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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c{ctFaR p Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S Date: Z <br /> ddress: -->-f- <br /> 7 City: Zip Code: � D <br /> � <br /> Owner/Operator: i Telephone: <br /> Program Element: Progra Record: Inspection Type: In •µms <br /> B180 Posted 'Yes U Remit Posted Yes ❑P Re-Inspection on or After: <br /> IN=In Compliance IO=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 facilit <br /> ^� u Demonstration of Knowledge nu OUT ccs Supervision <br /> 1,1 Uemonsbation of knowledi.food safety Certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> 2. Communicable diseasereporting. restrictions 8 exclusions 25. Personal cleanliness and hair restraints <br /> discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements ;i•, <br /> IA. Proper eating,tasting.drinking,or tobacco use 26. Approved thawing methods used <br /> Preventing Contamination by Hands" 27. Food protected from contamination during storage <br /> Hands dean and prolpe[ry washedproper glove use 28. Washing fruits and vegetables before use <br /> 11andevas ring lac1116 sepplied and accessible 29. Toxic substances properly identifiedstored,and used <br /> Time and Temperature Re rw - Food Storlige/Display/Service <br /> -- <br /> 7. Proper hot and cold holding temperatures 30. Food storage:food storage containers labeled <br /> Proper use of time as a public health control 1. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 2. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures <br /> 11. Proper reheating procedures for hot holding 3. Nonfood contact surfaces clean <br /> . Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food 5. EquipmenVutensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 6. Equipment,utensils and linens:storage and use <br /> X14. Food contact surface cleaned and sanitizedwarev:asomg procedures 37. Vending machines maintained <br /> "Food From Approved Source _ 38. Approved and sufficient ventilation and lighting <br /> ` 15. Food obtained flair approved sowce 39. Thermometers provided,accurate,and easily visible <br /> '16. Compliance with shell stock regulations,tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations . .Physical Facilites <br /> Conformance With Approved Procedures1. Plumbing maintained;proper back flow prevention <br /> 1110_ Conti Iran r with HACCP plan or variance ccndmons 2. Garbage and refuse properly disposed <br /> Consumer Advisory 43, Toilet facilities clean,supplied,and maintained <br /> 19f+dvisory provided for raw or undercooked food 44. Premises.personal/cleaning items:vermin-proofing <br /> Highly Susceptible Populations Permanent Food Fa' �l <br /> .I20. Prom tided foods nor offered at high risk facilities li 5_ Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 4C. No living or sleeping quarters inside facility <br /> 21. Not and cold potable water ava;rable 1 Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 22 Sewage'wastewater properly disposedtoilet fac,hty useable 48. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> No rodents. insects. biros or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: it Phone: !� rJ 2 Page 1 of <br /> EHO 16-23(1st pg�4/9112 6 J F000 PROGRAM OIR <br />