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f "'" SAN JOAQUIN COUNTY r—cFr- :y ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-6232 l Telephone:(209) 468-3420 Fax. (209) 464-0138 Web:www.s' oct v.org/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: '6j)D(o cI'U17IFS OF Inspection Date: Address: 3W� 3 W HemNlcw i-Al., V-106,K)-vn/ PE: 2yov j PR#:&0003&s 22 Owner/Operator: AM /XVFL /wC Phone: ❑ Annual Inspection Wcomplaint Inspection ❑ Consultation Inspection ❑ Re-inspection # Units in Facility: #Units Inspected: Reinspection On or About: The items checked below are violations to be corrected. See Reverse Side of this Form for Detailed Summary of Violations and Code References. Room(s): ❑ 1. Room Cleanliness: Lack of cleanliness&sanitation; Accumulation of debris,trash, garbage,combustible items or similar materials. Room Maintenance; General lack of repair or improp nce; Broken or non- e' 2 functioning sink/toilet/bath; Lack of hot water. Floorsproperly covered or in 11Zgood repair.Walls&Ceilings:Walls/ceilings in need or repair: Holes,water damage, peeling or deteriorating paint; Dampness or excessive moisture in room. ' 3 Heatin : Lack of approved heating in each unit; Approved heater not maintained in a safe, El3. condition; Lack of adequate heat(Standard:707 at 3 feet from floor). Drinking Utensils&Ice Buckets: Not protected from contamination; Lack of or improper ❑ 4. washing&sanitizing after each use(multi-use); Lack of or improper protective bagging (multi-use)or individual protective wrapping(single-use). ❑ 5 Bedding: Maftress/linens infested with lice, bedbugs, or other insects; Not free from filth or foul matter; Unsafe; Linens not changed weekly or before new guest. ❑ & Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate close fitting covers; Garbage receptacles unclean or in disrepair. ❑ 7. Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits, or other publicly shared spaces. ❑ a. Pest Control: Infestation of insects,vermin or rodents. ❑ 9. Other Nuisance:Any other condition which is hazardous to health. Other Substandard or Unsafe Conditions: Electrical,structural, or plumbing hazards; Lack i ❑ lo. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather; Inadequate sewage or water facilities. Pest control Used? DKYes ❑ No Company Name: O/ZJCIh! Frequency: ONcif fr HO,4j Hotel/Motel Business License? ❑Yes ❑ No Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑County Code EnforcementlFire❑ Other Rooms inspected: 20y Comments: 004111 w Xcel vao 0/1 001� 13 v'T�9>�J 77&,,P--T Ccs "A-C- PP � 6�t� oo/LN,A16, cov&RCS Ivlr# 4r52 Qv6 x lrp r. y Otvlt! /eM70k P"V14?LSo W17W fffi MIO 170HC.X (avipe' Mfl f2C`✓WVn'O 45VO 6e-r1—ht/1, f, Pr 1 Gv 61)G..!' • R 6010e /m/1- PitaPeS Y' Orh rvcrc.f' kirh�1191,Mx & TrN9Nxj'- All violations in rooms not inspected must also be corrected. All re-ins ections by the Environmental Health Department will be billed at the current hourly rate. I Received By: Title: F Environmental Health Specialist: Phone: 1{�$ _qjly;�_ Page 1 of 2- EHD 24-01 4-30-12 HOTEL;MOTEL OR f