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SAN JOAQUIN COUNTY { ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd CrFok� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility; -- V Date: 1 _ _ 2- Address: Z S O e , City: -(CAC Zip Code: (� S _J-7-7 Owner/Operator: Telephone: Program Element; Program Record: -4 Inspection Type: 8180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: IN=In Compliance WO=Not Observed WA=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 aose a threat to public health and must be corrected immediatel . Non-corn liance maX warrant closure of the food-facility a �� laA Aemonstra6onof Knowledge I Mat bur u� .&upervision n'. �..__---d-- 1 Demonstration of knowledge;food safety certificate 24. Person In Charge is presen(and performs duties Employas.Heatth and Hygiene Personal Cleanliness .._ 12. Communicable disease;reporting,restrictions&exclusions �� 25. Personal cleanliness and hair restraints ��- k �,10,' 7,No discharge from eyes,nose,or mouth;no open wounds ' General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use TI 26. Approved thawing methods used Preventing Contaminatiiinii"Ha`pds 7. Food protected from contamination during storage Hantls clean and properly washed;proper glove use �- 8. Washing fruits and vegetables before use y� Handwashing facilities supplied and accessible 29. Toxic substances properly identified.stored,and used Time and Temperature'1#efaGa ,.,. , Food Storage/AisplaylService -? T Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled 8. Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided 9. Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures '; ,,.Equipmentf'Utensils f-I 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean & 4"'t on From Contamination 34. Warewashing facilities maintained;test strips available 41 f returned food 35. Equipment/utensils approved;installed;clean;good repair contamination and adulteration 36. Equipment,utensils and linens:storage and use rface cleaned and sanitized/warewashing procedures 37. Vending machines maintained 'Food From Approved Source 1 38. Approved and sufficient ventilation and lighting I15. Food obtained from approved source 1 '!i 9. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display ( 40. Proper use and storage of wiping cloths J_ 113. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 18 Compl onxe with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory. 3. 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 Facw 0 Prohibited foods nor offered at high risk facilities �� 5. Floors,walls and ceiling are maintained and kept clean Water I Hot Water 46, No living or sleeping quarters inside facility 1.He:and cold potable water available. Colisptiance Iaquid.Waste Disposal 7. Signs posted; last inspection report available 1:12. Sewagehvastewater properly disposed toilet facility useable 48. Compliance with pian review requirements - Vermin1 49. Facility operating with a valid health permit 3. No rodents, insects.birds or animals inside facility 50. Impoundment 51. Permit Suspension Received ByfTitle: Ce \e V �. EH Specialist: Phone: L-7 �_ 1 '2 �Z, Page 1 of EHD 16-23 (1st p3)41W12 J FOOD PROGRAM OIR vJ b5(6 nn rG) ck�S \7�