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PQM," SAN JOAOUIN COUI. .' <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> i <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q.,.... ..�;:P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sboov.org/ehd <br /> �rFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ; Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: YLA r �j `fin • Telephone::g ln't )_� -1 <br /> Program Element: b 2 Program Record: ��3 �' Inspection Type: YC Q <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 immediate! . Non-compliance may warrant closure of the food facility <br /> Demonstration of Knowledge r.w+ ouT cus Supervision u,rr <br /> 11. Demonstration of knowledge:food safety certificaV1 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> L_2. 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 /> i4. Proper eating,tasting,drinking.or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> vt5. Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> 16. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship Food Storage/Display/Service <br /> 1:.7. Proper not and cold holding temperatures 30. Food storage:food storaae containers labeled <br /> -A. 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 /> _.__....__._ ..__.____......____ <br /> -_.__------.._.__.-- -..-- <br /> 10. Proper cooking time and temperatures Equipment/Utensils/Linens <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 /> .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 /> 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;tagsidisplay 1 I 40. Proper use and storage of wipinc cloths <br /> . Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> !19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> vl�O. 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 /> - 21.Hot and cold potable water available. Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 22. Sewage wastewater properly disposed.toilet facility useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> i23. No rodents,insects,birds or animals inside facility T 50. Impoundment <br /> 51. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: Phone: l Page 1 of Z <br /> EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR <br />