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SAN JOAQUIN COM' '
<br />ENVIRONMENTAL HEALTH DErARTMENT
<br />1868 East HazeIton Avenue, Stockton, CA 95205-6232
<br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orq/ehd
<br />FOOD PROGRAM OFFICIAL INSPECTION REPORT
<br />Name of Facility: jp...,c , aA i , _ ,
<br />12:1
<br />Date: f/diVic
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<br />Address: i3z4 „jax,4 yx,,4447_ 3 City: Zip Code:
<br />Owner/Operator: 77 h- , Telephone: ,-7 1i7,_. L 3 lb.
<br />Program Element: 7 / (-- Program Record:
<br />e C C (eLIP II Inspection Type: ..,-17h Jill
<br />SB180 Posted Ye No Permit Posted Yes No Re-Inspection on or After:
<br />IN = In Compliance N/0 = Not Observed N/A = Not Applicable COS = Corrected
<br />See reverse side for code sections and general requirements that
<br />Ma 'or violations .ose a threat to • ublic health and must be corrected immediate!
<br />on-site MAJ = Major Violation OUT = Not in Compliance
<br />correspond to each violation listed below.
<br />. Non-com •liance ma warrant closure of the food facili
<br />5. TOO TQA,
<br />, Demonstration of Knowledge , , , - - MA; OUT' COS Supervision
<br />.. .
<br />OUT f
<br />1. Demonstration of knowledge; food safety certificate Person Peon In Charge is present and performs duties
<br />, Employee Health' and Hygiene Personal Cleanliness ,‘
<br />0. Communicable disease; reporting, restrictions & exclusions I Personal cleanliness and hair restraints
<br />C. No discharge from eyes, nose, or mouth; no open wounds General Food Safety Requirements ... ,.... ,
<br />,. Proper eating, tasting, drinking, or tobacco use Approved thawing methods used
<br />4 '4
<br />
<br />PP 1M , . , Food protected from contamination during storage
<br />5. Hands clean and properly washed; proper glove use Washing fruits and vegetables before use
<br />26. Handwashing facilities supplied and accessible 29. Toxic substances properly identified, stored, and used
<br />,-4 .', Time s,;•i•
<br />.- Food Storage(DspI 1
<br />. Proper hot and cold holding temperatures 0. 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 />4. Proper cooling methods 32. Food properly labeled and honestly presented
<br />Proper cooking time and temperatures -,E. riUl '
<br />Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean
<br />. :-.
<br />- 34. Warewashing facilities maintained; test strips available
<br />la 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 1..'ved: 38. Approved and sufficient ventilation and lighting
<br />15. Food obtained from approved source ,w 39. Thermometers provided, accurate, and easily visible
<br />16. Compliance with shell stock regulations; tags/display , 0. Proper use and storage of wiping cloths
<br />1 7. Compliance with Gulf oyster regulations Physicatfacilities
<br />Conformance With Approved Procedures '1. Plumbing maintained; proper back flow prevention
<br />Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed
<br />Consumer Ad • 3. Toilet facilities clean, supplied, and maintained
<br />. Advisory provided for raw or undercooked food 44. Premises; personal/cleaning items; vermin-proofing
<br />Highly Susceptible Populations ,.. Perm _ , Facilities
<br />Prohibited foods not offered at high risk facilities Floors, walls and ceiling are maintained and kept clean
<br />Water / Hot Water No living or sleeping quarters inside facility
<br />1. Hot a nd cold potable water available.
<br />, --,
<br />Liquid Waste p ... Signs posted; last inspection report available
<br />Sewage/wastewater properly disposed; toilet facility useable 48. Compliance with plan review requirements
<br />Vermin. ... , 9. Facility operating with a valid health permit
<br />No rodents, insects, birds or animals inside facility Impoundment
<br />Permit Suspension
<br />Received By/T' e:
<br />EH Specialist:
<br />-.••••
<br />74 cr_cra Phone: ifrkfs" ( Page 1 of •
<br />EHD 16-23 (1st pg) 4/9/12
<br /> FOOD PROGRAM OIR
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