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tqV t4 SAN JOAQUIN COUN X ENVIRONMENTAL HEALTH DEORTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: -)*'It',-/I LAVli. Date: Address: � � J-',* Q_- 'P-V-LCk c�- ara- City: Zip Code: Owner/Operator: 0- h"( evl��t t&a4'-4 h Telephone: Program Element: F"Tci-Program Record: Inspection Type:,/� ""j.z SB 180 Posted Yes '*�0 Permit Posted es 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. rviolations pose a threat to eublic health and must be corrected immediatel . Non-comeliance ma X warrant closure of the food facility Demonstration of Knowledge I M- I our cos Supervision IarT 1. 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 Contamirlai!o'A.' yl lands, 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 property identified,stored,and used Time and erature Relationship Food Stora§0JspIaY1Se'rYice �1_1 1 17. 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 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment'!Utensils Linens' Xi 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available 12. No re service of returned food 35. Equip ment/ute nsi Is approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 114. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food From Approved 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 7. Compliance with Gulf oyster regulations Physical FaCitiiles orimance With Approved Procedures, 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed 01113 Advisory umer Advi 43. Toilet facilities clean,supplied,and maintained 119- Advisory provided for raw or undercooked food 1 44. Premises;persona[/cleaning items;vermin-proofing Highly,Susceptible Populations Permanent Food Facilities, M. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water W Hot ater:',,' 46,77No living or sleeping quarters inside facility 1 , � 7 1, k1.Hot and cold potable water available. ceantt Enforcement _71 Liquid Waste Disposal 47. Signs posted;last inspection report available I �2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin9. Facility operating with a valid health permit 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title EH Specialist: f Phone: Page 1 of EHD 16-23 (1 st pg) 419/12 FOOD PROGRAM OIR