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i0. SAN JOAQUIN COUNTY <br /> _ .o <br /> —��- z. ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> �4 a <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ghd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: �j PL►7Z� Inspection Date: IO 01a doily <br /> Address: I 1PE: PR# <br /> Fll?.Er/Io1Jr .c�`T., J`�GKTnN 2'fcc> :r'itvS275fiS <br /> Owner/Operator: PftItI[)cli:�� WiLoS Phone: <br /> 1T10 Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: IT-1 # Units Inspected: Reinspection On or About: <br /> The items checked below are violations to be corrected. <br /> See Reverse Side of this Form for Detailed Summary of Violations and Code References. Room(s): <br /> ❑ 1 Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris, trash, <br /> garbage, combustible items or similar materials. <br /> Room Maintenance: General lack of repair or improper maintenance; Broken or non- <br /> 2. <br /> on- <br /> 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in <br /> good repair. Walls& Ceilings: Walls/ceilings in need of cleaning or repair: Holes, water <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture in room. <br /> ❑ 3 Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, <br /> working condition; Lack of adequate heat(Standard. 70°F at 3 feet from floor). <br /> Drinking Utensils& Ice Buckets: Not protected from contamination; Lack of or improper <br /> ❑ 4, washing &sanitizing after each use(multi-use); Lack of or improper protective bagging <br /> (multi-use)or individual protective wrapping (single-use). <br /> ❑ 5' Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or <br /> foul matter; Unsafe; Linens not changed weekly or before new guest. <br /> ❑ 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers; Garbage receptacles unclean or in disrepair. <br /> ❑ 7. Public Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways, exits, or other, <br /> publicly shared spaces. <br /> ❑ 8. Pest Control: Infestation of insects, vermin or rodents. <br /> ❑ 9. Other Nuisance Any other condition which is hazardous to health. <br /> Other Substandard or Unsafe Conditions: Electrical, structural,or plumbing hazards; Lack <br /> ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br /> protection from weather; Inadequate sewage or water facilities. <br /> Pest control Used? Yes ❑ No Company Name: (/+1t-i N Frequency: pA/lrt <br /> Hotel/Motel Business License? , Yes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other <br /> Rooms inspected: 135 3 /3fl l` cl 139 0 Wg Vu 212 Z/_3 W 2 2 323 <br /> Comments: 31Y 1/0 5,7 y VZ <br /> 8 21N - J'm,, NN-r -ro Tne 660 y (o <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspections by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Health Specialis : o <br /> �' Page 1 of <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />