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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.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: 12-Z3 ddress:' City: ` 1 Zip Code: wner/Operator. Che.\Se `4 Telephone: Program Element: Program Record: J Inspection Type: 8180 Posted n Yes n Hermit Posted n Yes n P Re -Inspection on or After: IN = In Compliance NIO = 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-compliance may warrant closure of the facility - f wa ¢ .Demonstration of Knowledge ru„ ow cus Supervision. :our 1 Demonstration of knowledge_ food safety certificate 24_ Person In Charge is present and performs duties Hygiene Communicable disease; reporting, restrictions & exclusions Personal Cleanliness 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 5. Hands clean and properly washed. proper glove use 27. Food protected from contamination during storage 28. Washing fruits and vegetables before use Flandwashing facilities supplied and accessible �_ 29. 30. Tonic substances properly identified, stored, and used Food Sto Food storage, food storage containers labeled Time and Temperature Relationship 7. Proper hot and cold holding temperatures 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 , . Equipment / Utensils I Lin 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean Protection From Contamination Warewashing facilities maintained; test strips available x, 12. No re -service of returned food 5. Equipmentlutensils approved; installed; dean; good repair 13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 14. Food contact s�dace cleaned and sanitized dre.asidirm 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 16. Compliance with shell stock regulations, tags/display 40. Proper use and storage of wiping cloths Physical Facilities 17. Compliance with Gulf oyster regulations Conformance Wfid Approved Procedures 41. Plumbing maintained; proper back flow prevention ` 18. Compliance vmh HACCP plan or variance conditions o/ 42. Garbage and refuse properly disposed - Consumer Advisory 43. Toilet facilities clean, supplied, and maintained yhl�19 Advisory provided for ravr or undercooked food 44. Premises; personal/cleaning items; vermin -proofing Highly Susceptible Populations Permanent Food Facilities + 0. Prohibited foods not offered at high risk facilities 45. Floors, walls and ceiling are maintained and kept clean Water / Hot Water _ �21. Hat and cold potable water available- 6. No living or sleeping quarters inside facility Liquid Wa 47. Signs posted last inspection report available `22 Sewagelwastewater properly disposedtoilet facility useable 48. Compliance with plan review requirements - Vermin 9. Facility operating with a valid health permit ,:- i23_ No rodents. insects. birds or animals inside facility 50. Impoundment 51. Penni/ Suspension Received By/Title: � � EH Special's _ Phone: Oct-- 302.5 Page 1 of 2G r/ EHD 16-23 (1st pg) 419/12 FOOD PROGRAM OIR_