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SAN .JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siclov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: a'SA ti At W, S,'1r E� R t CE Date: 01-2-S-2,3 Address: ItD-]5 6. A -to $T, City. oc Zip Code: 95LIG A4 Owner/Operator: Telephone: Program Element: k 6' 1 5 Program Record: 5 Inspection Type: (ZD UTI t.4r_- SB180 Posted 0 Yes 0 Permit Posted 0 Yes 111, Re -Inspection on or After: 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'or violations pose a threat to public health and must be corrected immediatel . Non-compliance may warrant closure of the food facility �xrm rfn Demonstration of Knowled Supervision wr 1. Demonstration of knowledge.- food safety certificate Employee Health and:Hygie. _ Communicable disease, reporting, restrictions & exclusions 24- Person In Charge Is present and performs duties "-nliness 25. Personal cleanliness and hair restraints :Requirements 26. Approved thawing methods used No discharge from eyes, nose, or mouth; no open wounds Proper eating, tasting, drinking, or tobacco use Preisetrtt Contamination by Han.' 5 Hands clean and properly washed. proper glove use 7. Food protected from contamination during storage 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly identified, stored, and used Proper hot 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 Warewashing facilities maintained; test strips available Protection From CO. 12. No re -service of returned food -:- 5. Equipment/utensils approved; installed; clean; good repair 13. Food free from contamination and adulteration 6. Equipment, utensils and linens: storage and use 14 Food contac7 sn rtere cleaner and sani.izedwarewasnmg procedures 7. Vending machines maintained Food From Approved Source 8. Approved and sufficient ventilation and lighting 15. Food obtained from approved source - 9. Thermometers provided, accurate, and easily visible 16. Compliance with shell stock regulations; tags/display 0. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations 1' Conformance With Approved Procedures 1. Plumbing maintained; proper back flow prevention 18. Compliance with HACCP plan or variance conditions _ Consumer Advisory 1 42. Garbage and refuse property disposed 43. Toilet facilities clean, supplied, and maintained -'-- I 19 Advisory provided for raw or undercooked food 44. Premisespersonatbleaning items. vermin -proofing Highly Susceptible Populations Permanent Food Facilities 0. 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 ,21 Hot and cold potable water available. g Compliance and Enforcement Liquid Waste Disposal _; 7. Signs posted; last inspection report available L3 22. Sewage/wastewater properly disposedtoilet tacility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit LMI03. No rodentsinsects. birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/Title: EH Specialist: Ct--4144,bI-k Im U R f Phone: 2-09_561 - $923 Pagel of 2 EHO 16-23 (1 st pg) 419112 FOOD PROGRAM OIR