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SAN .JOAQUIN COUNTY <br />? ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />�i1'Ba <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: PI V e 5r AR_-KGv <br />Date: 01-10-2-3 <br />Address: 12-47 S . $q N S•T- city. <br />5 TO G k-ro Zip Code: 9 s 2 06 <br />Owner/Operator: <br />Telephone: <br />Program Element: ' Program Record: RE x5 Ll 114117 <br />Inspection Type: R p <br />SB780 Posted es ❑ Rermit Posted IrYes ❑ P <br />Re -Inspection on or After: <br />IN = In Compliance N/O = Not Observed N/A = Not Applicable COS = Corrected on-site MAJ = Major Violation OUT = Not in Compliance <br />See reverse side for code sections and general requirements that correspond to each violation fisted below. <br />Major violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the foodiii <br />N ;N.olw: Demonstration of Knowledge <br />`Supervision out` <br />L Demonstration of knowledgefood safety certificate <br />24. <br />Person In Charge is present and performs duties <br />Employs,1121JUJIlgil Hygiene <br />C0.mNmmicable disease, reporting, restrictions 8 exclusions <br />Personal Cleanliness <br />25 <br />Personal cleanliness and ran restraints <br />3. No �scharge from eyes, now, or mouth; no open wounds <br />General Food Safety Requirements <br />�4. Prope eating, tasting, driking, nor tobacco use <br />_'S. <br />Approved thawing methods used <br />5 Preventing Contamination by Hands <br />27. <br />Food protected from contamination during storage <br />Hands clean and properly washed. proper glove use <br />28_ <br />Washing fruits and vegetables before use <br />[6. Handwas unci aaihtieo supplied and accessible <br />Time and Temperature Relationship <br />29. <br />Toxic substances properly identified, stored, and used <br />30. <br />`- Fool toragelDisplayt5ervi ,' <br />Food storagefood storage containers labeled <br />7. Proper hot and cold holding temperatures <br />Proper use of ti as a public health control <br />1. <br />Customer self-service food protected; individual utensils provided <br />Properwoling methods <br />2. <br />Food properly labeled and honestly presented <br />10. Proper cooking time and temperatures <br />Equipment / Utensils / Ltnens <br />11. Proper reheating procedures for hot holding <br />ei•_ .„ Protection,From Contamination <br />33. <br />Nonfood contact surfaces clean <br />34. <br />Warewashing facilities maintained; test strips available B <br />12. No re -service of returned food <br />35. <br />Equipment/utensils approved; installed; dean; good repair <br />-1713. 13. Food free from contamination and adulteration <br />36. <br />Equipment, utensils and linens: storage and use <br />14. Food contzct su,lace cleaned and san Bized'warewashmg procedures <br />37. <br />Vending machines maintained <br />Food From Approved Source v _ <br />38. <br />Approved and sufficient ventilation and lighting <br />15. Food obtained from approved source <br />39. <br />Thermometers provided, accurate, and easily visible <br />16. Compliance with shell stock regulations; tags/display <br />40. <br />Proper use and storage of wiping cloths <br />17. Compliance with Gulf oyster regulations <br />41. <br />,_ Physical Facilities-.- :r;•. <br />Plumbing maintained, proper back flow prevention <br />Conformance With Approved Procedures <br />I18 Compliance with HACCP plan or variance conditions <br />42. <br />Garbage and refuse properly disposed <br />Consumer Advisory <br />43. <br />Toilet facilities dean, supplied, and maintained <br />19. Advisory provided fol rave or undercooked food <br />44. <br />Premises- personallcleaning items', vermin -proofing <br />Highly Susceptible Populations <br />I Permanent Food Facilities <br />' 0 Prohibited foods not offered at high risk faclldles <br />45_ <br />Floors, walls and calling are maintained and kept clean <br />Water / Hot Water <br />46. <br />No living or sleeping quarters inside facility <br />l'21 Hot and cold potable water available <br />- Compliance and Enforcement <br />Liquid Waste Disposal <br />47. <br />Signs posted; last inspection report available <br />122 SewanNwastewater properly disposed toilet facility useable <br />48. <br />Compliance with plan review requirements <br />Vermin <br />4.9. <br />Facility operating with a valid health permit <br />j23 No rodnts. insects buds or animals inside facility <br />50. <br />Impoundment <br />51, <br />Permit Suspension <br />Received By/Title: <br />EH Specialist: C u n 1)t— Utzo <br />Phone: 7A p 556 I— O 92 3 Page 1 of Z <br />EHD 16-23 (1st PA) 419112 FOOD PROGRAM OR <br />