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SAN JOAQUIN COUNTY 'aPA..•t1...coG ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.org/ehd NPO'e FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: " C - Date: Address: 22. Se� Clry. �O\r Zip Code: qJ Owner/Operator: Telephone: Program Element: Program Record: fl Inspection Type: 6180 Posted ❑ Yes U Rennit Posted ❑ Yes ❑ P Re -Inspection on or After: IN = 1n 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. Mato[ violations pose a threat to eublic health and must be corrected immediatel . Non-compliance ma warrant closure of the food facility_ _ IN rA*WA Demonstration of Knowledge: W-1 ouT cos Supervision II1- Demonstration of knowledge: food safety certificate ! 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness -- '., A Communicable disease: reporting. restrictions & exclusions 25 Personal cleanliness and hair restraints General Food Safety Requirements No discharge from eyes, nose, or mouth; no open wounds Proper eating, tasting, drinking, or tobacco use ', 20. Approved thawing methods used - n andsAMU 5. Hands clean and properly washed; proper glove use 27. Food protected from contamination during storage F8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible Time and Temperatu. Proper hat and cold holding temperatures 9. 0. Toxic substances properly identified, stored, and used Food storage; 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. 3. Food properly labeled and honestly presented ME Nonfood contact surfaces clean 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding ,`.-. Protect o _ ._, 12. No re -service of returned food 4. Warewashing facll'bes maintained; test strips available 5. Equipment/utensils approved; installed; clean; good repair 13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures •r ".. �;r 15. Food obtained from approved source 1 37. Vending machines maintained 8. Approved and sufficient ventilation and lighting 39. Thermometers provided, accurate, and easily visible 16. Compliance with shell stock regulations; tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations C it ., ... , : ,� 'Physical Facilities Conformance With!., -ed Procedures 41 Plumbing maintainedproper back flow prevention IX 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean, supplied, and maintained K 119. Advisory provided for raw 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 / Hat Water 46. No living or sleeping quarters inside facility 1. Hot and cold potable wale[ available. Complianceand Enforcement -- - fd Waste Disposal 2. Sewagelwastewater properly disposedtoilet facility useable 3. No rodents, insects, birds or animals inside facility A7. Signs posted last inspection report available 8. 9. Compliance with plan review requirements Facility operating with a valid health permit 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialis • - Phone: 2`.)c;lC_ f_ ( (0_�� e Page 1 of EHD 1&23 (1st pg) 4/9/12 FOOD PROGRAM OR 5