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�o�Q .coG SAN JOAQUIN COUN` .� ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 c ;P Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.slgov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: K Date: 3 31 f Address: t„I L4 C s Pa G / �� d. , ,. City: s� �� a Zip Code: p t-10 7 Owner/Operator: J I'y Iw��C� �G� L/\��G� Telephone: /7 $_9.930 Program Element: Z U Program Record: ((p $ Inspection Type: v fi K\_ SB180 Posted)Yes No Permit Posted des 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. Ma"or violations 2ose a threat to Eublic health and must be corrected immediate) . Non-corn liance may warrant closure of the food facilit 3N tvo IWA Demonstration of Knowledge MA:r... OUT cos Supervision OUT 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Pxeventing Contamination'by Hands 27. 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 Time and"'em et ature Relationship Food Stora. p„ p ge/Display/Service _ 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled ✓ . Proper use of time 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 f fcqutpmen Utensils f Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair J.13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewash irig procedures 37. Vending machines maintained Food From`Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 1. Plumbing maintained:proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained V119. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly_Susceptible Populations> 'i Permanent Food Facilities_ 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46, No living or sleeping quarters inside facility I.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 3. No rodents,insects, i s or anim Is inside facility177- 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: I Page 1 of END 16-23 (1sl pg) 4i9112 FOOD PROGRAM 0111R