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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.s*gov.org/ehd 4Giddw' FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: I Date: ddress: City: Zip Code: Owner/Operator, Telephone(4I Vf_!r � Program Element: Program Record: Inspection Type: -11 8180 Posted Qf�,Yes ❑ Permit Posted Ok Yes ❑ P Re -Inspection on or After: u 11a IN = In Compliance i = 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 food facility Demonstration of Knowledge 1 rn-..:: ,- _:m__— __v__ 1. Demonstration of knowledge. food safety certificate <sa cus 24 SupervisionAli ob` Person In Charge is present and performs dunes Employee Health and Hygiene Personal Cleanliness Communicable diseasereporting. restrictions & exclusions 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 27. Food protected from contamination during storage Hands clean and properly washed; proper glove use 28 washing fruits and vegetables before use Handwashing facilities supplied and accessible 29_ Toxic substances properly identified, stored, and used 30 �- FoodStorai isplayi. elt tf '- -. Food storagefood storage containers labeled Proper hot and cold holding temperatures B. Proper use of time as a public health control 31. Customer self-service food protected; individual utensils provided 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures I I EqyjfW Utensils 7 Linens 11. Proper reheating procedures for hot holding Protection From Contamination 33. ;+4. Nonfood contact surfaces clean Warewashing facilities maintained; test strips available 12. No re -service of returned food ''. 35. 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 warewasin ng procedures 37. Vending machines maintained ............ rom Approved Source 38. Approved and sufficient ventilation and lighting .; 15. Food obtained from approved source 11 E3. Compliance with shell stock regulations; tags/display 9. Thermometers provided, accurate, and easily visible -I 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations „; Physical Facilities Conformance With ApprovedProcedures 1. Plumbing maintained; proper back Flow prevention 18 Compliance with 11ACCP plan dr 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 00. Piohmited foods not offered at high risk facilities 45. Floors, walls and catling are maintained and kept clean Water / Hot Water C. No living or sleeping quarters inside facility �21. Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted, last inspection report available �2 Sewage/wastewater piopody disposedtoilet facility useable 48, Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit :I 3. No rodents_ insectsbirds or animals inside facility 50_ Impoundment 51. Permit Suspension Received BylTitla: EH Specialist: Phone: Page 1 of EHD 1623 (1st pg) 4/9/12 v FOOD PROGRAM OR