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P41'" SAN JOAQUIN COUP <br /> .yam ENVIRONMENTAL HEALTH DEPARTMENT <br /> J. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • c... �P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> S�/FORD <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: mi J1A + -k Cra + Date: O_0_1 <br /> Address: to 2$ (J--) b4t:x►'n W.-e LYS City: bio CW- t-o r) Zip Code: 6 X 1z) <br /> Owner/Operator: tS PC Telephone: �L l 13- <br /> _ 'h0/ 1 <br /> Program Element: I!o �j Program Record: P(t0 -7 Inspection Type: v�}j yt2, <br /> SB180 PostedxYes No Permit Postedr)(Yes No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance <br /> See reverse side for code sections and general requirements that correspond to each violation listed below. <br /> Major violations pose a threat to public health and must be corrected immediately, Non-compliance may warrant closure of the food facility <br /> [n1A Demonstration of Knowledge nn ouT cos Supervision OUT <br /> Demonstration of knowledge.food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> 4. Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> 5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship Food Storage/Drisplay/Service <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 1 Proper cooking time and temperatures Equipment/Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> Protection From Contamination 34. Warewashing facilities maintained;test strips available <br /> 2. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 4. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> y,,v-_0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters inside facility <br /> 21.Hot and cold potable water available. Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted:last inspection report available <br /> 122. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 77 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: � � Phone: � ..�o�,� Page 1 of <br /> EHD 16-23 (1st pg) 4/9/12 0O FOOD PROGRAM OIR <br />