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,�Pa !Ma• A� SAN JOAQUIN COON- I..., a ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.orD/ehd 4r Foa FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ktw�4 OF co Date: T1-'Wt Address: 7�, L� 11 City: - Zip Code: 6-1 Z '1 Fe Owner/Operator: I�ni �N L� .�. Telephone: Program Elemen b -f Program Reeord. 6 Inspection Type: Yi 8180 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 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 ublic health and must be corrected immediately. Non-compliance may warrant closure of the food facilit JProper Demonstration of Knowledge aea.a oar ms SupervisionDemonstration of knowledge;food safety certificate 24. Person In Charge is prosent and performs duties d Hygiene Personal Cleanliness Communicable disease;reporting,fastnetions&exclusions 25. Personal cleanliness and hair restraints _No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements eating,tasting,drinking,or tobacco use 26. Approved thawing methods used urination by Hands - 27. Food protected from contamination during storage Hands clean and properly washed:proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used lmnns�ionship •Storage/D_ 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 property labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils/Linens 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair 1.13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sani fed/warewashing procedures ELL 37. Vending machines maintained Food From ApprovedSource 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 116_ Compliance with shell stock regulations.tags'display 40. Proper use and storage of wiping cloths f 7. Compliance with tfat tvurunocicooked gulations Physical Facilities ConforApproved Procedures 41. Plumbing maintained;proper back flow prevention 18. Compliance with r variance conditions 42. Garbage and refuse properly disposed isory43. Toilet facilities clean,supplied,and maintained 19. Advisory provWefood 44. Premises;personal/cleaning items;vermin-proofing 'hly 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 1.Hot and cold potable water available. Compliance; Ext agement "- sI Liquid Waste Disposal 47. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed,toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 23. No rodents.insects.birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: _ f Page 1 of 1Z EHD16-23 (tsti 4/8/12 U FOOD PROGRAM OIR