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SAN JOAQUIN COUNT ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd Uk6'd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ,05 n AS # Date: ddress: City: G ,� Zip Code: Fr-e �- r. ! Y vs Telephone: Owner/Operator: 4r Program Element: Program- eeord: Inspection Type: B180 Posted 0 Yes ' No Permit Posted 0 Yes)q 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. Ma or violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility N wo WA Demonstration of Knowledge cute our cos Supervision OUT If. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 7. Food protected from contamination during storage t/ Hands clean and properly washed;proper glove use B. Washing fruits and vegetables before use Handwashing facilities supplied and accessible Toxic substances property identified,stored,and used Time and Temperature Relationship Food Storage/Display/Service _ Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled Proper use of time as a public health control 1. Customer self-service two protected;individual utensils provided Proper cooling methods 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils/Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available v4 1 12. No re-service of returned food 35. Equipment/utensils approved;Installed;clean;good repair 61--1:113. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitizedhvarewashing procedures 37. Vending machines maintained / Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible . Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 7. compliance with Gulf oyster regulations Physical Facilities ConformanceWith Approved Procedures 41. Plumbing maintained;proper back flow prevention L�fff. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed _ Consumer Advisory 43. 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 . Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement _ Liquid Waste Disposal _ 7. Signs posted;last inspection report available . Sewagelwastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 3. No rodents,insect or animals inside facility . Impoundment 1. Permit Suspension Received By/Title: EH Specialist: Phone: Page 1 of Z EHD 16-23 (1st pg)4/9112 FOOD PROGRAM OIR