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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigo org/ehd cr 6•A FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: /I6 v IVY l•C. I I Date: L �� Address: ? City: - _-aq Zip Code: r. Owner/OperatoI ) v Telephone: Program Element: Program Record: Q5 LInspection Type: {'t. SB1 a0 d 0 Yes 0 No Permit Posted 0 Yes 0 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. Maier violations eose a threat to eublic health and must be corrected immediatel . Non-compliance maX warrant closure of the food facilif -hN4 i. Demonstration of knowledge;food safety certificate r 24. Person In Charge is present and performs duties aIod/• Demonstration of f(nowled'ge rM� o co$� p__"stun - �'c-- . t eCKiHan =gnese r Communicable disease;reporting,restrictions&exclusions K 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds -'J ,General Fdotl Safety'Requir&A. Proper eating,tasting,drinking,or tobacco use j 26. Approved thavl ng methods used _ Pyreveritirig;Coritamina ionb�"{F.and-s 27. Food proteaed 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 properly Identified,stored,and used iTimeartd�TemperafurelRelation'syiiP StoragelDisp aylServ"-�ice- 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 property labeled and honestly presented 10. Proper cooking time and temperatures 11 'lE, uipmeoGl76teri uolinehs 1. Proper reheating procedures for hot holding ), 33. Nonfood contact surfaces clean Cos- Protechon'Fiom ntammatron 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food LJ1f 35. Equipmentlutensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 1 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitizedAvarewashing procedures 37. Vending machines maintained 1Fod'd;Frbm,Appi'dJed Source y 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source r 39. Thermometers provided,accurate,and easily visible 6. Compliancewith shell stock regulations;tagstdisplay 40. Proper use and storage of wiping cloths JL117. Compliancewith Gulf oyster regulations i ____FP,hys�cal Facilities! {Confa"r" 'ance'N/i4h;ApproyedlPipceres 1. Plumbing maintained;proper back Flow prevention 8. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed _ Go`ns`ume`r,Ad`vispry 3. Toilet facilities clean,supplied,and maintained r 19. Advisory provided for raw or undercooked food 44. Premises;personalfcleaning items;vermin-proofing iFiighiy'Suscep`ti, eP,opulat ons _ ?Parma-nent,Foo_d`�Facihties 1 0. Prohibited foods not offered at high risk facilities f �. 5. Floors,walls and ceiling are maintained and kept dean T _ ^Water'I Hot, Ater _ 6. No living or sleeping quarters Inside facility 1.Hot and cold potable water available. La andEnfbicerilen,`t Lig7id . aste Di`spdsal I 7. Signs posted;last inspection report avallable 2. Sewagelwastewater property disposed;toilet facility useable 48. Compliance with plan review requirements - _ •Vermih 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: EH Specialist: ••� /�N,„r„_ LPhone: Pagel of EHD 1&23 list pg) 4/9112 , �'vpYY FOOD PROGRAM OIR