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oaQul SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT I Name of Facility: Date:ff i Address- City: Yct zip Code: 3L� 3 y 1 z c� . /T OwnerlOperator: cc Ven Telephone: S g c� 7U I p P P n 0 � r. . 0 Program Element: Program Record: G Inspection Type: )Q-1U4 ;n e i SBI80 Posted es o Permit Posted VYes ❑ No Re-Inspection on or After: I IN=In Compliance N10=Not Observed NIA=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 public health and must be corrected immediate) . Non-compliance may warrant closure of the food facility tr�rL I Qemonstrat o ofSiCnow[edgem ' ma o cos i ` _ _ Supervision., our, 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties _ Employee Healthiand Hygiene „. w `_ _•., ;,��.' Per aC ai"Cleanliness 2. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints �3. No discharge from eyes,nose,or mouth;no open wounds r ....•, General Food$aTety,Requirements i Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used 7. -` Preventing Conta ina ion b Hands .�• :,�. . �� 27. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used �"� �` aTime;andg7emperatu_re Relationshipx Food.,5toragelDispfaylService Proper hot and cold holding temperatures. 30. Food storage;food storage containers labeled 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 14 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures ,�. - •- Equipment•1'U ensils hLi ens° 11, Properreheating procedures for hot holding 33. Nonfood contact surfaces clean � i +: rotect on From Contaminatinn3 � 34. Warewashing facilities maintained;test strips available - } 12. No re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use i 14f=ood contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained FoodFrom P' ro' e'd'Sourcea 'i r 38. Approved and sufficient ventilation and lighting M0 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 s Ph-vs'cal CaacilrtlesT _ ! _ Confoa ce,W,i h Approved Pracedurest' - 1. Plumbing maintained;proper back flow prevention 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed { s. ConsumeraAdvisory' ...; ' 3. Toilet facilities clean,supplied,and maintained r 19. Advisory provided for raw or undercooked food 113F 1 44. Premises;personal/cleaning items;vermin-proofing Highly�,Suscepti le Popu� I�ati„ons.. •,, ��.�,::-: �-_ Pe.mane Food Faci "tie5� � 1 yf-o. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean - _ ater'1 Hat Water' . � 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Comp lana antl Enforcement - Liquitl9 aste D'spasala, _ _-_ 7. Signs posted;last inspection report available 2. Sewagelwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment t 51. Permit Suspension Received By/Title: - EH Specialist: - - P one: Page 1 of EHD 16-23(1st pg) 419112 - FOOD PROGRAM OR