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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> ' Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> HOTEUMOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: ,B!/O6CT /NA/ Y, VV17-ES. VF t7pe.K7014 Inspection Date: 10 12 Y113 <br /> W4 0 <br /> Address: 3 y7-3 h/ �4� thNe, �CfC PO4 PE:2Yo0 PR# <br /> •Gt�vv 9 3/419 <br /> Owner/Operator: Amer /Yom, /,46 Phone: 413.3_Lp00 11T/1 <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 /> 2' functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in V'0 <br /> good repair. Walls&Ceilings:Walls/ I nein need of cleaning or repair: Holes, water <br /> damage, peeling or deteriorating paint''f3"ampness 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 /> Drinking 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 /> foul matter; Unsafe; Linens not changed weekly or before new guest. <br /> F-1 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 /> 8. Pest Control: Infestation of insects,vermin or rodents. 6Ervw ' <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? 25,Yes [] No Company Name: O/ZCl/./ Frequency: AX A-mw <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: /0(0 /Oe //Q Z/O 3/0 (CvooRl /29, /28- - REc?7rK6&-in,003(c8-/a <br /> Comments: C011A 47' kfGE1vC-0 0.N /0/o Jot3 �r-mxao 17J,7 Acc," /ob /*V GOC.r/�ftl/J�S <br /> /ANO Wil nOvcso 7i0 Roon Io8itiv0 Ir IfiW 6e�2)Lt6v6s, c�r�P�gii��Nr <br /> OV /leo/1 //O Tl1-Cr4 2/O. 7?�CV 310 — eU IZ©O17 s /71r� 0,,dbs'. <br /> ­♦ <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspections by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: X Title: <br /> Environmental Health Specialist: Phone: (� _9 Page 1 of .Z <br /> EHD 24-01 4-30-12 HOTEL/MOTEL OR <br />