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Environmental Health Department <br /> COuT <br /> f Grectness grows here. Time In: 11:05 am <br /> Time Out: 11:55 am <br /> Food Program Official Inspection Report <br /> Name of Facility: WINDSOR ELMHAVEN CARE CENTER Date: 01/11/2019 <br /> Address: 6940 PACIFIC AVE, STOCKTON 95207 <br /> Owner/Operator: WINDSOR HEALTHCARE LLP Telephone: (209)477-4817 <br /> Program Element: 1628-LICENSED HEALTH CARE FACILITY <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 /> #33 Nonfood Contact Surfaces Clean <br /> OBSERVATIONS:Walls have mold at ware washing area. Remove by 1 week. If necessary replace caulk/seal. <br /> CALCODE DESCRIPTION:All nonfood contact surfaces of utensils and equipment shall be clean. (114115(c)) <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:Water line under 2 comp sink(on top of base)is leaking. Repair by 2 weeks. <br /> Waste line under dish washer is leaking. Repair by 1-2 weeks. <br /> Left hand prep sink faucet is loose.Tighten by 1 week. <br /> CALCODE DESCRIPTION:The potable water supply shall be protected with a backflow or back siphonage protection device,as required <br /> by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing <br /> ordinances,shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose <br /> used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, <br /> 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Alvaro Galdamez Expiration Date:January 14,2021 <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: 128°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 108°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> beans--steam table--161.00°F walk in--41.00°F <br /> 2 door traulsen--41.00°F gravy--steam table--161.00°F <br /> tomatoes--steam table--171.00°F fish--pan--190.00°F <br /> NOTES <br /> No comment entered. <br /> FA0011262 PR0527299 SCO01 01/11/2019 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />