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TquI <br /> - - SAN JOAQUIN COUNTY <br /> AN <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.siciov.org/ehd <br /> HOTEUMOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: 0UIDGET lAtAi A av/rES' Of MCKToIJ knspection Date: <br /> Address: 3y 13 W fj jMN11cQ LN. PIE:9*0 PR#:00003&&_ <br /> Owner/Operator: R4 e: /JOTFL/6v,0`r_r IAI;,4 & ',_vi Te�r of sjaCKl0n1 Phone: <br /> ❑ Annual Inspection Complaint Inspection ❑ Consultation Inspection ❑ Re-inspection <br /> #Units in Facility: # Units Inspected: Reinspection On or About: <br /> The items checked below are violations to be corrected. <br /> See Reverse Side of this Form for Detailed Summary of Violations and Code References. Room(s): <br /> ❑ 1 Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, <br /> garbage,combustible items or similar materials. <br /> Room Maintenance: General lack of repair or improper maintenance; Broken or non- <br /> El 2 functioning sink/toiletlbath; Lack of hot water. Floors: Not clean, properly covered or in <br /> good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture in room. <br /> ❑ 3 Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, <br /> working condition; Lack of adequate heat(Standard: 70°F at 3 feet from floor). <br /> Drinkinci Utensils& Ice Buckets: Not protected from contamination; Lack of or improper <br /> ❑ 4. washing&sanitizing after each use(multi-use); Lack of or improper protective bagging <br /> (multi-use)or individual protective wrapping(single-use). <br /> 5. Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or <br /> Elfoul matter; Unsafe; Linens not changed weekly or before new guest. <br /> ❑ 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers; Garbage receptacles unclean or in disrepair. <br /> ❑ 7 Public Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways, exits,or other <br /> publicly shared spaces. <br /> ❑ B. Pest Control: Infestation of insects,vermin or rodents. <br /> ❑ 9. Other Nuisance:Any other condition which is hazardous to health. <br /> Other Substandard or Unsafe Conditions: Electrical, structural, or.plumbing hazards; Lack <br /> ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br /> protection from weather; Inadequate sewage or water facilities, <br /> Pest control Used? Xyes ❑ No Company Name: t71CK r Q Frequency: C/C)&V HOA/r1 <br /> Hotel/Motel Business License? ❑Yes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: 20+ 3 01 2j C) 2L 3 11- <br /> Comments: 2Comments: <br /> CV1-ffLAA17- /Ig<.ElKCW (,-TjhMr 7rjer 7T)MC 19gC CI /Z-r7,- ,,Haas <br /> DAt 7W / M �6&rNKET' rrJf&'lS 7� i.o OK�O LAKE 77 /frV BFl "-1- 7, ! <br /> NDT r!fv, A- n �a? 7001' .6WKE�T.c' wlM 1=wjli= <br /> (r77Ct<1A1& 0417- <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspections the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Healtecialist: Phone: yb�'y+ �- Page 1 of 2 <br /> L� 2 / V <br /> EHD 24-01 4-30-12 HOTEL/MOTEL OIR <br /> 5 y <br />