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zoPa :n1•�eG SAN JOAQUIN COUNTY <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.siaov org/ehd <br /> 'rU'ab'R� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Cers Date: ,2. 13 <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: \ �p'Z Program Record: S\q' O 3 Inspection Type: <br /> 6180 Posted 0 Yes 0 No Permit Posted 0 Yes 0 No Re-Inspection on or After: <br /> IN=In Compliance N/0=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Maier violations ose a threat to public health and must be corrected immediately. Non-cora liana ma warrant closure of the food facilifir <br /> rDemonstration of Know <br /> u <br /> 1. Demonstration of knowledge:food safety certificate K 4. Person In Charge is present and performs duties <br /> Employee Healt <br /> =No <br /> le disease;reporting,restrictions&exclusions 5. Personal cleanliness and hair restraints <br /> from eyes,nose,or mouth;no open woundsg,tasting,drinking,or tobacco use 6. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> t s <br /> 7. <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> 4. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> p 8. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations 1=01 <br /> e--With Ap oved P 41. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> sumerAdvisory 43. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 44. Premises;personaVcleaning items;vermin-proofing <br /> Highly Susceptible Populations' <br /> 0. Prohibited foods not offered at high risk facilities 4 5. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water ,'4 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. <br /> '- <br /> * Z Signs posted;last inspection report availableiaid Waste <br /> . Sewagehvastewater properly disposed;toilet facility useable 4& Compliance with plan review requirements <br /> Vermin- 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: -- Phone: 'Ab'3-0330 <br /> Pagel of 2 <br /> FOOD PROGRAM OREHD 16-23 list pg) 4/9/12 <br />