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Time In: 11:50 am <br /> Time Out: 12:28 pm <br /> o� N San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> 4GjF��ie� <br /> Food Program Official Inspection Report <br /> Name of Facility: SUSD-VALENTINE PEYTON SCHOOL Date: 10/05/2015 <br /> Address: 2525 GOLD BROOK DR, STOCKTON 95205 <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 foodborne 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 53 F and can peach with <br /> syrup 49F, at the salad bar was first taken out of refrigerator/walk-in. Provide documentation of the time when PHF is first <br /> out of temperature (between 41 F and 135F). Note: staff stated food at salad bar is open parallel to service time: 10:15am <br /> to 12:45pm. <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Tangela Shipp Expiration Date: March 04,2020 <br /> Warermash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 128°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 111 °F <br /> FOOD ITEM --LOCATION --TEMP° F --COMMENTS <br /> staff RR-- 100.00°F Prep sink#3 (by prep table)-- 119.00°F <br /> Prep sink#1 (by font countyer)-- 119.00°F corn--salad bar--53.00° F <br /> Mop-- 130.00°F Prep sink#2-- 119.00°F <br /> can peach with syrup--salad bar--49.00° F Hot dog hot hold table-- 136.00°F <br /> 3-comp-- 128.00°F 2D True rt--41.00°F <br /> Carter Hoffman-- 138.00° F 2D True left--40.00° F <br /> NOTES <br /> Sanitizer bucket 200 ppm <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: tangela shipp, LFS11 <br /> EH Specialist: JEFFREY WONG Phone: (209)468-0335 <br /> FACO20189 PR0534911 SC101 10/05/2015 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />