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SAN JOAQUIN COUNTY �.••.�••.oma I 'i ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 �4•. :P Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd ✓ikon i FOOD PROGRAM OFFICIAL INSPECTION REPORT ' Name of Facility: 0 Date: Address: City: �a Zip Code: Owner/Operator: N , - O Telephone: P3 9 870 Program Element: . Program R card: 0 3s Inspection Type: ` B180 Posted es �No erm't ted �1(es 0 No Re-Inspection on or After: IN=In Compliance NIO=Not Observed NIA=Not Applicable COS=Corrected on-site MA,i=Major Violation OUT=Not in Compliance See reverse side for code sections and;general requirements that correspond to each violation listed below. Major violations ose a threat to public health acid must be corrected immediate! . Non-compliance may warrant closure of the food facility N wa,r�ra ^N peinunstra�ign-af KrioHYlecige k nta �ovr•cos• - --- -5upervrsron _ 1. Demonstration of knowledge;food safety certificate I 24. Person In Charge is present and performs duties .. - Employi ee Hea[tfi aittl i9ygiene _. _ sem r. erso, a[Cleatilirtes"s: � _. - - - 1 Communicable disease;reporting,restrictions&exclusions I 25. Personal cleanliness and hair restraints I. No discharge from eyes,nose,or mouth;no open wounds _ ,General IF Rt f - Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used I _,..Y-�.r�-,-rte _ _ Preventing G6ntaminatiort-by--Watids. k 27. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashin facilities supplied and accessible ! 29. Toxic substances properly identified,stared,and used 's 9 Pp p p y Time and TeM09.ature..Relationshi P. P= a,_ s: __ kFond 5torag_plDisplaylService_ 7. Proper hot and cold holding temperatures K 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 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures1quipment.Y Ute_ns_ils flLini_ns_ 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean _ Pedticti_dn FromC_o_ntamination 34. Warewashing facilities maintained;test strips available _-. it 1_ 12. No re-service of returned food 4 35. Equipment utensils approved;installed;dean;good repair J13. 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 Food From Approved.Sour eY� - 38. Approved and sufficient ventilation and lighting µI15. Food obtained from approved source A 1=,` 39. Thermometers provided,accurate,and easily visible I 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations �PJ1yslc$f FaGifities 'ConformanCe:With.Af3 rOe#:PtOC2dl�res: -� 1. Plumbing maintained;proper back flow prevention 18. Compliance with�HACCP plan or variance conditions 42. Garbage and refuse properly disposed sC4nsUinar�Advlsory' 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food ) 4. Premises;personallGeaning items;vermin-proofing _ `hligniy.:Susceptible°Pcplations. _ _ 'Permaneri od.Facilities 0. Prohibited foods not offered at high risk facilities ; 5. Floors,walls and ceiling are maintained and kept clean :Water'/udimater. 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. iarece,;and'E_n_forcerrtent T_ ____ Liquii'WastelDisposal_ 7;Signs posted;last inspection report available �~ a2. Sewagelwastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone(- Page 1 of I EHD 16-23 (1st pg) 12115/09 FOOD PROGRAM OIR - I