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;' VV y SAN JOAQUIN COUNTY A <br /> a4LC '... <br /> 2.. —V-- s ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> '= Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: ZQe <br /> 71� e O L 1 Inspection Date: 2 2 / 129 <br /> Address: I S5 O (S 'El Dor(/Jo 84. 5to kto n Zo b PE:'C.� I� PR#:O2y0 3q <br /> Owner/Operator: PCA-+C 1 5LD h i y, L �c,,_V K— Phone: <br /> Annual lnpection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> # Units in Facility: 2 #Units Inspected: 3 1 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- 0 oto '=j I Lr—o' <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 /> 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 /> ❑ <br /> 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. <br /> ❑ 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> 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 publicly shared spaces. <br /> 8. Pest Control: Infestation of insects,vermin or rodents. �� CUC Vo aC S <br /> ❑ 9. Other Nuisance:Any other condition which is hazardous to health. <br /> Other Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazards;Lack 2 O rxroS eat. <br /> 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate 4„r1're5 <br /> protection from weather: Inadequate sewage or water facilities. <br /> Pest control Used? es ❑ No Company Name: St >✓ re,5 07ifVuFrequency: T C z_ C. h on t K <br /> Hotel/Motel Business License? es [:] No <br /> Multi-Jurisdictional Violations to be Referred to:❑City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: S 9 Z <br /> Comments: V t p o z Fo Y Pe-3t Vo o i-n <br /> xrojad n-ri� Vi -P 1 .6orn Zo . Sc§v7okt efc c -0(1.S <br /> (, (rte 1,-n C*' 011 o on 5rp S ! , neCU�t re'!Z <br /> -ro re- V- , ` <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: Title: <br /> Environmental Health Specialist: CSS k� Phone: 2 v 9 Q <br /> 6 —3 Page 1 of <br /> EHD 24-01 4-30-12 ✓ c) SHOTEUMOTEL OR <br />