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1111■ III �
<br /> SAN JOAQUIN COUNT
<br /> CNVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.or /q ehd
<br /> ��FOR
<br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br /> Name of Facility: C�C-C. / rd t,vckyr Date: Cf_1 _f4/
<br /> Address: L�PA , City: 0'A Zip Code: �SZC�q
<br /> Owner/Operator: Q,r k Uf 4 ri-ieQ,j%e Telephone: I
<br /> Program Element: Program Recor . /6 Inspection Type:
<br /> SB180 Posted Yes No Permit Posted Yes No 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 /> Major violations pose a threat to public health and must be corrected immediatel . Non-compliance may warrant closure of the food facility
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<br /> Demonstration of knowledge;food safety certificate a 24. Person In Charge is present and performs duties
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<br /> �±ersanat�leanitness
<br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints
<br /> 3. No discharge from eyes,nose,or mouth;no open wounds generAt IFoodaSa!ety-ReCjl7ir l#e1tt9
<br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used
<br /> 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 /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used
<br /> Time and Terriperature ftetatfonship Food StorageMilspla�y/Service
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<br /> 7. 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 /> Proper cooling methods 32. Food properly labeled and honestly presented
<br /> 0. Proper cooking time and temperaturesUi13te 51 ng
<br /> Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean
<br /> ProteC#ttln 1=rain Contaritioation _ 34. Warewashing facilities maintained;test strips available
<br /> 12. No re-service of returned food 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 /> . Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained
<br /> �. ,. OOltol3` roYeLi111rGe. „ 38. Approved and sufficient ventilation and lighting
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<br /> 15. Food obtained from approved source "`` 39. Thermometers provided,accurate,and easily visible
<br /> 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths
<br /> 17. Compliance with Gulf oyster regulationsPhyStCititi83
<br /> FornlanCe Wtth Approved Procedures = 1. Plumbing maintained;proper back flow prevention
<br /> Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed
<br /> „ -Gonsurner Advisory, �;, 3. Toilet facilities clean,supplied,and maintained
<br /> 9. Advisory provided for raw or undercooked food 14 1 44. Premises;personal/cleaning items;vermin-proofing
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<br /> 0. Prohibited foods not offered at high risk facilities " 45. Floors,walls and ceiling are maintained and kept clean
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<br /> ,,, s � Cp WBS R,.. 46. No living or sleeping quarters inside facility
<br /> 21.Hot and cold potable water available. •' mpliarice and EttF4rCeftltel�ift � ,.,. ,
<br /> tS�ISp; 47. Signs posted;last inspection report available
<br /> 22. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements
<br /> �„ �, z � .,• „llernr[rf ��ti .• ',', _ 49. Facility operating with a valid health permit
<br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment
<br /> 51. Permit Suspension
<br /> Received By/Tit1e,�
<br /> EH Specialist: 6121 lI Phone: Page 1 of
<br /> EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OR
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