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,oe.saG SAN .JOAQUIN COUNTY <br />q` ?� ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: l .�� <br />Date: ( 3-2- <br />ddress: - , City: <br />f <br />Zip Code: C, _ <br />vrner/Operator: 411( <br />Telephone: <br />Program Element: ElProgrdM Record:Pie 2- <br />Inspection Type: <br />B180 Posted ❑ Yes ❑ Rermit Posted Yes ❑ f <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 />Major violations pose a threat to public health and must be corrected immediately_ _ Non-compliance nr warrant closure of the food facility _ <br />of Knowledge <br />M1a-^c' <br />-os <br />ouDemonstration <br />1. Demonstration orknowledge. food safety cediificale <br />24 <br />Person In Charge is present and performs duties <br />Employee Health and Hygiene <br />Personal Cleanliness <br />i2. Communicable diseasereporting. restrictions & exclusions <br />25 <br />Personal cleanliness and hair restraints <br />3. No discharge from eyes, nose, or mouth; no open wounds <br />General Food Safety Requirements <br />Proper eating. tasting. drinking, or tobacco use <br />J <br />26. <br />Approved thawing methods used <br />Preventing. Contamination by HanTmommonomw <br />27. <br />Food protected from contamination during storage X <br />��5 Hands clean and properly washedproper glove use 1 <br />77 3 Handwashing facilities supplied and accessible X1 <br />Time antl '; ture Relationshi " <br />7. Proper hot and cold holding temperatures <br />28. <br />29. <br />30. <br />Washing fruits and vegetables before use <br />Toxic substances properly identifiedstared. and used <br />Food Storage/Display/Service <br />Food storagefood storage containers labeled <br />Proper use of time as a public health control <br />1. <br />Customer self-service food protected; individual utensils provided <br />Proper cooling methods <br />10. Proper cooking time and temperatures <br />1. Proper reheating procedures for hot holding <br />32. <br />3. <br />Food properly labeled and honestly presented <br />Nonfood contact surfaces clean <br />12. No re -service of returned food <br />4. <br />35. <br />Warewashing facilities maintained; test strips available <br />Equipmentlutensils approved; installed; clean; good repair <br />..,,13. Food free from contamination and adulteration <br />6. <br />Equipment, utensils and linens: storage and use <br />1 114 Food contact surface cleaned and so iit,zed'warewashing procedures <br />37. <br />Vending machines maintained <br />Food From Approved Source '- ._.. <br />38. <br />Approved and sufficient ventilation and lighting <br />_h5. Food obtained from approved source <br />16. Compliance with shell stock regulations; tags/display <br />39. <br />Thermometers provided. accurate. and easily visible <br />40. <br />Proper use and storage of wiping cloths <br />17. Compliance with Gulf oyster regulations <br />,: . Physical Facilities <br />Conformance With Approved Procedures <br />41 <br />Plumbing maintained: proper back flow prevention <br />18. Compliance voth HACCP plan or variance conditions <br />12. <br />Garbage and refuse properly disposed <br />Consumer Advisory <br />3 <br />Toilet facilities clean, supplied, and maintained <br />a 19. Advisory provided for raw or undercooked food <br />44. <br />Premises: personal/cleaning items- vermin -proofing <br />Highly Susceptible Populations <br />Permanent Food,Facilities <br />0. Prohibited foods not offered at high risk facilities - <br />5. <br />Floors, walls and ceiling are maintained and kept clean <br />m Water / Hot Water <br />46. <br />No living or sleeping quarters inside facility <br />1. Hoi and cold potable water available. <br />Compliance and Enforcement <br />Liquid Waste Disposal <br />22 Sewage/wastewater properly disposedtoilet facility useable <br />47. <br />8. <br />Signs posted, last inspection report available <br />Compliance with plan review requirements <br />Vermin <br />9. <br />Facility operating with a valid health permit <br />3 No rodents, insectsbirds or animals inside facility <br />150. <br />Impoundment <br />1. <br />Permit Suspension <br />Received BylTitle: �0 f O 714 <br />Zo9_ll S <br />EH Specialist: � <br />Phone: _ Us Z Page 1 of <br />EHD 16-23 (1st 1419112 v J FOOD PROGRAM OIR <br />