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o.PAgfH• a SAN aJOAQUIN COUNTY <br />r. 4 ENVIRONMENTAL HEALTH DEPARTMENT <br />b <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.orglehd <br />�If ORS <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: YA '( ea k <br />Date: l Z <br />Address: / / O �- t // City: <br />ly 17-�7Z <br />v /T Zip Code: <br />rl <br />caner/Operator: 1yn ,' <br />/_/ / `� <br />Telephone: <br />Program Element: - Program Record: <br />Inspection Type: <br />B180 Posted ❑ Yes ❑ Permit Posted ❑ Yes ❑ P <br />Re -Inspection on or After: <br />IN = In Compliance NIO = Not Observed NIA = 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 listed below. <br />Major violations pose a threat to public health and must be corrected immediately. Non-compliance my warrant closure of the food facility <br />�•, wo H:. <br />Demonstration of Knowledge <br />rn;,r ou* <br />cos <br />'Supervision - am <br />I Demonstration of knowledge'. food safety certificate <br />24_ <br />Person In Charge is present and periomts duties <br />Employee Health and Hygiene _ALL <br />Personal Cleanliness <br />j2. Communicable disease, reporting. restrictions & exclusions <br />25- <br />Personal cleanliness and hail restraints <br />3. No discharge from eyes, nose, or mouth; no open wounds <br />General Food Safety Requirements <br />4. Proper eating. tasting. drinking. or tobacco use <br />26. <br />Approved thawing methods used <br />Preventing Contamination by Hands <br />27. <br />Food protected from contamination during storage <br />i5. Hands clean and properly washed, proper glove use <br />28. <br />Washing fruits and vegetables before use <br />l3 Handwashing facilities supplied and accessible <br />29. <br />Toxic substances properly identified, stated, and used <br />" time and 111Wure Relationship "`" <br />Food Storage7DisplaylService <br />Proper hot and cold holding temperatures <br />30. <br />Food storage: food storage containers labeled <br />Proper use of time as a public health control <br />31. <br />Customer self-service food protected; individual utensils provided <br />Proper cooling methods <br />10. Proper cooking time and temperatures <br />11_ Proper reheating procedures for hot holding <br />Protection From Contamination., <br />32. <br />33. <br />Food properly labeled and honestly presented <br />Nonfood contact surfaces clean <br />34. <br />Warewashing facilities maintained; test strips available <br />12. No re -service of returned food <br />35. <br />Equipment/utensils approved; installed; clean; good repair <br />"13. Food free from contamination and adulteration <br />36. <br />Equipment, utensils and linens: storage and use <br />14 Food contact surfacc c ear ed ,-d s , rh dwa-e� ? ^-oceu ire= <br />37. <br />Vending machines maintained <br />_ Food From Approved Source Aeon <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 />43. <br />Proper use and storage of wiping cloths <br />Physical Facilities <br />17. Compliance with Gulf oyster regulations <br />Conformance With Approved Procedures `" <br />1. <br />Plumblrg maintained proper back flow prevention <br />18. Compliance with HACCP plan or variance conditions <br />Consumer Advisory <br />42. <br />43. <br />Garbage and refuse properly disposed <br />Toilet facilities clean, supplied, and maintained <br />19. Advisory provided for raw or undercooked food <br />44. <br />Premises: personal/cleaning items. vermin -proofing <br />Highly Susceptible Populations <br />.Permanent Food Facilities <br />0. Prohibited foods not offered at high risk facilities <br />45. <br />Floors. walls and ceiling are maintained and kept clean <br />- Water/ Hot Water <br />46. <br />No living or sleeping quarters inside facility <br />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 />t22. Sewage/wastewater properly disposedtoilet facility useable <br />ui, <br />Compliance with plan review requirements <br />Vermin <br />9. <br />Facility operating with a valid health permit <br />,123. No rodentsinsects. birds or anima's inside facility <br />50. <br />Impoundment <br />51. <br />Permit Suspension <br />Received By/Title: �- - <br />EH Specialist: o x <br />.1-l19 - u 01 _ /o (a oO <br />Phone: - 1 14 �jos-2 Page 1 of <br />EHD 16-23 list 14/9112 U FOOD PROGRAM OR <br />