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r MJOA(1111 Environmental Health Department <br /> COUNTY I <br /> Gf$oLIS@SS 5rws hemTime In: 9.55 am <br /> Time Out: 10:25 am <br /> Food Program Official Inspection Report <br /> Name of Facility: JEFFERSON ESD-JEFFERSON SCHOOL Date: 10/02/2023 <br /> Address: 7500 LINNE RD,TRACY 95376 <br /> Owner/Operator: JEFFERSON SCHOOL DIST Telephone: (209)836-3388 <br /> Program Element: 1632-EXEMPT FOOD <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 /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:The deflector plate on the interior of the ice machine has some build-up. Clean and sanitize the deflector <br /> plate by 2 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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Sabu Abraham Expiration Date:April 06,2028 <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 110°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> True milk box--37.00°F restroom hand sink--100.00°F <br /> sausage pancake--151.00°F walk-in cooler--41.00°F <br /> NOTES <br /> Food is prepped on site. <br /> Lunch is served at 11:45a& 12:35p(Tu-Fri)/ 12:12p& 12:45p(Mon) <br /> wiping cloth bucket 200ppm Cl/Cl strips are available <br /> No signature obtained <br /> Report typed 3:16p-3:23p <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: discussed w/Sabu &Priyanka, <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0003207 PRO161531 SCO01 10/02/2023 <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 />