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Aq�fy SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br />t' Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />aR`' HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br />Name of Facility:t1 Y O.L a <br />Inspection Date: 315lZ <br />Address: 1 S 65 S_ f 1 npyp. A• <br />PE: 2k jj <br />PR#:01 0A.� <br />Owner/Operator: e I oan 6N.,tt b e yt <br />Phone: (2 40 6 6— 9 tl, 8 <br />Annual I spection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re -Inspection <br /># Units in Facility: 'L9 <br />1 # Units Inspected: 3 <br />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. <br />Room(s): <br />1 <br />Room Cleanliness: Lack of cleanliness & sanitation; Accumulation of debris, trash, <br />garbage, combustible items or similar materials. <br />/10 Il U°' <br />2 uo r" <br />F] <br />2' <br />Room Maintenance: General lack of repair or improper maintenance; Broken or non - <br />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 />❑ <br />3. <br />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 />❑ <br />4. <br />Drinking Utensils & Ice Buckets: Not protected from contamination; Lack of or improper <br />washing & sanitizing after each use (multi -use); Lack of or improper protective bagging <br />(multi -use) or individual protective wrapping (single -use). <br />E]- <br />Bedding: Mattress/linens infested with lice, bedbugs, or other insects; Not free from filth or <br />foul matter; Unsafe; Linens not changed weekly or before new guest. <br />Q <br />❑ <br />6 <br />Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br />close fitting covers; Garbage receptacles unclean or in disrepair. <br />O <br />❑ <br />7. <br />Public Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways, exits, or other <br />publicly shared spaces. <br />_ -- <br />❑ <br />s. <br />Pest Control. Infestation of insects, vermin or rodents. <br />❑ <br />9. <br />Other Nuisance: Any other condition which is hazardous to health. <br />❑ <br />10. <br />Other Substandard or Unsafe Conditions: Electrical, structural, or plumbing hazards; Lack <br />of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br />protection from weather; Inadequate sewage or water facilities. <br />Pest control Used? Yes E] No Company Name: re V.e -\iio Frequency: <br />Hotel/Motel Business License? es ❑ No tt. L31 LL! <br />Multi -Jurisdictional Violations to be Referred to: ❑ City Building/Code EnforcemenVFire ❑ County Code Enforcement/Fire ❑ Other <br />Rooms inspected: U <br />ell <br />Comments: <br />f} JotloXe- k ct e (tu Y3 WvVltc''^� <br />W i ( V -eco G, lav V(r� v is �) A 6-0,- e 1'f1 <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 />(� C,UGrI-, <br />Environmental Health Specia ist:% Phone: Lp 9� �� _ y <br />Page 1 of <br />HOTEUMOTEL OREHD 24-01 4-30-12 <br />