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SANJOAQUI Environmental Health Department <br /> ,n !�-L. x COU T Time In: 2:55 pm <br /> € Time Out: 3:30 pm <br /> c,Foa�'`r Erectness grows Frere, <br /> Food Program Service Request Inspection Report <br /> Name of Facility: POLLOS BROCCOLI Date: 04/03/2023 <br /> Address: 2201 S B ST , STOCKTON 95206 <br /> Requestor: JAIME ZAVALA MEDINA, POLLOS BROCCOLI Telephone: (209)905-4937 <br /> Program Element: 1602-FOOD CONSULTATION Request#: SR0086569 <br /> Inspection Type: 061 -CONSULTATION <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 /> #1 Demonstration of Knowledge <br /> OBSERVATIONS:A food manager's certificate was not available during the inspection. Provide a copy of the food <br /> manager's certificate to cmuro@sjgov.org within 60 days. <br /> CALCODE DESCRIPTION:All food employees shall have adequate knowledge of and be trained in food safety as it relates to their <br /> assigned duties. (113947)Food facilities that prepare,handle or serve non-prepackaged potentially hazardous food,shall have an <br /> employee who has passed an approved food safety certification examination. (113947-113947.1)Any food handler hired after June 1, <br /> 2011 shall obtain a Food Handler Card within 30 days(113948). <br /> #21 Hot and Cold Potable Water Not Available <br /> OBSERVATIONS:The maximum hot water for facility was observed at 118 F. Increase hot water heater to maintain 120 F <br /> minimum. Correct before operation. <br /> CALCODE DESCRIPTION:An adequate,protected,pressurized,potable supply of hot water and cold water shall be provided at all times. <br /> (113953(c), 114099.2(b) 114101(a), 114189, 114192, 114192.1, 114195) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Needed Expiration Date: <br /> Warewash Chlorine(Cl): 100 ppm Heat: °F Water/Hot Water Ware Sink Temp: 118°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Meat case cooler--41.00°F Mop sink-- 120.00°F <br /> NOTES <br /> No major violations. <br /> OKAY to issue permit once permit fee is paid and pink and green facility forms are submitted. <br /> PROGRAM ELEMENT: 1616 <br /> Print and maintain a copy of the most current inspection report on-site. <br /> Please note:The signature of the person receiving the inspection report was not captured. <br /> SR0086569 SC061 04/03/2023 <br /> EHD 16-23 Rev.07/05/2022 Page 1 of 2 Food Program Service Request Inspection Report <br />