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SAN JOAQUIN COUN' Z' ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ;P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siclov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: h - 14 q m S Date: Address: 91460 y5D M Q 4OL0 1-i City: c I _ � Zip Code: �5 .7 5 Owner/Operator- I-u ,D Telephone: +63,6 7,7 t Program Element: .0:3Program Record: t7I l0 d`1.3 Inspection Type:2-yta f2_otXfi rLp SB180 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. Ma•or violations pose a threat to ublic health and must be corrected immediate) - Non-corn liance may warrant closure of the food facility IN wo V .. ; Demonstration of Knowledge ' ""! "taxi c+ur cos ,,.....Supervision '. ; our. t. Demonstration of knowledge;food safety certificate 24- Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination7 by Hands ry . 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 ... Time and Temperature Relationship PSrAge/Dis lYrvi �_.ood to 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 Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperaturesEquipment!Utensils/"Linens 11. Proper reheating procedures for hot holding „ 33- Nonfood contact surfaces clean _ 'Protection From Contafnination 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 sanitized/warewashing procedures 37. Vending machines maintained Foo4 From Approved Source 38. Approved and sufficient ventilation and lighting r 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths tlitT Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Prdr edures 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42- Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 19 Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing ;." Highly Susceptible Populations __ - Permanent Food Factli#ies 0. Prohibited foods not offered at high risk facilities 5. 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 anCj EA#orcement .. Liquid Waste Disposal" 47. Signs posted;last inspection report available �2. Sewage/wastewater properly disposed,toilet facility useable 48. Compliance with plan review requirements Vermtn, _ `z 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: t(� E -7- - EH Specialist: r�v� n Phone: I,� Page 1 of �1_ EHD 16-23(1st pg) 4/9/12 FOOD PROGRAM OR