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�oaq�U Io SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT f X 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sbgov.org/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: t I + , (' �( Inspection Date: 3 Address: SJ 0 V, ( ' Y.kr � ) J C"t,r PE: ZY , PR#:O2 <00 Owner/Operator: (A, (A-Y- � �K�I/ Phone: Z0) ) YTO 032, ❑Annual Inspection Complaint Inspection ❑ Consultation Inspection Re-Inspection #Units in Facility: 7 O #Units Inspected: I 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): Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, El 1 garbage,combustible items or similar materials. Room Maintenance:General lack of repair or improper maintenance; Broken or non- F-] 2 functioning sink/toiletlbath; Lack of hot water. Floors: Not clean, properly covered or in 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. ❑ 3 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). ❑ 5 Beddin : Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or foul matter; Unsafe; Linens not changed weekly or before new guest. ❑ 6 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 ��/'!i ,S 1 's` r- SAOKe 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate J_ctec,fiW k�fte_ [pYYeCh protection from weather; Inadequate sewage or water facilities. O'f'% S %f e-- Pest control Used? Yes ❑ No Company Name: C.v P c, Frequency: %&T Hotel/Motel Business License? Yes ❑ No 22 Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other Rooms inspected: 21 33' 3.) Comments: CAI P reViat--3 ►u 1 rAIo Kj C0VreC, 1,,vi" 1 Ye- cont, e k ro =6- e->" 'V10 All violations in ro, not inspected must also be corrected. All re-inspections by the Environment ealth Department will be billed at the current hourly rate. Received By: Title: Environmental Health Specialist: ' I Phone: 7 i (ZOW 5B t) Page 1 of 4 4EHD 24-01 4-30-12 HOTEUMOTEL OR