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°P4grN. 1 . SAN JOAQUIN COUNTY >'� A r. y ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 r Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd 'r4cpk�x FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: - 4 Date: Ll Address: I I f (A �k ly City: %Yu` Zip Code: ,3E Owner/Operators: fx r � Fu 9 Telephone: 11 r� a^d-' Program Element: I Program Record: 4 } ,$) t(j f Inspection Type: 8780 Posted Yes ❑ No Permit Posted 7(Yes No Re-Inspection on or Aker: IN=In Compliance NIC,=Not Observed N/A=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. me* for violations ose a threat to public health and must be corrected immediate) . Non-com liance may warrant closure of the food facility w rvo r'^ Demonstration of Knowledge Mar aur cos Supervision - ar 7 1. Demonstration of knowledgefood safe[/certificate 24. Person In Charge is present and performs duties MENNEw- Employee Health and Hygiene - Personal Cleanliness . Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating.tasting,drinking,or tobacco use 26. Approved thawing methods used JLd.Preventinmination by Hands -r5.!: 27. Food protected from contamination during storage ds clean and properly washed;proper glove use 8. Washing fruits and vegetables before use dwashing facilities supplied and accessible 29. Toxic substances properly identified,stored and used Time and Temperature Relationship Food Storage/Display/Serviceper hot and cold holding temperatures 0. Food storage;food storage containers labeled per use of time as a public health control 31. Customer self-service food protected individual utensils provided per cooling methods 32. Food properly labeled and honestly presented per cooking time and temperatures Equipment)Utensils/Linens per reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available re-service of returned food 5. Equipmentlutensils approved;installed;clean;good repaird free from contamination and adulteration 36. Equipment,utensils and linens:storage and use contact surface cleaned and saniffzed/warewashing procedures 37. Vending machines maintained 8. Approved and sufficient ventilation and lighting d obtained from approved source 39. Thermometers provided,accurate.and easily visible . Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths V 117, 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 9.Advisory provided for raw or undercooked food 44. Premises;personal/cleaning Items;vermin-proofing : .Susceptible Populations Permanent Food Facilities k 0. Prohibited foods not offered at high risk taoilitas 45. Floors,walls and ceiling are maintained and kept clean ter/Hot Water 46. No living or sleeping quarters inside facility 1.Hot end COM potable water available. Compliance and Enforcement Liquid Waste Disposal 7. Signs posted last inspection report available /( Sewage/wastewater properly disposed.toilet facility useable 8. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit X No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Title: - EH Specialist: Phone: P Page 1 of EHD 16-23 (1st pg) 12115109 FOOD PROGRAM OIR