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SAN JOAQUIN COUNTY z ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd 41FOrr� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Q Date:3 4*,R3 ddress: t f3 / in /J G City: /' .. 1 Zip Code: owner/Operator:: Ome Telephone: ;Z0-v Program Element: Program Record: Inspection Type: SB180 Posted D Yes Fil Kermit Posted %Yes ❑ P Re -Inspection on or After: /V/19 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 facility �m N:o rt•x Demonstration of Knowledge rx--1 Wilcos Supervision au, �1. Demonstration of knowledgefood safety certificate 24_ Person In Charge is present and performs duties Employee Health and Hygiene - Communicable disease. reporting, restrictions & exclusions 25. Personal Cleanliness 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 Hands clean and properly washed; proper glove use 28 Washing fruits and vegetables before use Handwashing facilities supplied and accessible m Proper hot and cold holding temperatures 29 30. Toxic substances properly identified, stored, and used ' Food Storage/Display/Service Food storage; food storage containers labeled Proper use of time as a public health control 710. 31. Customer self-service food protected; individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented Proper cooking time and temperatures t 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained; test strips available 12. No re -service of returned food 35. Equipment/utensils approved, installed; dean; good repair 13. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 14. Food contact so nate cleaned and sandrzed'v.arewashing procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting . .. 15. Food obtained from approved source 39. Thermometers provided, accurate, and easily visible 16. Compliance with shell stock regulations; tags/display 40. Proper use and storage of wiping cloths 11 7. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Procedures 41 Plumbing maintained proper back now prevention 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 4. Premises. personallcleaning Items: vermin -proofing Highly Susceptible Populations 11 1 :Permanent Food Facilities _ 0. Prohibited foods not offered nt high risk facilities 4 5. Floors walls and ceiling are maintained and kept clean Water/ Hot Water 6. 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 report available X22 Sewage/waslewater properly disposedtoilet facility useable 48. Compliance with plan review requirements Vermin 49, Facility operating with a valid health permit ... 43. No rodents, insects. birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: :Page1 of Phone: J„/ 30 EHD 16-23(lst pi 419112 V FOOD PROGRAM OR