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o44utry c ciF p'n'� SAN .JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sioov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: „� Date: j 3 ddress: CA City: Vl Zip Code: caner/Operaor. vlln Telephone: lC� Program Element: Program Record: Inspection Type: B180 Posted Yes 0 Rermit Posted Yes ❑ f Re -Inspection on or After: N 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. Ma) violations pose a threat to public health and must be corrected immediate) . Non-compliance may warrant closure of the food facilit _ .n no wa Demonstration of Knowledge M)a an cos Supervision uur 1. Demonstration of knowledge_ food safety certificate 24. Person In Charge is present and performs duties - Employee Health and Hygiene Personal Cleanliness - Communicable disease, reporting, restrictions 8 exclusions 25- Personal cleanliness and hair restraints 3. No discharge from eyes, nose, or mouth; no open wounds - General Food Safety Requirements �' Proper eating, tasting. drinking, or tobacco use 26. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage 5. Hands clean and properly washed; proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible Timeand^ elafionsh" Proper hot and cold holding temperatures 9. Toxic substances properly identified, stored, and used 0. Food storage; food storage containers labeled Proper use of time as a public health control 1. Customer self-service food protected; individual utensils provided Proper cooling methods 2. Food properly labeled antl honestly presented 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding 12. No re -service of returned food 3. Nonfood contact surfaces clean . Warewashing facilities maintained; test strips available 35. Equipmentfutensils approved; installed; clean; good repair 13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 14. Food contact surface cleaned and Sat itized aie,samg omcadures 37. Vending machines maintained Food From Approved Source "r 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided. accurate. and easily visible _1L 16. Compliance with shell stock regulations; tags/display 17. Compliance with Gulf oyster regulations --I, 40. 41. Proper use and storage of wiping cloths _ ,, Physical Facilities r� _ Plumbing maintained: proper back flow prevention _ Conformance With Approved Procedures 18. Compliance with HACCP 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. personalicleaning items: vermin -proofing Highly Susceptible Populations Permanent Food Facilities �20 Prohibited foods not offered of high risk facilities 45. Floors, walls and ceiling are maintained and kept clean Water / Hot Water 0. No living or sleeping quarters inside facility - �1. Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted last inspection reportavailable 22 Sewage/wastewater properly disposedtoilet facility useable 48. Compliance with plan review requirements jiffiLunin - 9. Facility operating with a valid health permit 3. No rodents, Insectsbirds or animals inside facility 50- Impoundment 1. Permit Suspension Received By/Tit �L_ EH Specialist Phone: Pagel of EHD.16-23(1st1419112 V FOOD PROGRAM OR