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aQPa �o SAN JOAQUIN COUNTY <br /> ?a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> i •.. ;P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.ora/ehd <br /> qCi F IiRN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ° Date: <br /> Address: City: 0 r Zip Code: <br /> Owner/Operator: Telephone:' &Y-6322 <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted []Yes ElNo Permit Posted 11 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 facilif <br /> IN wo wA - Demonstration of Knowledge eew our cos Supervision <br /> 1. 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 /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> 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 /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship Food Storage/Display/Service <br /> 7. 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 /> 10. Proper cooking time and temperatures Equipment!Utensils f 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 /> 12. 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 /> 14. 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 /> 117.. 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 /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities' <br /> EIS. 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 /> i.Hot and cold potable water available. Compliance and Enforcement,",— _ <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 22. Sewage/wastewater properly disposed;toilet facility useable Compliance with plan review requirements <br /> Vermin _ _ _ 49. Facility operating with a valid health permit <br /> rodents,insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: Phone: i-LC��545, Page 1 of <br /> EHD 16-23 (1st pg) 4012 FOOD PROGRAM OR <br />