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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 hire, Time In: 11.06 am <br /> Time Out: 11:36 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-VICTOR SCHOOL Date: 03/30/2023 <br /> Address: 17670 BRUELLA RD, VICTOR 95253 <br /> Owner/Operator: LODI UNIFIED SCHOOL DISTRICT Telephone: (209)331-7000 <br /> Program Element: 1632-EXEMPT FOOD <br /> Inspection Type: ROUTINE INSPECTION (Chargeable) <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: Sherene Villanueva Expiration Date:June 26,2026 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 D Crescor warmer--cafeteria--173.00°F 3 D Traulsen--cafeteria--41.00°F <br /> Norlake milk cooler--cafeteria--44.00°F hand sinks--M&W staff restrooms--100.00°F <br /> NOTES <br /> Routine inspection. <br /> Breakfast is served at 7:35 AM and lunch is served from 11:05-11:55 AM. Facility also has a bridge program that serves <br /> snacks and supper. <br /> Facility gets 2 deliveries from Lodi USD Central Kitchen per day the first is around 10:45 AM and it includes the lunch for the <br /> day and the breakfast for the next day.The second delivery is around 12:45 PM and it includes the snacks and supper for the <br /> day. <br /> The food items delivered at premade/packaged and are kept warm/cool as necessary until served. <br /> SYSCO Surface Clean Sanitizer TRU premixed spray bottle is used to sanitize surfaces. <br /> No warewashing is done on site, utensils are disposable trays are sent back to Lodi USD Central kitchen for warewashing. <br /> Discussed report with Emiley Cunha. <br /> No signature captured. <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 /> FA0006502 PR0505059 SC101 03/30/2023 <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 />