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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �;.,. ` .. Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.si4ov.org/ehd �rcda�+ FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ' -r r - $ Date: I 13 123 Address: 12-1City: Zip Code: _ Owner/Operator: Telephone: Program Element: jSL &69Progr Record: Inspection Type: 6180 Posted ❑Yes ❑ Permit Posted ❑Yes ❑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 threattopublic health and must be corrected imm_edretely Non-compliance may warrant_closure_of the food facili�_. ,ry IN aw Demonstration of Knowledge tik, 017 CQ Supervision 1. Demonstration of knowledgefood safety certificate 24. Person In Charge is Pesen'.and performs duties Employee.Health and Hygiene Personal Cleanliness �- Communicable disease.reporting, restrictions&exclusions 25. Personal cleanliness and hair restraints 3. No discharge from eyes,now,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 27. Food protected from contamination during storage 5. Hands clean and properly washed;proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used - Timeand Temperature Reta[ionship Food Storage/DisplayiService r. Proper hot and cold holding temperatures 30. Food storager food storage containers labeled Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided Proper cooling methods 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding 33. Nonfood Contact surfaces clean Protection From Contamination 3C Warewashing facilities maintained;test strips available I12 No re service of returned food 35. Equipment/utensils approved:installed;dean;good repair ,13. Food free from contamination and aduneration 36. Equipment,utensils and linens:storage and use 14_ Food contaet surface cleaned and saoaiseda,s asn,ng procedures 37. Vending machines maintained Food From Approved Source - 38. Approved and sufficient ventilation and lighting i'i15. Food obtained from approved source 31 Thermometers provided,accurate,and easily visible Compliance11 stock regulations; �- 0. Proper use and storage of wiping cloths �_ ! - Phystcaf Facilities 17. Compliance with Gulf oyster regulations i- Conformance With Approved Procedures 41. Plumbing maintained-proper back flow prevention 18- Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed r Consumer Advisory 43. Toilet facilities clean,supplied,and maintained r" 19. Advisory provided for raw or undercooked food 44. Premises:personal/cleaning items vermin-proofing X Highly Susceptible Populations Permanent Food Facilities I20. Prohibited foods riot offered at high risk facilities "�, 5. F lourswalls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility k1 Hot and cold potable water available ° compliance and Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available -)22. Sewage/wastewater properly disposed toilet facility useable 8. Compliance with plan review requirements r _- Vermin 0. Facility operating with a valid health permit -3_ No rodents. insects birds or animals inside facility 50. Impoundment 1151. Permit Suspension Received By/Title: r EH Specialist: Phone: 2oV Page 1 of EHD 16-23 list pg) 4/9112 FOOD PROGRAM OR