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QP <br />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: til7} <br />Address: M City: <br />Zip Code: <br />Owner/Operator: I nc, <br />Telephone: <br />Program Element: U IDW Program Record: �,� <br />Inspection Type: <br />SB180 Posted No Permit Posteds <br />Re -Inspection on or After: <br />IN = In Compliance N/O = Not Observed N/A = 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 />Major violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facifit <br />w m,a urk I Demonstration of Knowledge <br />maul our <br />ens <br />Supervision <br /><xn <br />�1. Demonstration of knowledge; food safety certificate <br />24. <br />Person In Charge is present and performs duties <br />Employee Health and Hygiene <br />Personal Cleanliness - <br />2 Communicable disease; reporting, restrictions 8 exclusion <br />25. <br />Personal cleanliness and hair restraints <br />3. No discharge from eyes, nose, or mouth; no open wounds <br />General Food Safety Requirements <br />4. Proper eating, tasting, drinking, or tobacco use <br />26. <br />Approved thawing methods used <br />Preventing Contamination by Hands" <br />27. <br />Food protected from contamination during storage <br />5. Hands clean and properly washed: proper glove use <br />28. <br />Washing fruits and vegetables before use <br />6. Handwashing facilities supplied and accessible <br />9. <br />Toxic substances properly identified, stored. and used <br />Time and Temperature Relationship <br />Food Storage/Display/Service <br />7. Proper hot and cold holding temperatures <br />30. <br />Food storage; food storage containers labeled <br />X <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 />1o. Proper cooking time and temperatures <br />Equipment / Utensils /linens - <br />11. Proper reheating procedures for hot holding <br />33. <br />Nonfood contact surfaces clean <br />Protection From Contamination <br />34. <br />Warewashing facilities maintained; test strips available <br />12. No re -service of returned food <br />35. <br />Equipmentlutensils approved; installed; clean; good repair <br />':13. Food free from contamination and adulteration <br />36. <br />Equipment, utensils and linens: storage and use <br />14. Food conlacl sunace cleaned and sanitized/warewashing procedures <br />37. <br />Vending machines maintained <br />Food From Approved Source <br />38. <br />Approved and sufficient ventilation and lighting <br />15. Food obtained from approved source <br />39. <br />Thermometers provided, accurate, and easily visible <br />16. Compliance with shell stock regulations; tags/display <br />40. <br />Proper use and storage of wiping cloths <br />17. Compliance with Gulf oyster regulations <br />Physical Facilities <br />Conformance With Approved Procedures <br />41. <br />Plumbing maintained; proper back flow prevention <br />18. Compliance with HACCP plan or variance conditions <br />42. <br />Garbage and refuse properly disposed <br />Consumer Advisory <br />43. <br />Toilet facilities clean, supplied, and maintained <br />19. Advisory provided for raw or undercooked food <br />44. <br />Premises; personal/cleaning items; vermin -proofing <br />Highly Susceptible Populations <br />;; Permanent Food Facilities <br />20. Prohibited foods not offered at high risk facilities <br />45 <br />Floors, walls and ceiling are maintained and kept clean <br />Water / Hot Water <br />16. <br />No living or sleeping quarters inside facility <br />21. Hot and cold potable water available. <br />Compliance and Enforcement ` <br />Liquid Waste Disposal <br />7. <br />Signs posted; last inspection report available <br />22. Sewage/wastewater properly disposed: toilet facility usea <br />48. <br />Compliance with plan review requirements <br />Vermin <br />49. <br />Facility operating with a valid health permit <br />23. No rodents, insects, birds or animals inside facility <br />50. <br />Impoundment <br />51. <br />Permit Suspension <br />Received By/Title: <br />EH Specialist: <br />Phone: I In _t_lfPage 1 of <br />1G <br />EHD 16-23 (1st11/03/17 FOOD PROGRAM OIR <br />