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t aY - ` SAN JOAQUIN COUN-A 1 ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:- w.s' ov.or /ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: r1-I / City; Zip Code: Owner/Operator: d f / > Telephone:14411 L'i /\1171 Program Elemen L Program Record- Inspection Type: SB180 Poste Yes ❑ No I Permit Posted es ❑ No Re-Inspection on or After: IN=In Compliance NIO=Not Observed NIA=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 pose a threat to eublic health and must be corrected immediate! . Nan-corn !lance maK warrant closure of the food facility :N wo Nia Demonstration of Knowledge nnar our cns Supervision OUT 1. Demonstration of knowledge;food safety certificate 4. 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 Safe Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage Hands clean and property 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 Starage/Display/Service 7. Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 3. 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 Equi ment i Utensils/Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From ContaminatiorE 34. Warewashing facilities maintained;test strips available K]l 2 . No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 6. 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 sufficlent ventilation and fighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tagstdisplay 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 11 B. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained . Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities 0. Prohibited foods not offered at high risk facilities 5. 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. Compllance and Enforcement =Liquid Waste Disposal 47. Signs posted;last inspection report available . Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements 9. Facility operating with a valid health permit { P 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: Eli Specialist: Phone2 Page 1 of EHD 16-23 (1 st pg) 1118112 J FOOD PROGRAM OIR