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oPQ�I" SAN JOAQUIN COUNTY <br />' ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />• ., m ;P . Telephone: (209) 468 <br />,-3420 Fax: (209) 464-0138 Web: www.s'gov.org/ehd <br />4ciFa'a� <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility:Date: <br />L./�T/��oP ANN_ >' �/- 2-8 -� <br />Address: City: L"iT11t-?'ni' Zip Code: <br />OwnerlOperator: Telephone: �S si 305-3 <br />Program Element: /632 Program Record: (Zp /(, 2 3 29 Inspection Type: 2,410 &mll, ,c <br />SB180 Posted Yes No Permit Posted fYes 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 fcr code sections and general requirements that correspond to each violation listed below. <br />Ma'or violations pose a threat to public health and must be corrected immediatel . Non-compliance may warrant closure of the food facility <br />Demorwtradon of Knowledge ' " our cas <br />Supervision our <br />�( 1. Demonstration of knowledge; food safety certificate L 1 <br />24, Person In Charge is present and performs duties <br />Employee Heabh WW *Aim <br />Personal Cleanliness <br />Communicable disease; reporting, restrictions & exclusions <br />25. Personal cleanliness and hair restraints <br />3. No discharge from eyes, nose, or mouth; no open wounds <br />General Food Safety Requirements <br />TProper eating, tasting, drinking, or tobacco use <br />26. Approved thawing methods used <br />Preventing Contamination by Hands <br />27. Food protected from contamination during storage <br />5. Hands clean and properly washed; proper glove use <br />28. Washing fruits and vegetables before use <br />X H indwashing facilities supplied and accessible <br />29. Toxic substances properly identified, stored, and used <br />Tune and Temperature Relationship <br />Food Storage1DisplayMWvlca <br />7. Proper hot and cold holding temperatures <br />30. Food storage; food storage containers labeled <br />8. Proper use of time as a public health control <br />31. Customer self-service food protected; individual utensils <br />provided <br />X 9. Proper cooling methods <br />32. Food properly labeled and honestly presented <br />k 10. Proper cooking time and temperatures <br />Equipment / Utensils I Unens <br />it 11. Proper reheating procedures for hot holding <br />33. Nonfood contact surfaces clean <br />Protection From Contamination <br />34. Warewashing facilities maintained; test strips available <br />K 12. No re -service of returned food <br />35. Equipment/utensils approved; installed; clean; good repair <br />N 13. Food free from contamination and adulteration <br />36. Equipment, utensils and linens: storage and use <br />14. Food contact surface cleaned and sanitized/warewashing procedures <br />37. Vending machines maintained <br />Food From Approved Source <br />38. Approved and sufficient ventilation and lighting <br />X 15. Food obtained from approved source <br />39. Thermometers provided, accurate, and easily visible <br />JC 16. compliance with shell stock regulations; tags/display <br />40. Proper use and storage of wiping cloths <br />/l 17. Compliance with Gulf oyster regulations <br />Physical Facilities <br />Conformance With Approved Procedures <br />41. Plumbing maintained; proper back flow prevention <br />ri 18. Compliance with HACCP plan or variance conditions <br />42. Garbage and refuse properly disposed <br />Consumer Advisory <br />43. Toilet facilities clean, supplied, and maintained <br />19. Advisory provided for raw or undercooked food <br />44. Premises; personal/cleaning items; vermin -proofing <br />Highly Susceptible Populations <br />Permanent Food Facilities <br />JC 0. Prohibited foods not offered at high risk facilities <br />45. Floors, walls and ceiling are maintained and kept clean <br />Water / Hot Water <br />46. No living or sleeping quarters inside facility <br />X 1. Hot and cold potable water available. <br />Compliance and Enforcement <br />Liquid Waste Disposal <br />47. Signs posted; last inspection report available <br />X 2. Sewage/wastewater properly disposed; toilet facility useable <br />48. Compliance with plan review requirements <br />Vermin <br />49. Facility operating with a valid health permit <br />50. Impoundment <br />51. Permit Suspension <br />yC 3. No rodents, insects, birds or animals inside facility <br />Received By/Title: <br />EH Specialist:, `I Phone: (6 8 _ 3 71V-2 Page 1 of <br />EHD 16-23 (1st pg) 11106/08 FOOD PROGRAM OIR <br />