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SAN JOAQUIN COUNT (4NVIRONMENT `z :X AL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sigov.ongIehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: kvn -e,,A_ r Date: f za/ Address: 2 r /) �� City- Zip Code: ` Owner/Operator: 1 C Telephone: Program Element• Z- Program Record: Inspection Type; r. 8160 Posted Yes No Permit Posted C 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. Major violations gose a threat toublic health and must be corrected immediate) . Non-corn liance mqX warrant closure of the food facilitv r;:g�. _ �1$�{ tf� A� iy� '�g's:N- •,:^:s,.:., �.c�r»�r�'t7r.I "'7wh`,'sr.8 »»» a,c-b.s, � ,. r.� 7, Demonstration of knowledge,food safety certificate 24. Person In Charge is present and performs duties dyg.�n> .K ertafaat C1ea�frr� r" Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints '= No discharge from eyes,nose,or mouth;no open wounds Tom. Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 13taTnM ,a 7. 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 Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of fime 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 temperatures I R 9 T..P + y. l 17. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean _ m m _ 34. warewashing facilities maintained;test strips available 2- 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 H19114. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained _ a � � 38. Approved and sufficient ventilation and lighting 39. The provided,accurate,and easily visible ; _15, Food obtained from approved source A. 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations rsgance]Nrttt __.rte• ntained;proper back flow prevention 1. Plumbing mai 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food o- 4. Premises;personal/cleaning items;vermin-proofing m � ` Wi1f;eibfe _ 1`+ei_mann�'t �# KAO. Prohibited foods not offered at high risk facilities h & Floors,walls and ceiling are maintained and kept clean r. mgm _ � r; ober 6. No living or sleeping quarters inside facility -.. _ 1,Hot and cold potable water available. t GE ap .. s_. tt3Ns i P 7. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements �llerrttri; _" 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility so. impoundment 51. Permit Suspension Received BylTitle: �� EH Specialist: Phone: Page t of EHR 1&23 list pg) W12 FOOD PROGRAM OIR