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Time In: 12:47 prn <br /> Time Out: 1:51 pm <br /> Pquin/ San Joaquin County <br /> �O.�.CGG <br /> a. Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq., ;a• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �rFORN <br /> Food Program Official Inspection Report <br /> Name of Facility: FAIRMONT REHABILITATION HOSPITAL Date: 07/21/2017 <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:Hot water at 2 comp/ware washing sink is at 116F. <br /> Hot water at mop sink is 115F. <br /> No water observed prep sink. <br /> Provide hot and cold water at these sinks with hot water at a minimum of 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 /> #47 Signs Posted; Last Inspection Report Available <br /> OBSERVATIONS:Most recent inspection report is not available. Maintain. <br /> CALCODE DESCRIPTION:Handwashing signs shall be posted in each toilet room, directing attention to the need to thoroughly wash <br /> hands after using the restroom(113953.5)(b)No smoking signs shall be posted in food preparation, food storage, warewashing, and <br /> utensil storage areas(113978). (c)Consumers shall be notified that clean tableware is to be used when they return to self-service areas <br /> such as salad bars and buffets. (d)Any food facility constructed before January 1, 2004, without public toilet facilities,shall prominently <br /> post a sign within the food facility in a public area stating that toilet facilities are not provided(113725.1, 114381 (e)). Proper posting of <br /> nutritional information at facilities with 20 or more chains in California(114094). <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Viola Sawyer Expiration Date:April 17,2022 <br /> Warewash Chlorine(Cl): 50 ppm Heat: °F Water/Hot Water Ware Sink Temp: °F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: °F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 2 comp/warewashing--116.00°F 6 door refrigerator--under counter--41.00°F <br /> hand sink--kitchen--107.00°F mop sink--115.00°F <br /> hand sink--restroom(L)--110.00°F hand sink--restroom(R)--111.00°F <br /> walk-in--41.00°F <br /> NOTES <br /> sanitizer spray bottle 400ppm (quat) <br /> FA0009730 PR0527300 SCO01 07/21/2017 <br /> EHD 16-23 Rev.06/30/15 Page 1 of 2 Food Program OIR <br />