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of`gmrf � SAN �JOAQUIN COUNTY ): - .OG ENVIRONMENTAL HEALTH DEPARTMENT _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 • c.. ip• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sagov.org/ehd 4Ci��Ris FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: L Imo+ n(,�' YA Date: ':: r2 1 Address: 1 2! _ J.TA z1 hr City: �{��,. Zip Code: cli�'�-1JCF;- Owner/Operator: ( l'On eSAA LR L t a� ev Telephone: q+fo -0 Program Element: r Program Record: ` r Inspection Type: 6��(W- S B 180 - SB180 Posted Z Yes E Permit Posted Yes o t Re-Inspection on or After: 2 W ee v S 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 immediately. Non-compliance may warrant closure of the food facility r rano f w Demonstration of Knowledge Fn . Our cos Supervision - -- -- .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 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 by Elands 7. 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 properly identified.stored,and used _T' ceRelataonshi Food StoragelDisplaylService P.. ..:z , Proper hot and cold holding temperatures L2. ood storage;food storage containers labeled Proper use of time as a public health control ustomer self-service food protected;individual utensils provided Proper cooling methods ood properly labeled and honestly presented 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean on From Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. EquipmenUutensils 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 From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 9. Thermometers provided,accurate,and easily visible ---- f 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths rt17. Compliance with Gulf oyster regulations Physical Facilities formance" ith Approved Procedures 41. Plumbing maintained;proper back flow prevention Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean,supplied,and maintained l19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items:vermin-proofing Highly Susceptible Populations Permanent Food Facilities 20 Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46, No living or sleeping quarters inside facility L21 Hot and cold potable v.ater available Compliance and Enforcement Liquid Waste Disposal 47. Signs posted,last inspection report available L 22 Sewage"wastewater properly disposed toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit --- - -- -- ------ - - - ---- __... _--+---- 123 No rodents, insects, birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: l/G EH Specialist: I Phone: nn n _ ��Page 1 of 0J J2 Received 16-23(1st pg) 4/9/1 V"1 FOOD PROGRAM OIR