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S A NJ QA U I N Environmental Health Department <br /> Imo•=' i'v COUNTY <br /> p/ Time In: 10:15 am <br /> Greo[rless grows here. <br /> Time Out: 10:35 am <br /> COMPLAINT INSPECTION REPORT <br /> Name of Facility: POPPY COFFEE Date: 10/21/2021 <br /> Address: 4343 PACIFIC AVE, STOCKTON 95207 <br /> Owner/Operator: WOODWARD, PAIGE Telephone: (209)817-6987 <br /> Program Element: 1600- FOOD PROGRAM Complaint#: C00054371 <br /> Responsible Party Contact: <br /> DESCRIPTION OF COMPLAINT ALLEGATIONS <br /> The San Joaquin County Environmental Health Department received the following complaint: <br /> EMPLOYEE CUT HER HAND ON THE SLICER. OWNER DID NOT HAVE EMPLOYEES DISCARD POTENTIALLY <br /> CONTAMINATED FOOD OR CLEAN EQUIPMENT(BLOOD WAS JUST WIPED OFF WITH A PAPER TOWEL). FACILITY <br /> ALSO LACKS THE 5 YEAR FOOD SAFETY CERTIFICATE. <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: Anjanetta Ailea Cadio Expiration Date:July 18,2022 <br /> Warewash Chlorine(Cl): 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 /> No Temperature Data Collected <br /> NOTES <br /> Spoke to manager who is aware of this incident. He stated that this happened several months ago(at the beginning of <br /> summer).The employee who had this accident wants to collect workers comp.The employee worked only for a few days and <br /> then quit. He stated that when something like this happens,they toss the food, breakdown the slicer and wash/rinse/sanitize <br /> at the ware washing sink. Food safety certificate is available. <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: Vince Zaragoza, manager <br /> EH Specialist: MARIBEL FLOHRSCHUTZ Phone: (209)616-3051 <br /> FA0025065 C00054371 SCO04 10/21/2021 <br /> EHD 16-23 Rev.01/07/2021 Page 1 of 1 Complaint Inspection Report <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 />