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,q�i►r SAN JOAQUIN COUNTY <br /> �o c� ENVIRONMENTAL HEALTH DEPARTMENT <br /> `� ► 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> P <br /> `Y... HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: ! ' e,r;,w n _'ZInspection Date: /LY 9 <br /> Address: 550 StX)Cto h J 520 <br /> b PE: PR#:O G�000# <br /> Owner/Operator: Gti a e,X e�y- Phone:(50-Y) J cy y r-'9 T T/1�q <br /> Annual Inspection [I Complaint Inspection El Consultation Inspection ❑ Re-Inspection � <br /> #Units in Facility: #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- ZY6— C ru c.Ki' e <br /> .d� 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean,properly covered or in <br /> Jul 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 /> ❑ s 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 /> ❑ 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? XYes ❑ N Company Name: G Nlh e 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: O 'L Y 2 6 ?, S , 2 3 <br /> Comments: So o it I I K fe 1o Y " j r -e c-te <br /> Y <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: Rn N4, o 'T'q Title: <br /> Environmental Health Specialist: ( S G C't O� � th-j to s�2LPaLge of <br /> EHD 24-01 4-30-12 J I / HOTEUMOTEL OR <br />