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COA!!v� �F_ SAN JOAQUIN COLIN' ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sioov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: L Date: 3 -3, 1-6 Address: wo C4' City: +0 e,C4, Zip Code: ,�II2,q6 -7 toPOL, -1'-7C_- 6 Owner/Operator: rl-4 I a &'K 7:!> Lr Telephone: 1 Program Element: 1(10 _25 Ugram Record: P PLO I cp 0-11 Inspection Type: YLSL SB180 Posted XYes No Permit Posted es No Re-Inspection on or After: IN=In Compliance N/0=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. ajor violations 2ose a threat to Bublic health and must be corrected immediate) . Non-comeliance may warrant closure of the food facility IN N* wn , , , I I :Demonstration of Knowledge --7- 11 OUT cos I Supervision OUT 11. 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 Preventing Contaminatjlqnby 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 Temperature Relationship Food StorageirDisplaylservicei V 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 Equipment/Utensils/Linens 11. Proper reheating procedures for hot holding 33 Nonfood contact surfaces clean --7-77777777,___L_ 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 1 adulteration 3. Food free from contamination and E 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food From Approved Source 38, Approved and sufficient ventilation and lighting 11 Thermometers provided,accurate,and easily visible 1 40. Proper use and storage of wiping cloths 5. Food obtained from approved source 39. 6. Compliance with shell stock regulations;tags display 17. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained:proper back flow prevention V'I I )f�B. Compliance with HACCP plan or variance conditions 42- Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items,vermin-proofing Highly Susceptible Populations Permanent Food Facilities, V�O Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Weiir' 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. -Compliance and Enforcement Uquid Waste Disposal 47. Signs posted;last inspection report available IN 2. Sewage/wastewater properly disposed;toilet facility 48. Compliance with plan review requirements Vermin 9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension 1 Received By/Title: rl EH Specialist: Phone: Page 1 of ;L J444 -- EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAY OIR