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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />c'ft7Foai+v'r . Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Date:141 2 <br />7 <br />Address: '1 ll0 ✓ `✓ City: <br />_I <br />Yvk <br />L Zip Code: <br />40 <br />Owner/Operator: <br />R �R'' _L <br />Telephone: <br />Program Element: rogram Record: <br />Inspection Type: <br />B180 Posted ❑ Yes D Rermit Posted Yes ❑ P <br />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 for code sections and general requirements that correspond to each violation listed below. <br />MJor violations pose a threat to public health and must be corrected immediately. Non compliance my warrant closure of the food facility <br />7eni-,I Demonstration of Knowledge vo, ori cos, <br />Supervision <br />moo' <br />\(�1 Domonst,a:,on of knowledge: food safety certificate <br />24 <br />Person In Charge is present and performs duties <br />Employee Health and Hygiene <br />f2_ Communicable disease, reporting. restrictions & exclusions <br />25. <br />Personal Cleanliness <br />Personal cleanliness and hair restraints <br />No discharge from eyes, nose, or mouth; no open wounds <br />General Food Safety Requirements <br />Proper eating, tasting, drinking, or tobacco use ,.i <br />26. <br />-. <br />Approved thawing methods used <br />Hands clean and properly washed: proper glove use <br />27. <br />Food protected from contamination during storage <br />28. <br />Washing fruits and vegetables before use <br />Handwashing facilities supplied and accessible <br />mperature Relafi <br />29. <br />30. <br />Toxic substances properly identified. stored_ and Used <br />Food Storage/Display/Service <br />Food storage; food storage containers labeled <br />Proper hot and cold holding temperatures <br />Proper use of time as a public health control <br />i. <br />Customer self-service food protected; individual utensils provided <br />Proper cooling methods <br />2. <br />. <br />Food properly labeled and honestly presented <br />Nonfood contact surfaces clean <br />Warewashing facilities maintained; test strips available <br />10. Proper cooking time and temperatures <br />11. Proper reheating procedures for hot holding <br />12. No re -service of returned food <br />5. <br />Equipmentfutensils approved; installed; clean; good repair <br />113 Food free from contamination and adulteration <br />6. <br />Equipment, utensils and linens: storage and use <br />14. Food contact surface cleaned and sanitaedtwarewashing procedures <br />F -Approved So" <br />15. Food obtained from approved source <br />7. <br />Vending machines maintained <br />8. <br />Approved and sufficient ventilation and lighting <br />9. <br />Thermometers provided, accurate, and easily visible <br />16. Compliance with shell stock regulations; tags/display <br />0. <br />1. <br />Proper use and storage of wiping cloths <br />Plumbing maintained; proper back flow prevention <br />17. Compliance with Gulf oyster regulations <br />fo'vibance'With:AplSraved <br />18. Compliance with HACCP plan or variance conditions <br />Consumer Advisory; <br />19 Advisory provided for raw or undercooked food <br />2. <br />Garbage and refuse properly disposed <br />3. <br />Toilet facilities clean, supplied, and maintained <br />Premises; personal/Leaning items; vermin -proofing <br />0. Prohibited foods not offered at high risk facilities <br />1. Hol and cold potable water available. <br />5. <br />6. <br />7. <br />Floors, walls and ceiling are maintained and kept clean <br />No living or sleeping quarters inside facility <br />Signs posted; last inspection report available <br />2. Sewage/wastewater properly disposed; toilet facility useable <br />3. No rodents, insects, birds or animals inside facility <br />8. <br />9. <br />50. <br />Compliance with plan review requirements <br />Facility operating with a valid health permit <br />Impoundment <br />51. <br />Permit Suspension <br />Received Byrntle: <br />EH Specialist:93WVVI It (yL <br />Phone: Z L:rr In _� v Page t of <br />EHD 16-23 (1st pg) 4/9112 FOOD PROGRAM OIR <br />