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oB4�tPC c SAN JOAQUIN COUN& a � ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd Clad'A FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: &A,,--40. •�� Date: !_ 0 Address: / City: Zip Code: B s Owner/Operator: U_S 0 G/_ - Telephone: ? Program Element: Program Record: /�-&0 1 Inspection Type: ']Z&y IV lce- SBI80 Posted ❑Yes ❑ No Permit Posted 0 Yes ❑ No Re-Inspection on or After: l�rS• IN =In Compliance N/O=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. Major violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the rood facility w -1-1 Demonstration of Knowledge rw» our cos Supervision our 1. Demonstration of knowledge;food safely certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness 2. Communicable disease;reporting, restrictions&exclusions 25. Personal cleanliness and hair restraints 3. No discharge from eyes,nose,or mouth;no open wountls General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage V7 1 5. Hands clean and properly washed; proper glove use 28. Washing fruits and vegetables before use V1 1 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used Time and Temperature Relationship Food Storage/Display/Service 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled t/8. Proper use of time as a public health control 31. Customer self-service food protected individual utensils provided ' I #9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils I Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available V VJ 12. No re-service of returned food 35. Equipment/utensils approved;installed;dean;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 7. vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting r]E15. d obtained from approved source 39. Thermometers provided,accurate,and easily visiblepliance with shell stock regulations;tags/display 0. Proper use and storage of wiping clothspliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 1. Plumbing maintained;proper back flow prevention %ox18. 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 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 21.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 22. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health pennit 23. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Title: EH Specialist: L Phone: /�0Page 1 of EHD 16-23(1st pg /12 `f / FOOD PROGRAM OR