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J op,4V.!N. o 2. C •ya • c•(CiKORi''`a SAN aJOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sioov.orq/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility:"i eciii Date: Address: 2 \5 O.G l V city: Zip Code: Owner/Operator: Telephone: Program Element: Program Record: 22 Inspection Type: ` 6180 Posted ❑ Yes ❑ Rermit Posted ❑ Yes ❑ P Re -Inspection on or After: IN = In Compliance N/O = Not Observed N/A = 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 may warrant closure of the food facilites. nN.nro N;.� Demonstration of Knowledge Supervision c�c. L De m onstrabon of knowledge, food safely certificate y 24. 1 eismr In Cha ge is f sen and pcdorms duties Employ - Communicable disease, reporting, restrictions & exclusions - Personal Cleanliness 25. Personal cleanliness and hair restraints 3. No discharge from eyes, nose, or mouth; no open wounds General Food Safety Requirements fTf a. Proper eating, tasting, drinking. or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage 15 Hands clean and properly washed, proper glove use 28. Washing fruits and vegetables before use V. Handwashing facilities supplied and accessible 9. Toxic substances properly identified, storedand used Time and Temperature 'Relationship "' '" '" "" "- ' - xfod Storage/DisplaplServlce 7. Proper hot and cold holding temperatures 30. Food storage. food storage containers labeled Proper use of time as a public health control 31. Customer self-service food protected; individual utensils provided Proper cooling methods 32. Food propedy labeled and honestly presented 10. Proper cooking time and temperatures Equipment / Utensils t Linens 11. Proper reheating procedures for hot holding Protec6on.FrotR gpntamination ....: 33. Nonfood contact surfaces clean 34. Warewashing facilities maintained; test strips available 12 No re service of returned food 35. Equipmentlutensils approved; installed; clean; goad repair 113. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 1a. Food costa: t surface cleaned and sanitizedrwarewashmg procedures 37. Vending machines maintained Food From Approved Source "r 38. Approved and sufficient ventilation and lighting 1115. Food obtained from approved source ..... 39. Thermometers provided, accurate. and easily visible 16. Compliance with shell stock regulations; tags/dispi 40. Proper use and storage of winino cloths 17. Compliance with Gulf oyster regulations '', Physical Facilities ' " Conformance With Approved Procedures 41. Plumbing. maintained; proper back flow prevention K11 0 . Compliance wah IiACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 43. Toilet facilities clean, supplied, and maintained 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 41 Flnors, walls and ceiling are maintained and kept clean Water/ Hot Water 5 No living or sleeping quarters inside facility II"" K1. Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 4T Signs posted; last inspection report available 22 Sewage/wastewater properly disposed. todel facility useable 48, Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit 3. No rodents in cts birds or a, rial, inside faatry 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist,Phone: Z _ 1 �� Page 1 of EHD 16-23 list p9) 419112 FOOD PROGRAM OR d5