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SAN JOAQUIN COUN" <br /> ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ;4 Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.orD/ehd <br /> SCI Fd'�~ <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: � <br /> ddress: City: Zip Code: <br /> GP <br /> caner/Operator: Telephone: <br /> Program Element: fj Program ecord: Inspection Type: <br /> Bt 80 Posted eyes No Permit Poste&Yes n No Re-Inspection on or After: <br /> IN=In Compliance WO=Not Observed WA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations pow a threat to blit heaM and must be oonectsd! Non Hwy wwraat cloaure of the food <br /> Mmty <br /> 1. Demonstration of krwwfedge;food safety certificate 4. Person In Charge Is present and performs duties <br /> Communicable disease;reporting,restrictions 8 exclusions 5. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds <br /> Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used <br /> 7. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible . Toxic substances properly identified,stored,and used <br /> Proper hot and cold holding temperatures Food storage;food storage containers labeled <br /> Proper use of time as a public health control 1. Customer self-service food protected;individual utensils Provided <br /> Proper cooling methods Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food Equipment/utensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sansized/warewashing procedures 7. Vending machines maintained <br /> . Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible <br /> . Compliance with shell stock regulations;tags/display Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations <br /> dProcedu 1. Plumbing maintained;proper back flow prevention <br /> 8. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed <br /> 3. Toilet facilities clean,supplied,and maintained <br /> 8. Advisory provided for raw or undercooked food 44. Premises;personaVdeaning hems;vermin-proofing <br /> . Prohibited foods not offered at high FM facilities 45. Floors,walls and ceiling are maintained and kept dean <br /> 46. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water availab <br /> 47. Signs posted;last inspection report available '�p <br /> Sewage/wastewater properly disposed;totiet facility useable 48. Compliance with plan review requirements <br /> �.,;.,_.y„,•€ 9. Facility operating with a valid health permit <br /> . No rodents,insects,birds or animals Inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: J� <br /> ti <br /> H Specialist: Phon Page 1 of 7 <br /> EHD 16-23(1st p9) 4/9/12 L FOOD PROGRAM OIR <br />