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SAN JOAQUIN COUNTY N: 7 X ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:vwwv.sigov.orCl/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ff> a L Date: a _ ddress: ,),aO rofnd C City: 5 � Zip Code: et5ao7 Owner/Operator: L A Telephone: Program Element: Program Record: P 0510�j 3 Inspection Type: av-fi n Q- SB180 Posted Yes ❑ No Permit Posted 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 immediate) . Non-compliance may warrant closure of the food facilit N wo wnSmogs tfo of nowt g a Supervision Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties eal h H .glen ersonal Clean ss 2. Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints 3. 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 Contamination 27. Food protected from contamination during storage v 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 Food Sto f-, a /Servic Temperature Relationsfiipa oPY - 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 0. Proper cooking time and temperatures quipment j Utensils/Linens 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From_ Contamination's = 34. Warewashing facilities maintained;test strips available 2. No re-service of returned food 35. Equipmentlutensils 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 Food Fo proved Source.. 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations 61 Conformance WithmApproved Procedures, 1. Plumbing maintained;proper backflow prevention 8. Compliance with HACCP plan or variance conditions 2. Garbage and refuse properly disposed Z'Co nsu,me'r�Advisory 3. Toilet facilities clean,supplied,and maintained 9. Advisory provided for raw or undercooked food y4. Premises;personal/cleaning items;vermin-proofing - , Highly SusceLtible Po�pulaions i m�anent -ood_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 1.Hot and cold potable water available. Compliance_and Enforcement Ligwd Waste Disposal 47. Signs posted;last inspection report available 22. Sewage/wastewater properly disposed;toilet facility useable 8. Compliance with plan review requirements 9. Facility operating with a valid health permit 3. No rodents,Insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: Stow �-AN EH Specialist: ? Phone: � 5 3_ -7'Z 1-7 Page 1 of 2 Q� EHD 16-23 (1st pg) 4/9/12 0 FOOD PROGRAM OR