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1aRAi+.try SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orq/ehd �IFpa \ FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility:71 Date: Address: CityTr%c Zip Code: Owner/Operator: Telephone: Program Element: t Program Record: S 2-APi 0 3 Inspection Type: re. SB180 Posted []Yes ❑ Permit Posted ❑ Yes OP Re -Inspection on or After: 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. _Ma_ br violations pose a threat to ublic health and must be corrected im_mediatel . Non-compliance may warrant closure of the food facility__ ,N ino Ka - Demonstration of Knowledge MAA our cos Supervision qu* \ �1 Demonstiarion of knowledge. food safety cendicate 24. Person In Charge is present and performs duties Employee Health and Hygiene Personal Cleanliness �. Communicable disease, reporting. restrictions & exclusions 25- Personal cleanliness and hair restraints ✓ I3. No discharge from eyes, nose, or mouth; no open wounds General Food Safety Requirements 4. Proper eating. tasting, drinking. or tobacco use 26. Approved thawing methods used Preventing Contamination by Hand: 27. Food protected from contamination during storage 5 Hands clean and propedy washed. proper glove use 8. Washing fruits and vegetables before use Handwashing facilities supplied and accessible Time and Temperature Relationship 7. Proper hot and cold holding temperatures 9. 0. Toxic substances properly identified, stored, and used 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 to. Proper cooking time and temperatures 11. Proper reheating procedures for hot holding -,-. 12. No re -service of returned food 3. 4. 5. Nonfood contact surfaces dean Warewashing facilities maintained; test strips available EquipmenVutensils approved; Installed; clean; good repair ` 113. Food free from contamination and adulteration 36. Equipment, utensils and linens: storage and use 4. Food contact surface cleaned and sanitizedrwarewashmg 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 17. Compliance with Gulf oyster regulations 4�1Conformance With Approved Procedures 18. Compliance with HACCP plan or variance conditions. Consumer Advisory Physical Facilities 41 42 Plumbing maintainedproper back flow prevention Garbage and refuse properly disposed 43. Toilet facilities clean, supplied, and maintained �a. 19. Advisory provided for raw or undercooked food 44 Premises'. personal/cleaning items'. vermin -proofing - Highly Susceptible Populations Permanent Food Facilities _ '. 112o. Prohibited foods not offered at high risk facilities 45. Floors- walls and ceiling are maintained and kept clean Water I Hot Water 46. No living or sleeping quarters inside facility '1 Hot and cold potable water available. I i Compliance and Enforcement Liquid Waste Disposal y -" 7. Signs posted; last inspection report available ;22 Scwag9nvasvweter propedy disposed. toilet facility useable 8. Compliance with plan review requirements Vermin �,23 No rode9ts insects h rds or animals inside facility 49. Facility operating with a valid health permit 50. Impoundment t. Permit Suspension 11 Received By/Title: C �� V T 0S e {'"3 5 EH Specialist• 9 ^ - w Phone: 2 `� _ (01 b_ 3D,,SPage 1 of 21 EHD 1623 (1st pg) 4/9112 FOOD PROGRAM OR t)