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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd P HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: Co C`MOS NO-Ce Inspection Date: Address: 3 3 S' J d a (A,i �l tc� , PEZY !� PR#:O Z y00Soo Owner/Operator: a D h a Yee,S I Phone:l Z.J ' .9 y8- S-J nnuaI Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: 2 �} #Units Inspected: Reinspection On or About: The items checked below are violations to be corrected. See Reverse Side of this Form for Detailed Summary of Violations and Code References. Room(s): ❑ 1' Room Cleanliness:Lack of cleanliness&sanitation;Accumulation of debris,trash,garbage,combustible items or similar materials. Room Maintenance: General lack of repair or improper maintenance; Broken or non- 1 1 +� 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in 'tel good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water damage, peeling or deteriorating paint;Dampness or excessive moisture in room. ❑ s. Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe,working condition; Lack of adequate heat(Standard:70°F at 3 feet from floor). Drinking Utensils&Ice Buckets: Not protected from contamination; Lack of or improper ❑ 4. washing&sanitizing after each use(multi-use); Lack of or improper protective bagging (multi-use)or individual protective wrapping (single-use). Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or ❑ 5" foul matter; Unsafe; Linens not changed weekly or before new guest. ❑ s. Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate close fitting covers; Garbage receptacles unclean or in disrepair. 7.❑ Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits,or other publicly shared spaces. ❑ 8. Pest Control: Infestation of insects,vermin or rodents. ❑ 9. Other Nuisance:Any other condition which is hazardous to health. Other Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazards;Lack ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection fro weather; Inadequate sewage or water facilities. Pest control Used? Xes ❑ No Company Name: S t e, I Frequency: r7 0 M -1 Hotel/Motel Business License?X Yes ❑ No Multi-Jurisdictional Violations to be Referred to:❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑Other Rooms inspected: 105J04 —0 Comments: 15 M®Xld� ,e b i S-1 VO r ft 171 f,+` I Z c� c? S e ?.,-e i re- "r 1, 'S h eYS C Y p h Zr CCdrNr%e v' Y eP'n i` All violations in rooms not inspected must also be corrected. All[r-irl*pecfpjs by the Environmental Health Department will be billed at the current hourly rate. Received By: Title: Environmental Healfofpecialisf. L C G�t /'C h,& Phone: / Z v� y Cg-3 /Z Page 1 of EHD 24-01 4-30-12 HOTEUMOTEL OR