach-in -- 37.00º F hand sinks -- 100.00º F <br />3 door Traulsen reach-in -- 37.00º F walk-in freezer -- 21.00º F <br />restroom hand sink -- 100.00º F <br />FOOD ITEM -- LOCATION -- TEMP º F -- COMMENTS <br />COMMENTS AND OBSERVATIONS <br />The Food Service Director is on site and is aware of the complaint. Per Director, no other student illnesses have been <br />reported. kitchen staff employees are not/have not been ill with similar symptoms. <br />Per Director, the pre-packaged sun butter and jelly sandwiches are received frozen, stored in the walk-in freezer and taken <br />out of the walk-in freezer to thaw in the reach-in refrigerator the day prior to service. The sandwiches are good for 10 days <br />following being thawed. The sandwiches served Wednesday, 3-8-23 are within the best-by date. <br />Upon inspection this date: hot water is available, observed proper hot and cold food holding temperatures, handwashing <br />facilities are properly supplied, observed proper hand washing, observed proper food handling, sanitizer is available and being <br />used properly. <br />wiping cloth bucket 400 ppm Quat / Quat sanitizer test strips are available <br />No signature obtained <br />Report typed in the office 3:15p-3:30p <br />Page 1 of 2EHD 16-23 Rev. 04/07/22 Complaint Inspection Report <br />FA0027308 CO0055679 SC004 03/10/2023 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd