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SAN JOAQUIN COI ENVIRONMENTAL HEALTH DEPARTMENT 1868 East HazeIton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orcilehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: It_uvlot •-• Date: _ Address: Zip Code: 'ifCA \ el\e, A--\-.e.„ .4._ i rs, e c (24 vkc t. v City: 1 Owner/Operator: 1 1 1 1., ti (1 i 0'1 Telephone: ' Program Element: i i- (..; ,-) •ogram Record: e. k f.) ( l'-' 'Ii en Inspection Type: , • t ' -t t v't i je t. .fbi,if- SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: 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 , I Demonstration of Knowledge Supervision 1 1 Demonstration of knowledge: food safety certificate Person In Charge is present and performs duties .. Employee Health and Hygiene Personal Cleanliness 2 Communicable disease; reporting, restrictions & exclusions , Pcisonal cleanliness and hair restraints 1 :3 No discharge from eyes, nose, or mouth; no open wounds General Food Safety Requirements; 4 Proper eating, tasting, drinking, or tobacco use Approved thawing methods used amination by Hands 7. Food protected from contamination during storage 5. Hands clean and properly washed; proper glove use 8. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified, stored, and used Time and Temperature Relationship Food Storage/Display/Service 7. Proper hot and cold holding temperatures 0. Food storage; food storage containers labeled ' 8. Proper use of time as a public health control 1. Customer self-service food protected; individual utensils provided 9. Proper cooling methods 1- 2. Food properly labeled and honestly presented '..(-10. Proper cooking time and temperatures i „,Equipmeat / Utensils / Li nenS N1 1. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained; test strips available 2. No re service of returned food i 35. Equipment/utensils 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 -1- : I - 15. Food obtained from approved source 39. Thermometers provided, accurate, and easily visible r 16. Compliance with shell stock regulations; tags/display .40. Proper use and storage of wiping cloths , 17. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures - ,.- 41. Plumbing maintained; proper back flow prevention 18. Compliance with HACCP plan or variance conditions Garbage and refuse properly disposed , Consumer Advisory Toilet facilities clean, supplied, and maintained 19. 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 facilitics 45. Floors, walls and ceiling are maintained and kept clean Water/ Hot Water 46 No living or sleeping quarters inside facility 21. Hot and cold potable water' available. Compliance and Enforcement Liquid Waste Dtsp4al Signs posted: last inspection report available 22 Sewarko'\, stewater properly disposed: toilet facilitv useable J Compliance with plan review requirements Vermin 49 Facility operating with a valid health permit 23. No rodents, insects, birds or animals inside facility 0. Impoundment 51. Permit Suspension Received By/Title: 0111.' / _earir4. ' 1 "11111.1111V ..r ___ EH Specialist: r IF Phone: Page 1 of '.......".'....".) , Lfid ..... 344 0.....v EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR