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a""+• SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ..cdtiFiS•d`'xc • Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility:Q416g_ 1i 4,1,11 Date: 2 city: ddress: /211 Zip Code: _ Owner/Operator: t Telephone: Program Element: Program Recor Inspection Type: SB180 Posted 19yes ❑ Remit Posted es ❑ P 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. Major violations pose a threat to public health and must be corrected immediately. Non -con y_ warrant closure of the food facility Demonstration of: Knowledge : Demonstration of knowledge- food safety certificate24. 'i our cus I Supervision a=' Person In Charge is present and bedoinrE duties loyee Health and Hygiene Communicable disease; reporting. restrictions & exclusions i,i 25. 6. Personal Cleanliness Personal cleanliness and hair restraints _ Gene `9 irements Approved thawing methods used No discharge from eyes, nose, or mouth; no open wounds l Proper eating, tasting, drinking, or tobacco use revertin%,P_gqtwmne'gn_py Na Hands clean and properly washed; proper glove use 7. Food protected from contamination during storage 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible onsii 9. Toxic substances properly identified, stored, and used Proper hot and cold holding temperatures 0. Food storage; food storage containers labeled B. Proper use of time as a public health control 9. Proper cooling methods 1. Customer self-service food protected; individual utensils provided 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding Protection Prom Contaminatio 112. No re -service of returned food 33. Nonfood contact surfaces clean 4. Warewashing facilities maintained; test steps available 5. Equipmentlutensils approved; installed; dean; good repair 113. Food free from contamination and adulteration 6. Equipment, utensils and linens: storage and use 14. Food contact Surface cleaned and sanitized/warewashing procedures Food From Approvedlairrca'".,, _ 15. Food obtained from approved source _ 37. Vending machines maintained 38. Approved and sufficient ventilation and lighting 39. Thermometers provided. accurate, and easily visible 16. Compliance with shell stock regulations; tags/display 17. Compliance with Gulf oyster regulations Conformance With Approved Procedures T 40 1 Proper use and storage of wiping cloths Physical Facilities Plumbing maintained, proper back flow prevention j18 Compliance with HACCP pian 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 X120 Prohibited foods not offered at high risk facilities 45. Floorswalls and ceiling are maintained and kept clean Water/ Hot Water 46. No Irving or sleeping quarters Inside facility 1. Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted, last inspection report available 77 X22. Sewage/wastewater properly disposed: tolled facility useable 48. Compliance with plan review requirements Va 9. Facility operating with a valid health permit U3. No rodentsinsectsbirds or animals inside facility 50. Impoundment 51. Permit Suspension Received BylTitle: EH Specialist: - >�- Phone: Z©fi �, _ 2Page 1 lof EHD 16-23 (1st pg) 4/9112 FOOD PROGRAM OR