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Time In: 12-52 pm <br /> Time Out: 1:38 pm <br /> �P.Q•u�I!. P San Joaquin County <br /> y� Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �..• �P Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> '9Gl P Oftt� <br /> Food Program Official Inspection Report <br /> Name of Facility: FAIRMONT REHABILITATION HOSPITAL Date: 03/21/2016 <br /> Address: 950 S FAIRMONT AVE, LODI 95240 <br /> Owner/Operator: LODI SKILLED NURSING SVC Telephone: (209)368-0693 <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 /> #21 Hot and Cold Potable Water Not Available <br /> OBSERVATIONS:Mop sink is at 114F. <br /> 2 comp is at 113F. <br /> Provide hot and cold water at these sinks with hot water at a minimum of 120F. <br /> Ok, corrected on site sinks are now at 120F. <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: Maria Shell Expiration Date:September 15,2020 <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 110°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> mopsink- 114.00°F hand sink--restroom--110.00°F <br /> walk-in--41.00°F 2 comp--113.00°F <br /> 6 door reach-in--41.00°F hand sink--101.00°F <br /> NOTES <br /> No food prep at the time of inspection. <br /> Most recent inspection report is kept in the Administrator's office. <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: MARIA SHELL, CERTIFIED DIETAR <br /> EH Specialist: STEPHANIE RAMIREZ Phone: (209)468-9851 <br /> FA0009730 PRO527300 SCO01 03/21/2016 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 1 Food Program OIR <br />