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oAas I"•F 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.sigov.org/ehd <br />4Cl FOkN <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: I-l<fou-s 0 2 /-17 <br />Date: D I _a <br />Address: 3412- M ea AV15- City: <br />19.0 G Zip Code: y 52v <br />Owner/Operator: St LVI,A tS,At,)C (Ee-'- <br />Telephone: <br />Program Element: Program Record:Inspection <br />Type: / <br />8180 Posted Ye No Permit Posted Yes No <br />Re -Inspection on or After: <br />IN = In Compliance N/O = Not Observed WA = Not Applicable COS = Corrected onsite 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 maix warrant closure of the food facility <br />iN wo an Demonstration of Knowledge Wd our cos <br />Supervision o�R <br />'I1. Demonstration of knowledge; food safety certificate <br />24. <br />Person In Charge is present and performs duties <br />Empipyee Health and Hygiene <br />Personal Cleanliness <br />'2. Communicable disease; reporting, restrictions & exclusions <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 />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 />Hands clean and properly washed; proper glove use <br />28. <br />Washing fruits and vegetables before use <br />6. Harewashing facilities supplied and accessible <br />29. <br />Toxic substances properly identified, stored. and used <br />Time and Temperature Relationship <br />Food Storage/Display/Service' <br />17. Proper hot and cold holding temperatures <br />30. <br />Food storage; food storage containers labeled <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 />10. 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 />EquipmenVutensils 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 contact surface cleaned and sardized'wamwashing 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 />77. compliance with Gulf oyster regulations <br />Physical Facilities <br />Conformance With Approved Procedures <br />41. <br />Plumbing maintained; proper back flow prevention <br />1, 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 />46. <br />No living or sleeping quarters inside facility <br />21. liot and cold potable water available. <br />Compliance and Enforcement <br />Liquid Waste Disposal <br />47. <br />Signs posted; last inspection report available <br />22. Sewage/wastewater properly disposed; toilet facility useable <br />B. <br />Compliance with plan review requirements <br />Vermin <br />9. <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 Bylritle: <br />EH Specialist: A A4 Kp <br />Phone: .�g S I ij' 9 2 3 Page 1 of 2 <br />EHG 16-23 (1st P9) 1/03/17 FOOD PROGRAM OR <br />