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op,A4!!N, c SAN JOAQUIN COUNTY <br />?t ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.si.gov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: S D - <br />Date: <br />L) Z <br />ddress: O �,� <br />114 <br />ity: S -t' C Zip Code: <br />O <br />wner/Operator: <br />Telephone: <br />Program Element: Program Record: <br />Inspection Type: <br />8180 Posted ❑ Yes Rermit Posted ❑ Yes Ft <br />Re -Inspection on or After: <br />IN = In Compliance N/O = 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 may warrant closure of the food facility <br />Demonstration of Knowledger., _ i_.. Supervlsion _... ou+ <br />1_ Demonstration of knowledgefood safety certificate 24. Person In Charge is present and performs duties <br />Employee Health and Hygiene ,� ,,` Personal Cleanline� <br />Communicable disease, reporting. restrictions & exclusions 25. Personal cleanliness and hair restraints <br />No discharge from eyes, nose, or mouth; no open wounds - saf <br />Proper eating, tasting, drinking, or tobacco use _ 6. Approved thawing methods used <br />JWting Contamination by, Han"' -- <br />Hands clean and properly washed; proper glove use <br />7. <br />Food protected from contamination during storage <br />B. <br />Washing fruits and vegetables before use <br />Handwashing facilities supplied and accessible <br />me an flitnpelattsre <br />9. <br />Toxic substances properly identified, stored, and used <br />Proper hot and cold holding temperatures <br />0. <br />Food storage; food storage containers labeled <br />\ Proper use of time as a public health control <br />i. <br />Customer self-service food protected; individual utensils provided <br />Proper cooling methods <br />2. <br />Food properly labeled and honestly presented <br />10. Proper cooking time and temperatures <br />11. Proper reheating procedures for hot holding <br />3. <br />Equipment l Utensils./ Lin <br />Nonfood contact surfaces clean <br />_ Pr "on:. ,roar C Otam <br />4. <br />Warewashing facilities maintained; test strips available <br />12. No re -service of returned food <br />5. <br />Equipment/utensils approved; installed; dean; good repair <br />13. Food free from contamination and adulteration <br />6. <br />Equipment, utensils and linens: storage and use <br />14, Food contact surface cleaned and sanitized/warewashing procedures <br />37. <br />Vending machines maintained <br />Food From Approv8. <br />15. Food obtained from approved source <br />Approved and sufficient ventilation and lighting <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 />1. <br />Plumbing maintained; proper backflow prevention <br />formance With App',:: <br />8. Compliance with HACCP plan or variance conditions <br />42. <br />Garbage and refuse properly disposed <br />Consumer Advisory <br />43. <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 Popul <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/ Halumm <br />L Hot and cold potable water available. <br />Liquid Wa„ _., <br />2. Sewagelwastewater properly disposed toilet facility useable <br />a,.. <br />46. <br />No living or sleeping quarters inside facility <br />Compliance and Enforcement <br />7. <br />48. <br />Signs posted; last inspection report available <br />Compliance with plan review requirements <br />Vermin <br />49. <br />Facility operating with a valid health permit <br />3. No rodentsinsects, birds or animals inside facility <br />50. <br />Impoundment <br />1. <br />Permit Suspension <br />/} <br />Received By/Title: -fGs� `' n9C1 1LVQCQ P t - <br />EH Specialist✓ of „r p �i <br />Phone: 30'3�5 Page 1 of <br />EHD 16-23 (1st pg) 419112 FOOD PROGRAM OR <br />