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CF" SAN .JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility:ADate: 1 77 yfi2 7 r 1 ( nil A- City: Address: '744y Zip Code: Owner/Operator: Telephone:' ii 21_G712 O H Program Element: Program Record: it Inspection Type• SB180 Posted ❑ Yes ❑ Rermit Posted Yes ❑ Re -Inspection on or After: / 2 %z IN = In Compliance N/O = Not Observed NIA = 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 map warrant closure of the food facility Demonstration of Knowledge ec.i no^ cos Supervision 1 Dem onst:ation of k rcv led.,r food safety cedificate 24. Person In Charge is present and performs duties Employee Health and Hygiene R Conununicable d,s ase. reporting, restrictions & exclusions 3. No discharge from eyes, nose, or mouth; no open wounds 25- Personal Cleanliness Personal cleanliness and hair restraints &Safety.Requirements `i 4 Proper eating, tasting. drinking, or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage 5. Honda clean and properly washed. proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. 30. Toxic substances properly identified- stored. and used -° ''Food'Storage/Disptay/Service Food storage, food storage containers labeled Time and Temperature Relationsh Proper hot and cold holding temperatures 8. Proper use of time as a public health control 31. Customer self-service food protected; individual utensils provided 9. Proper cooling methods 32. 33. 34. 35. Food properly labeled and honestly presented Nonfood contact surfaces clean Warewashing facilities maintained; test strips available Equipmentiutensils approved; installed; clean; good repair 10. Proper cooking time and temperatures i t. Proper reheating procedures for hot holding 12. No re -service of returned food x 13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 14. Food contact su riace cleaned and sarntizednvarewashing procetlures 7. Vending machines maintained Food From Approved Sou 38. Approved and sufficient ventilation and lighting X15. Food obtained Morn approved source 30. Thermometers provided, accurate, and easily visible 76. Compliance with shell stock regulations; tags/display 17. Compliance with Gulf oyster regulations 40. Proper use and storage of wiping cloths Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained; proper back flow prevention 18. Compliance with HACCP plan or variance conditions Consumer Advisory 42. Garbage and refuse properly disposed 43. Toilet facilities clean, supplied, and maintained rs 19. 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 celling are maintained and kept clean Water / Hot Water 46. No living or sleeping quarters inside facility 'd "-11 Hot and cold potable water available. Compliance and Enforcement' Liquid Waste Disposal' 47. Signs posted: last inspection report available /T �2. Sewage/wastewater properly disposedtoilet facility useablo 8. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit i l23. No rodents. insects. birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: X EH Specialist: ` !QL Phone: n _ I 1 n _ , J Page 1 oh EHD 1623 (1st pg) 419112 FOOD PROGRAM OIR