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PgU,)v SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />•Z <br />1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.or /c /ehd <br /><! ..... HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br />Name of Facility: Inspectio Da e: <br />U T-^� r 1719, - <br />Address: PE: <br />I 0 w, s'- 2—ifes2�S <br />PR#: <br />2l <br />Owner/Operator: Phone: <br />W13 -W m qw- MAO <br />Annual Inspection [:]Complaint Inspection ❑ Consultation Inspection ❑Re -Inspection <br /># Units in Facility: <br /># Units Inspected: / <br />Reinspection On or About: A11 <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. <br />Room(s): <br />❑ <br />1 <br />Room Cleanliness: Lack of cleanliness & sanitation; Accumulation of debris, trash, <br />garbage, combustible items or similar materials. <br />17 <br />2 <br />Room Maintenance: General lack of repair or improper maintenance; Broken or non - <br />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 />r_1 <br />3' <br />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 />❑ <br />4. <br />Drinking Utensils & Ice Buckets: Not protected from contamination; Lack of or improper <br />washing & sanitizing after each use (multi -use); Lack of or improper protective bagging <br />(multi -use) or individual protective wrapping (single -use). <br />❑ <br />5 <br />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 />❑ <br />s <br />Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br />close fitting covers; Garbage receptacles unclean or in disrepair. <br />❑ <br />7. <br />Public Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways, exits, or other <br />publicly shared spaces. <br />❑ <br />8. <br />Pest Control: Infestation of insects, vermin or rodents. <br />❑ <br />9. <br />Other Nuisance: Any other condition which is hazardous to health. <br />❑ <br />10. <br />Other Substandard or Unsafe Conditions: Electrical, structural, or plumbing hazards; Lack <br />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: 0PK v Frequency; <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: #3a - '347', 4311, 13/ 4 4 3 2 "t 7� 3 71 <br />Comments: N4 v " , ,,S _17".1c <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 Specialist: CiPhone: Page 1 of I <br />EHD 24-01 4-30-12 HOTEUMOTEL OIR <br />