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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 2 —cry 'Lys <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> i;..inu�a ► � <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.orq/ehd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: vKe +C�VfJ �au/ / Inspection Date: <br /> Address: C2,39 s- ovi/So'l jw. t PEZ(%�/%a <br /> Owner/Operator: PQ_/_ e Phone: <br /> Annual <br /> Inspection El Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: 7.3 # Units Inspected: t5— 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. 4 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- <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 /> rEl 3. Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, <br /> 3" 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 /> ❑ Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> 6' j close fitting covers; Garbage receptacles unclean or in disrepair. <br /> ❑ <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: <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: 1,6Z /Ps– Za <br /> Comments: d . A._ ;,,,rte,( M 00 ,: <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: y Title: <br /> r <br /> Environmental Health Specialist: Phone: �bi� y 2 Page 1 of <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />