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,aP` •rA� SAN JOAQUIN COUN* ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: C r S \' Date: Address: 6.0 W GL Ov r w.a City: S�( -n Zip Code: aJ� Owner/Operator: C�Dafw wo-t : Ll' Telephone: Program Element: cj Program cord: \2. Inspection Type: 8180 Posted Yes a No Permit Posted es ❑ No Re-Inspection on or After: wa IL IN=In Compliance N/O=Not Observed WA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance See reverse side for code sections and general requirements that correspond to each violation listed below. Major violations pose a threat to publie health and must be corrected immediately. Non-compliance may warrant closure of the food facilit IN Nro wa Demo7drinkeng, �, our cos .Supervision 1. Demonstration of knood safety certificate 24. Person In Charge is present and performs duties plth and Hygiene Personal Cleanliness Communicable diseag,restrictions&exclusions 25. Personal cleanliness and hair restraints 3. No discharge from eyr mouth;no open wounds Food Safety Requirements t_.._.. . ... Preeor eating,tastingor tobacco use 26. Approved thawing methods used s., .....:;. Preventing Contamination by Handsr '! 7. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used ...;,.TimeandT ..r ny,idp(ahonship..... ' Food Storage/Display/Service 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled B. Proper use of time as a public health control 31. Customer self-service food protected.individual utensils provided P. Proper cooling methods 32. Food properly labeled and honestly presented 19. Proper cooking time and temperatures " Equipment/.Utensils I Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 4. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths v. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities _FT0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 6. No living or sleeping quarters inside facility 21. Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 4T Signs pasted:last inspection report available yI i22 Sewage/wastewater properly disposed:toilet facility useable 48. Compliance with plan review requirements Vermin r 9. Facility operating with a valid health permit 23. No rodents, insects,birds or animalsity0. Impoundment 1. Permit Suspension Received Byfritle: 'W EH Specialist: Phone: a0 n1 -4-G fX10 b Page 1 oft El 11-23 tsi 1,911213 " FOOD PROGRAM OIR