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SAN JOAQUIN COUN <br /> 2 ENVIRONMENTAL HEALTH DEPARTMENT <br /> Q: <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> C•v., �P Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.orq/ehd <br /> �tF60 <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L� r� Y 1 _� ci+Iio� Date: <br /> Address: 2�Q LO `M Y� L4-1 City: Zip Code: <br /> Owner/Operator: ' l Telephone: '�$�-t�• <br /> Program Element: Program Record: (�j ZA_3`5Inspection Type: <br /> SB180 Posted Kes ❑ Permit Posted Yes ❑P Re-Inspection on or After: <br /> IN=In Compliance N/O=Not Observed N/A=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 /> Ma jor violations pose a threat to public health and must be corrected immediatel . Non-compliance may warrant closure of the food facile <br /> ------------ <br /> M rvo NIA Demonstration of Knowledge Supervision ou- <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 /> 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 /> Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used <br /> Preventing Co!�atnination by Hands 7. Food protected from contamination during storage <br /> 5. Hands clean and properly washed,proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified.stored,and used <br /> -----_...------- - - .. a.._,_- -- -- - - .... <br /> Time and Temperature Relationship Food Storage/Display/Servi <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> 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 l Utensii' 'n <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> Protection From Contamination 34. Warewashing facilities maintained;test strips available <br /> U' 12. No re-service of returned food j 35. Equipment/utensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> 15. 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 /> 17. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained,proper back flow prevention V <br /> Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> L,�9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> . Prohibited foods not offered at high risk facilities 45 Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 46 No living or sleeping quarters inside facility <br /> �1. Hot and cold potable water available. Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted:last inspection report available <br /> 2. Sewage/wastewater properly disposed:toilet facility useable 48. Compliance with plan review requirements <br /> 'Vermin 9. Facility operating with a valid health permit <br /> 3 W rodents,insects,birds or animals inside facility 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: Phone: Page 1 of Z <br /> ,t. �-`7 81'7 <br /> EHD 16-23(1st pg) 4/9/12 FOOD PROGRAM OR <br />