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uti�r SAN JOAQUIN COUNTY ENVhrt)NMENTAL HEALTH DEPARTML�T w {l 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:vvww.sjgov.orq/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: 101vAOArr A407M Inspection Date: 0311 p o20/S Address: ISS-9 f f-L OiDMJOU (PI-1 V-)V(X?0AJ PE: Z "lb t PR#:o2Y00?1�1' Owner/Operator: If v0NpjtAj1k11n T-M Phone: �JU /T1P Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: .21 #Units Inspected: (o 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- F-1 2. functioning sink/toilet/bath; 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" Bedding: 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 ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather; Inadequate sewage or water facilities. Pest control Used? Yes ❑ No Company Name: C,"7LC /t-7.f7 Frequency: hJ Hotel/Motel Business License? ❑ Yes ❑ No Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire ❑ Other Rooms inspected: S Z Ig Z'0 11 Comments: � I/ — N6V f510/l 60VOUJ6 IN /UVl ltr tjO:V� OCDdvR,v ftjfj2Ks- iF s- sfi-j�-fc ter- t y # iz- To de 94r09rry ry NC-AT yr-9i2 ftcey4ai '4�> owwm- AI iolations in rooms not inspected must also be corrected. All re-inspection the Environmental Health Department will be billed at the current hourly rate. Received By: Y. Title: Environmental Health Sp i list: Phone: % � Page 1 of 1 EHD 24-01 4-30-121 (j HOTEUMOTEL OIR