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Time In: 10'50 am <br /> San Joaquin County Time Out: 11:40 am <br /> op4�th. <br /> 2' Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sicciov.org/ehd <br /> �IFdVt <br /> Food Program Official Inspection Report <br /> Name of Facility: SUSD-GEORGE BUSH ELEMENTARY SCHOOL Date: 10/05/2015 <br /> Address: 5420 FRED RUSSO DR, STOCKTON 95212 <br /> Owner/Operator: STOCKTON UNIFIED SCHOOL DIST Telephone: (209) 933-7050 <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 foodbome illness.All major violations must be corrected immediately. Non-compliance may warrant immediate closure of <br /> the food facility. <br /> #8 Use of Time as a Public Health Control <br /> OBSERVATIONS: No documentation of when the potentially hazardous food (PHF), including corn 67 F and pineapples <br /> 55F, at the salad bar was first taken out of refrigerator/walk-in. Provide documentation of the time when PHF is first out of <br /> temperature (between 41 F and 135F). Note: staff stated food at said bar is first placed there around 9am and ends before <br /> 1 pm. <br /> CALCODE DESCRIPTION: When time only, rather than time and temperature is used as a public health control, records and <br /> documentation must be maintained(114000) <br /> #14 Food Contact Surfaces Sanitized or Warewashing Sanitization <br /> OBSERVATIONS:2 of 3 sanitizer buckets had no sanitizer(quat). Provide at least 200 ppm quat but no more than 400 <br /> ppm. Corrected. <br /> CALCODE DESCRIPTION:All food contact surfaces of utensils and equipment shall be clean and sanitized.(113984(e), 114097, <br /> 114099.1, 114099.4, 114099.6, 114101(b-d), 114105, 114109, 114111, 114113, 114115(a, b, d), 114117, 114125(b), 114135, 114141) <br /> #4o Proper Use and Storage of Wiping Cloths <br /> OBSERVATIONS:3 wipe cloths not in sanitizer bucket at 3-comp sink. Store wipe cloth in sanitizer bucket or in laundry. <br /> Corrected. <br /> CALCODE DESCRIPTION: Wiping cloths used to wipe service counters, scales or other surfaces that may come into contact with food <br /> shall be used only once unless kept in clean water with sanitizer. (114135, 114185.1 114185.3(d-e)) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Kelli A Gomez Expiration Date:March 04,2020 <br /> Warewash Chlorine(CI): ppm Heat: °F Water/Hot Water Ware Sink Temp: 123°F <br /> Quaternary Ammonia(QA): 400 ppm Hand Sink Temp: 108°F <br /> FOOD ITEM—LOCATION—TEMP°F--COMMENTS <br /> FA0017872 PRO526416 SC701 10/05/2015 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program OR <br />