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0 SAN JOAQUIN COUN1 . <br /> � . ........� <br /> •.OG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q..• ,..�P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:vvww.sjgov.org/ehd <br /> �rFORN <br /> ` FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> - <br /> Name of Facility: C'1 T- W - I S (195 Q�,1 6 CF. Date: ` t2clC4 <br /> Address: 1C �ep,mS� City: 5 Zip Code: qC721'�- <br /> Owner/Operator: ii�U� L1 V- Grew � Telephone: <br /> Program Element: IpjVG) Program Record: U` 2 O� Inspection Type: ky"t tW(lz <br /> SB180 Posted _ es No Permit Posted es C No Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed NIA=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 /> pjNin� <br /> Demonstration of Knowledge Supervision OUT <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 /> 2. 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/Display/Service <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> 9. Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10 Proper cooking time and temperatures Equipment/Utensils I Linens <br /> 1. 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 /> Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 4. Food contact surface cleaned and sanitized/warewashing procedures-H+ 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> 5. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> 16. 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 /> 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 20. Prohibited foods not offered at high risk facilities 5. 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 /> 22. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 9. Facility operating with a valid health permit <br /> 23. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Titl <br /> EH Specialist: Phone: _4_��,1 � Page 1 of Z <br /> EHD 16.23(1st pg) 4/9/12 J FOOD PROGRAM OR <br />