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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sioov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Date: _ 2_ <br />ddress:�I O CA _ tty.Ile <br />/ <br />Zip Code: 9521_5 <br />Owner/Operator: L `1 b A O Y A L' A <br />'l I�PIr'oogramRecord: <br />Telephone: <br />Program Element: <br />Inspection Type: <br />SB180 Posted Ves 0 Rermit Posted o Yes ❑ P <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 />Ma'or violationsposea threat to public health and must be corrected immediatel . Non-compliance may warrant closure of the food facility <br />.v n rte <br />a a 'Demonstration of Knowledge <br />u>J� our cos <br />24. <br />, <br />Su.. <br />MF f��YY <br />Person In Charge Is present and perforans duties <br />1. Demonstration of knowledge; food safety certificate <br />Employee Health and Hygiene <br />Persoraii76 nlfness <br />P. Communicable disease, reporting, restrictions &exclusions <br />25. <br />26. <br />Personal cleanliness and hau restraints <br />General Food Safety Requirements <br />Approved thawing methods used <br />i3. No discharge from eyes, nose, or mouth; no of wounds <br />N. Proper eating. tasting. drinking. or tobacco use <br />Preventing Contamination by Hands <br />27. <br />Food protected from contamination during storage <br />5. Hands clean and properly washeQ 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 />• <br />Time and Temperatu ;- <br />Proper hot and cold holding temperatures <br />'' <br />30. <br />Food SterageiDisplayl5ervice <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 />32. <br />Food properly labeled and honestly presented <br />10. Proper cooking time and temperatures <br />. Equipment / Utensils linens <br />11. Proper reheating procedures for hot holding lit <br />_ <br />12. No re -service of returned food <br />33. <br />34. <br />35. <br />Nonfood contact surfaces clean <br />Warewashing facilities maintained; test strips available <br />Equipment/utensils approved; installed; dean; 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 sanitizedtwarewashing procedures <br />37. <br />Vending machines maintained <br />X15. rood obtained tram approved source <br />38. <br />39. <br />Approved and sufficient ventilation and lighting <br />Thermometers provided, accurate. and easily visible <br />16. Compliance with shell stock regulations; tags/display <br />0. <br />Proper use and storage of wiping cloths <br />17. Compliance with Gulf oyster regulations „..- <br />Physical Facilities <br />W nformanee With Approved Procedures <br />41. <br />Plumbing maintained proper back flow prevention <br />Com [ilia nce with HACCP plan or variance conditions <br />2. <br />Garbage and refuse properly disposed <br />Consumer Advisory <br />43, <br />Toilet facilities clean, supplied, and maintained <br />1.9. Advisory provided for raw or undercooked food <br />44. <br />Premisespersonal/cleaning items: vermin -proofing <br />Highly Susceptible Populal! <br />Permanent Food Facilities <br />"i Prohibited foods not offered at high risk facilities <br />Water Hot <br />1. Hot .�i i (rid l made water available. <br />Liquid We <br />2 S-wa ;c wastewehi -iopelp disposed; toilet facility useable <br />ve <br />5. <br />46. <br />47, <br />48. <br />49, <br />Floorswalls and ceding are maintained and kept clean Ile <br />No living or sleeping quarters inside facility <br />Compliance and Enforcement_ <br />Signs posted; last inspection report available <br />Compliance with plan review requirements <br />Facility operating with a valid health permit <br />3. No rodents. insects, birds or animals inside facility <br />5o. <br />Impoundment <br />1[51- <br />Permit Suspension <br />Received By/Title: <br />EH Specialist: `1 L-A ? 1 2_ AA <br />hone: %-,, ;;�6 _ p Page 1 of <br />EHD 16-23 dst pg) 419112 FOOD PROGRAM OIR <br />