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SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 468-0333 Web: http://www.socehd.com/index.html <br /> CONTINUATION FORM Page: 2 of 3 <br /> OFFICIAL INSPECTION REPORT Date: 06/10/2014 <br /> Facility Address: 3473 W Hammer Lane, Stockton Program: 2400 <br /> SUMMARY OF VIOLATIONS <br /> During the site inspections conducted on 12/26/2013 and 02/26/2014, owner/operator indicated that the <br /> rooms would remain out-of service until new mattresses are delivered. Pest control receipt for the <br /> 02/06/2014 service did not show affected rooms have been treated/serviced for bed bugs. Owner/ <br /> operator indicated that they would call for service once the mattresses are in. <br /> During a phone conversation on 04/02/2014, owner/operator indicated that they have ordered the <br /> mattresses and would pick it up that following weekend. On 05/15/2014, contaminated mattresses have <br /> been removed and replaced, according to the owner/operator. Also, the rooms have already been <br /> treated for bed bugs, according to the owner/operator. <br /> Following several phone calls to follow up on the documentation (disposal receipts, new mattresses, <br /> and pest control for bed bug treatment receipts) of the corrections made to address the issues, another <br /> site inspection was conducted on 06/10/2014. The following observations are noted: <br /> Room # 108 — Beds in room are made and ready for occupancy. The provided mattresses did not <br /> appear to be "new". There are black unknown marks on the mattresses but do not resemble as blood/ <br /> fecal stain from bed bugs. There are no live or dead bed bugs observed on the carpet. However, there <br /> are dirt/dust and food debris accumulating by the baseboards, especially behind the furniture and refri- <br /> gerator. There are 2 live roaches observed crawling out of the nightstand drawer. Also note that the <br /> drawer is missing one side. The wall next to the bed and nightstand is dirty with unknown staining. The <br /> box spring (next to bathroom) is observed to have black spots from what appear to be fecal/blood stains <br /> from bed bugs. However, no live or dead bed bugs observed at this time. <br /> Room # 110 — Guest(s) just checked out, according to owner/operator. One dead bug and dead roach <br /> observed under the desk and on carpet by the a/c unit. The wall next to the bed is dirty. One dead bed <br /> bug that had already dried up found on the mattress next to the window. The box spring next to the <br /> bathroom is dirty/soiled. <br /> ALL EHD AFF TIME ASSOCIATED WITH THIS CASE IS BILLED AT THE CURRENT HOURLY RATE($125.00. <br /> THIS FACILITY SU JECT TO REINSPECTION AT ANY TIME AT END'S CURRENT HOURLY RATE. <br /> EHD Inspector: Tf Received By: Title: <br /> CONTINUATION FORM <br />