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r MJOA(1111 Environmental Health Department <br /> COUNTY I <br /> Gf$oLIS@SS 5rws hemTime In: 10.57 am <br /> Time Out: 11:23 am <br /> Food Program Official Inspection Report <br /> Name of Facility: KIPP STOCKTON MIDDLE SCHOOL Date: 03/24/2023 <br /> Address: 742 DALLAS AVE, STOCKTON 95206 <br /> Owner/Operator: KIPP STOCKTON MIDDLE SCHOOL Telephone: <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Veronica Goodman Bustle Expiration Date:April 21,2027 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> bean&cheese burrito at hot hold-- 141.00°F restroom hand sink--100.00°F <br /> 2 door Hoshizaki--36.00°F french bread pizza at hot hold--136.00°F <br /> mop sink--120.00°F <br /> NOTES <br /> Lunch service times: 10:41a (1st)/ 11:54a (2nd) <br /> Food is delivered daily(8-9a)for Better 4 You Meals <br /> All food is pre-portioned and pre-packaged (no scooping/no warewashing) <br /> Phase III due to begin early June(ensure the Health Dept has received and approved plans for the project) <br /> No signature obtained <br /> Report typed 3:40p-3:48p <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/Jessica&Veronica, <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0026857 PR0547287 SCO01 03/24/2023 <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 />