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`'.. ll � � �A�] I N Environmental Health Department <br /> `- Irl +lJ <br /> L.. v•:v COUNTY <br /> .r{ � 7fa�p[r+85S grows hire, Time In: 10.54 am <br /> Time Out: 11:50 am <br /> Food Program Official Inspection Report <br /> Name of Facility: SUSD-WILHELMINA HENRY ELEMENTARY Date: 04/07/2021 <br /> Address: 1107S WAGNER , STOCKTON 95215 <br /> Owner/Operator: STOCKTON UNIFIED SCHOOL DIST Telephone: (209)933-7110 <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: Edward Orozco Expiration Date: May 06,2021 <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 300 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> Hand washing sink--Restroom--100.00°F Norlake milk cooler#2--Cafeteria--40.00°F <br /> Norlake milk cooler#1 --Cafeteria--39.00°F Beverage air milk cooler--Cafeteria--40.00°F <br /> Walk-in cooler--41.00°F <br /> NOTES <br /> Spring routine inspection. <br /> Facility is currently providing meals for families every Wednesday from 10:30am- 12:30pm. <br /> -The food items are ordered through Goldstar food distribution and Daylight produce. They are brought Tuesday morning, in <br /> which the staff on site prepackage all items and place them in freezers and coolers until distribution the following day. <br /> -The facility distributes shelf-stable,frozen, refrigerated foods and milk to the families of the students in a drive-thru fashion. <br /> -No ware-washing occurs on site, all utensils given are disposable. <br /> Observed no violations at this time. <br /> Official inspection report emailed. <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: B. Mano, Kitchen manager <br /> EH Specialist: VICTOR ACEVEDO Phone: (209)616-3023 <br /> FA0018000 PR0526593 SC101 04/07/2021 <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 />