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SAN JOAQUIN COUNT' ?� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd 4ikoa FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: _ Date: Address: •� 1 City: L2Jcu Zip Code: a S 2_,, Z Owner/Operator: Telephone: Program Element: \�-j Program Record: \b 2- Inspection Type: 8780 Posted Yes No Permit Posted Yes No Re-Inspection on or After: IN=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected onsfte 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 immediate!,. Non-compliance may warrant closure of the food!atilt n of tt, nt - f, 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Communicable disease;reporting,restrictions-&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds < , , XProper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 7. Food protected from contamination during storage Hands clean and property washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used Proper hot and 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 individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 71. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 34. 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 sanitizedlwarewashing procedures 37. Vending machines maintained Eiiiiiiiiiii if go! ` '' i=x �' _ 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 a' - .: may;fi41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse property disposed 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personai/cleaning items;vermin-proofing :.: . Prohibited foods not offered at high risk facilities _„ 5. Floors,walls and ceiling are maintained and kept clean aT9t�EY .. 6. No living or sleeping quarters inside facilely 1.Hot and cold potable water available. -. _ 7. Signs posted;last inspection report available 2. Sewage/wa 48. Compliance with plan review requirements �^" Y 9. Facility operating with a valid health permit 03. No rodents, VO. Impoundment 51. Permit Suspension Received By/1'itle: EH Specialist: - Phone: - VY©3 Page 1 of 2 EHD 1623 (161 pg) 4/9112 FOOD PROGRAM OIR