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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT �= 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd �"F° � HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: Inspectionate- to Address: PE- 15' 'R : /90't N r,✓l vC�vbv Cf4 li mf 2,�/9 8 Owner/Operator: Phone: Lt ❑Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection U Re-Inspection #Units in Facility: 347 #Units Inspected: Reinspection On or About: Al 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- 2. on- 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. ❑ s 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). Drinkinq 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? RI Yes ❑ No Company Name: Frequency: 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: 16 # 0 L j 10 Comments: JP1 _ ft t All violations in rooms not inspected must also be corrected. All re-ins ectio by the hvironmental Health Department will be billed at the current hourly rate. Received By: V- „ Title: Environmental Health Specialist: Phone:,-,/,) 6 Page 1 of EHD 24-01 4-30-12 HOTEUMOTEL OR