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SAN JOAQUIN COUN)4 Z ENVIRONMENTAL HEALTH DEPARTMENT N: < 600 East Main Street, Stockton, CA 95202-3029 �;....,. ..':a Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sioov.ora/ehd �rFOR� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: - t11- {. Date: Address: at4q✓ -�W, 1 _ w City: JyK`� Zip Code: Owner/Operator: Ill A 0 I i;/. Telephone: Program Element: if Program Rei 0 javx Inspection Type: / ,r 8780 Poste OM Yes ❑ No Permit Poste es ❑No Re4nspection on or After: 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 aces a threat to public health and must be corrected immediatel . Non-eom liana mar warrant closure of the food facility nstration of Knowled 'pw our ccs -' 'Supervision. :;:n 1. Demonstration of knowledge:food safety certificate .� 9 4. Parson In Charge is present and performs duties 'ployee Health and Hygiene ' personal Cleanliness Communicable disease; reporting,restrictions 8 exclusions 5. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds _ General Food Safety Requirements ILLAW Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used ;Preventing Contarr l y Hands 27. Food protected from contamination during storage Hends clean and properly washed:proper glove use 28. Washing fruits and vegetables before use Hantlwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used rme and Temperature Relationship Food Storegel isplay/Service Proper hot antl cold holding temperatures 30, Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer self-service food protected;indivitlual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils/Urns 0 012. No er reheating procedures for hot holding 33. Nonfood contact surfaces clean taction From Contamination 34. Warewashing facilities maintained;test strips available e-service of returned food 35. Equipment/utensils approved;installed;clean;good repair Am13. Food free from contamination and adulteration I 1 1 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized,'warewashing procedures7. Vending machines maintained ThId From Approved Source m" " 4 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 17. Compliance with Gulf oyster regulations Physical Facilities IIIIIIIIIIIIii0ince With Approved Procedures 41. Plumbing maintained:proper back flow prevention 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed -timer Advisory 43. Toilet facilities clean,supplied,and maintained 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items:vermin-proofing ' ible Populations Permanent Food Facilities - . Prohibited foods not offered at high risk facilities 45- Floors,walls and telling are maintained and kept clean of Water 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement lad Waste Disposal P 7. Signs posted;last inspection report available . Sewage/wastewater properly disposed;toiletfacility useable 48. Compliance with plan review requirements 49. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility50. Impoundmem 1. Permit Suspension Received By/Titl EN Specialist: Phone: L !/ U Page 1 of EHD 16-23 itst Pi 12/S(09 d FOOD PROGRAM OIR