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EHD Program Facility Records by Street Name
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2400 - Hotel and Motel Program
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PR0518822
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COMPLIANCE INFO
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Last modified
1/11/2024 12:49:27 PM
Creation date
10/4/2023 12:51:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2400 - Hotel and Motel Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0518822
PE
2416
FACILITY_ID
FA0014168
FACILITY_NAME
EXECUTIVE LODGE INN
STREET_NUMBER
339
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15127517
CURRENT_STATUS
01
SITE_LOCATION
339 S WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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P _" SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> '1 Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehl <br /> gClF.Oft HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: fy ecu nve W00 E Inspection Date: <br /> Address: -3,311WIWotJ Tiocw7o.-,1 PE: -1-41b PR(S) <br /> Owner/Operator: fXOlJD P#- 0FL_ CuEW CgeM07(21 Phone: <br /> RtW PTS Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> # Units in Facility: ?0 1 # Units Inspected: ,J 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 /> ❑ Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, <br /> 1 garbage,combustible items or similar materials, <br /> Room Maintenance: General lack of repair or improper maintenance; Broken or non- 11101 117-3 <br /> 2 functioning sink/toileYbath; Lack hot water. Floors: Not clean, properly covered or in <br /> good repair.Walls&Ceilings: a Is eilings it need of eanin or repair: Holes,water <br /> damage, peeling or deterioratin aint; Dampness or excessive moisture in room. <br /> ❑ <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 /> ❑ Bedding: Mattress/linens infested with lice,bedbugs,or other insects; Not free from filth or <br /> 5. 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 /> ❑ Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits,or other <br /> publicly shared spaces. _ <br /> r] 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: Cz^)C f'ff/ cWA, 17L, Frequency: ow17t i 2 /Lyons <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: 10512- <br /> 12 <br /> Comments: Pl W)T To' VaWTI` f f&i;A'n0i-J Zety —tv)S MIL WW OfM47TaL flRw,JD Plf-M_ <br /> 4"00 JlJ '?J04, Z V l y gag W Poo. <br /> P 6*e: dic RnvaCb PW Tr►zt FIV IMf 7a,�J wtu, dC QwLW !TT Dit uvAAinjr mov <br /> IPTL of 30.a0- <br /> ,---) <br /> All violations in rooms not inspected must also be corrected. <br /> All re-i ns.Idecliopils by the Environmental Health Department will be billed at the current hou rly rate. _3L),00. <br /> Received By: Title: <br /> Environmental Hi°alt -S (st: Phone: yb �yy} Page 1 of Q <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />
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