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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 �P Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd 9�iFb.R� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: d n I U o f)C C771)C Date: � 1-C) 1 c� Address: 1 U •5•city: Kn Zip Code: 9S �CVS Owner/Operator: hone:Tele )�� c� =15 r r1 L _ p qG 6 - Program Element: IL I Program Record: as Inspection Type: SB180 Posted )rYes No Permit Posted YYes No Re-Inspection on or After: n l IN=In Compliance N/O=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. Major violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility r" euo ►w - - Demonstration of Knowledge wvu our cos Supervision our 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties -Employee Health and Hygiene Personal Cleanliness k . 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 a 6. Approved thawing methods used Preventing Cc lir"on by Hands 27. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use J( 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible X 9. Toxic substances properly identified,stored,and used ?( Time'and Temperat ee R"onsW Food Storage/Display/Service 7. Proper hot and cold holding temperatures k 30. Food storage;food storage containers labeled X 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils y provided y 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment 1 Utensils/Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean PfotACLOn l7mm ContarglAatim 34. Warewashing facilities maintained;test strips available �( 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair Y 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 r' "AF004FIRMAoppowpd,Sptir�aQ ; 38. Approved and sufficient ventilation and lighting '+ 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible )( 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths �. 17. Compliance with Gulf oyster regulations I Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained,proper back flow prevention �( 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed ConsulllerAduisory 3. Toilet facilities clean,supplied,and maintained )r 19. Advisory provided for raw or undercooked food 44 Premises;personal/cleaning items;vermin-proofing fighly**.00jblaPQp11l . : Permanent Food Facilities 0. Prohibited foods not offered at high risk facilities 7T 1 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 Disposal 47. Signs posted;last inspection report available Y 22. Sewage/wastewater properly disposed,toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 23. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: /_ Page 1 of j� EHD 16-23 (1st pg) 11/06/08 G FOOD PROGRAM OIR