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oa�a�t"• SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �q.; ;P• Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.or /q ehd �fFORN FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: C� ddress: 7:,i 0/ W l D J 5 City. ��G�1 _ Zip Code: l� i� Owner/Operator: hQ ! Telephone: program Element: (� S Program Record: b160R Z Inspection Type: 18Posted es ❑ No Permit Posted r-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 pose a threat to public health and must be corrected immediately, Non-compliance may warrant closure of the food facility INwo rirA Demonstr do of n w dg Supervision 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee"-.e e ersonal Cleaniness 2. Communicable disease;reporting,restrictions&exclusions25. Personal cleanliness and hair restraints I-AiI3. No discharge from eyes,nose,or mouth;no open wounds 191 neral F000hdySafety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 7. Food protected from contamination during storage 5. 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 ood Sto Dtspl.;aylService Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. Proper cooling methods 32. Food properly labeled and honestly presented X 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding ni 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available ___.o 12. No re-service of returned food _-- 35. EquipmenUutensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained rom 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 mill W onfo ceWithApproved-Procedures. 1. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Acl 3. Toilet facilities clean,supplied,and maintained 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing y. �_ Highty=Susceptible Populations _-_ _:'Perm Food acilities 20. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean ater_%Hot Water 6. No living or sleeping quarters inside facility 21.Hot and cold potable water available. a o �ement_ Liqu aste Disposal_- 7. Signs posted;last inspection report available 7722. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements e 9. Facility operating with a valid health permit 23. No rodents,insects,birds or animals insipjacility 50. Impoundment 51. Permit Suspension Received By/T' EH Specialist: Phone: ut U qwPagel f EHD 16-23(1st pg) 4/9/12 'J / FOOD PROGRAM OIR