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e4"'"•. SAN JOAQUIN COUNTY <br />�. � ••.oma <br />y . ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.ora/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: rs C <br />Date: (_ I _ 2 <br />Address: 1 t1 a city--'T <br />ity <br />ro,,-c Zip Code: 9:S3-1-7 5 --.I <br />_1 <br />Owner/Operator: <br />Telephone: <br />Program Element:Program Record: S (,0 `-I <br />Inspection Type: <br />6180 Posted ❑ Yes ❑ No Permit Posted ❑ Yes ❑ No <br />Re -Inspection on or After: <br />IN = In Compliance WO = 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 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 />w nrci WA Demonstration of Knowledge <br />Mai oar cos <br />Supervision a,r <br />1. Demonstration of knowledge; food safety certificate <br />�. <br />24. <br />Person In Charge is present and performs duties <br />Employee Health and Hygiene <br />Personal Cleanliness <br />2. Communicable disease: reporting. restrictions & exclusions <br />25. <br />Personal cleanliness and hair restraints <br />3. No discharge from eyes, nose, or mouth; no open wounds <br />General Food Safety Requirements <br />\ <br />I 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 />v <br />'S. Hands clean and properly washed: proper glove use <br />28. <br />Washing Fruits and vegetables before use <br />Handwashing facilities supplied and accessible <br />29. <br />Toxic substances properly identified. stored, and used <br />Time and Temperature Relationship <br />Food Storage/Display/Service <br />7. Proper hot and cold holding temperatures <br />\ <br />30. <br />Food storage: food storage containers labeled <br />B. Proper use of time as a public health control <br />31. <br />Customer self-service food protected individual utensils provided <br />9. Proper cooling methods <br />32. <br />Food properly labeled and honestly presented <br />10. Proper cooking time and temperatures <br />Equipment/ Uferisiis / tieeri <br />11. Proper reheating procedures for hot holding <br />33. <br />Nonfood contact surfaces clean <br />Protection From Contamination <br />34. <br />Warewashing facilities maintained; test strips available <br />12. No re -service of returned food <br />5. <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 surface cleaned and sanitized'warewashing procedures <br />37. <br />vending machines maintained <br />Food From Approved Source <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 />_4 16. Compliance with shell stock regulations; tags/display <br />40. <br />Proper use and storage of wiping cloths <br />y 17. Compliance with Gulf oyster regulations <br />Physical Facilities <br />Conformance With Approved Procedures - <br />41, <br />Plumbing maintained; proper back flow prevention <br />A 18. 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 />-1]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 />�. X120. 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 />�1. Hot and cold potable water available. <br />Compliance and Enforcement <br />Liquid Waste Disposal <br />47. <br />Signs posted; last inspection report available <br />2. Sewage/wastewater properly disposed; toilet facility useable <br />8. <br />Compliance with plan review requirements <br />Vermin <br />9. <br />Facility operating with a valid health permit <br />�3. No rodents, insects, birds or animals inside facility <br />-O. <br />Impoundment <br />1. <br />Permit Suspension <br />Received Bylritle:�\ I 1 rn <br />EH Specialis - <br />Page 1 of <br />Phone: 2pci_ (o1 6-31p <br />EHD 16-23 (1st pg) 4/9/12 <br />FOOD PROGRAM OIR <br />5 <br />