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r MJOA(1111 Environmental Health Department <br /> COUNTY I <br /> Gf$oLIS@SS 5rws hemTimeln: 9-14am <br /> Time Out: 9:32 am <br /> Food Program Official Inspection Report <br /> Name of Facility: VAN BUSKIRK COMMUNITY CENTER Date: 10/13/2021 <br /> Address: 734 HOUSTON AVE, STOCKTON 95206 <br /> Owner/Operator: CITY OF STOCKTON Telephone: <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 /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Ashneel Singh Expiration Date: May 01,2023 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): ppm Hand Sink Temp: 120°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> 1 door Atosa freezer--3.50°F 1 door Atosa--35.00°F <br /> restroom hand sinks(men and women)--63.00°F <br /> NOTES <br /> Programs: <br /> *Tuesdays: Senior congregate meals(Meals on Wheels)on Tues&Th 11-11:30am. Food comes from SJ Co. General <br /> Hospital <br /> *Wednesdays: brown bag (1st and 3rd Wednesdays of the month). <br /> *Supper Program: Food comes from Lodi USD-served at 4:30pm <br /> *Food For Youth Program-when product is available <br /> No signature obtained <br /> Inspection report typed up at the office 2:56pm-3:03pm <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: Discussed w/Ashneel Singh, Sr Rec <br /> EH Specialist: KADEANNE LINHARES Phone: (209)616-3025 <br /> FA0002599 PRO161377 SC101 10/13/2021 <br /> EHD 16-23 Rev.09/16/2020 Page 1 of 1 Food Program OR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />