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Pq�,y SAN JOAQUIN COUNTY co ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.orq/ehd 4�hEl", p HOTELIMOTEL OFFICIAL INSPECTION REPORT Name of Facility: v� IA U i Inspection Date: 2,412I Address: PE;2 D PRO Z � i�25S- rn � Owner/Operator: Phone: [,Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection # Units in Facility: k2s #Units Inspected: 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, garbage,combustible items or similar materials. �7, Room Maintenance: General lack of repair or improper maintenance; Broken or non- 2ids 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. r❑ Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, 3. 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). ❑ 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. ❑ 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. Z ❑ 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: Frequency: Hotel/Motel Business License? LK Yes ❑ No Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other Rooms inspected:1 3 , y N} (511P V6A d I J6 1-13, 2r) 1: L � Comments: o3 6ro11 All violations in rooms not inspected must also be corrected. All r -ins ecti ns by the Environmental Health Department will be billed at the current hourly rate. Received By: - � Title: v Environmental He h Speciali Phone: ,/ _ Page 1 of �r�, U HOTEUMOTEL OR EHD 24-01 4-30-12