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r MJOA(1111 Environmental Health Department <br /> COUNTY I <br /> Gf$oLn@SS 5rws hemTime In: 11.49 am <br /> Time Out: 12:18 pm <br /> Food Program Official Inspection Report <br /> Name of Facility: BAKED BY MRS K Date: 03/20/2024 <br /> Address: 864 GOTLAND CT, TRACY 95376 <br /> Owner/Operator: KOSLOSKY, JANETTE Telephone: <br /> Program Element: 1609-CLASS B COTTAGE FOOD-INDIRECT SALES <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: Expiration Date: <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 /> restroom hand sink-- 100.00°F 2 door LG refrigertor--41.00°F <br /> 2 comp sink in kichen--120.00°F <br /> NOTES <br /> Routine in-home inspection conducted this date. <br /> Updated sample label received this date(street address removed) <br /> OK to renew <br /> Permit handed to owner <br /> No signature obtained <br /> Report typed in the office 3:11 p-3:19p <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/Janette Koslosky, owne <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0022030 PR0538142 SCO01 03/20/2024 <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 />