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SAN JOAQUIN COUNTY ?a ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 • c;.. _ i;�p. Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.siaov.ora/ehd Cl esS'A FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: City: STOrIMN Zip Code: Owner/Operator: Telephone: I✓U/ Program Element: Program Record: PROlugoM Inspection Type: 2 8180 Posted ❑Yes I Rermit Posted 7 Yes P Re-Inspection on or After: I K92 L_2aL� IN=In Compliance N/O=Not Observed NIA=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. Moor violations pose a_threat to pubhc health and must be corrected immediately. Non-compliance may warrant closure of the food facilit IN we w.: Demonstration of Knowledge •nal ou-r cus Superyision cu• 1. Demonstration of knowledge.food safety certificate 24. Person In Charge is present and performs duties " ovaNEmployesHealth and Hygiene Personal Cleanliness Communicable disease.reporting. restrictions&exclusions ' 25. Personal cleanliness and hair restraints 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 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 29. Toxic substances properly identified,stored,and used Time and Temperature Relations h 7. Proper hat and cold holding temperatures 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 and honestly presented 10. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean Non4. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment/utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use !14 Fooe contact surface cleaned and samt¢ed/warewash.ng pmced.ues 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 16. Food obtained Rom approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tagsidisplay 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical Facilities Conformance With Approved Proced' 1. Plumbing maintained:proper back flow prevention ' 13. Compliance wilh 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. Premisespersonal/cleaning items'. vermin-proofing Highly Susceptible Populations Permanent Food Facilities i P0 Prohibited foods not offered at high risk facilities 45. Floors walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility j21. Hat and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 47. Signs posted:last inspection report available 2. Sewage/wastewater properly disposed.toilet facility useable 'P,. Compliance with plan review requirements Vermin. 9. Facility operating with a valid health permit 23. No rodents.insects birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: EH Specialist: Phone: Page 1 of 41 EHD 16-23 list pg) 4/9112 FOOD PROGRAM OR