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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: 10.45 am <br /> Time Out: 11:15 am <br /> Food Program Official Inspection Report <br /> Name of Facility: LODI USD-CREEKSIDE SCHOOL Date: 04/21/2023 <br /> Address: 2515 ESTATE DR, STOCKTON 95209 <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 /> #45 Floors,Walls, Ceilings; Clean and Maintained <br /> OBSERVATIONS:Flooring in women's restroom is damaged. Repair floor so that it is smooth, cleanable and <br /> non-absorbent without tape within two weeks. (REPEAT) <br /> Heavy ice accumulation observed on the floor, ceiling, racks and pipes inside the walk-in freezer. Clean within three days. <br /> Maintain clean. (REPEAT) <br /> CALCODE DESCRIPTION:The walls/ceilings shall have durable,smooth,nonabsorbent,light-colored,and washable surfaces. All floor <br /> surfaces, other than the customer service areas, shall be approved, smooth, durable and made of nonabsorbent material that is easily <br /> cleanable.Approved base coving shall be provided in all areas,except customer service areas and where food is stored in original <br /> unopened containers. Food facilities shall be fully enclosed. All food facilities shall be kept clean and in good repair. (114143(d), <br /> 114266, 114268, 114268.1, 114271, 114272) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Barbara Thomas Expiration Date:June 05,2024 <br /> Warewash Chlorine(Cl): ppm Heat: 160°F Water/Hot Water Ware Sink Temp: 121 °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 111 °F <br /> FOOD ITEM--LOCATION--TEMP°IF--COMMENTS <br /> Two door Crescor warmer--Hood--142.00°F Prep sink--121.00°F <br /> Two door Crescor warmer--Cafeteria--146.00°F Milk box--40.00°F <br /> Walk-in cooler--41.00°F <br /> NOTES <br /> Routine chargeable inspection. No major violations. Time given for correction of minor violations. No re-inspection. <br /> Discussed inspection report with Barbara Thomas(Kitchen Lead). Official inspection report was emailed to operator. <br /> Maintain copy of inspection report on site. <br /> To minimize person-to-person contact,the signature of the person receiving the inspection report was not captured. <br /> FA0001799 PRO162094 SC101 04/21/2023 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 2 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 />