Laserfiche WebLink
CL. SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N- 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> ;bit `. <br /> Telephone: (209)468-3420 fax: (209)464-0138 Web:www.sigov.org/ehd <br /> CiFOR�'�p <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: _5 '�1 v Inspection Date: J� '/ /SCJ Z0 <br /> Address: 2.Z 1 Q S, / 7(�� k_� ►W� c��OG PE:2(�p8PR#:/v�Ll Zso� <br /> Owner/Operator: ate( ) C hcAM Phone: <br /> nnual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection U <br /> # Units in Facility: J16 #Units Inspected: 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 /> F-11. 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- 09 103- ) 11 y <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 /> ❑ 3' 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 /> 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 /> ❑ 5' Beddin : 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 /> ❑ 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers; Garbage receptacles unclean or in disrepair. <br /> fublic Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits,or other IS-t F100y h ti�iw�y <br /> blicly shared spaces.8st Control: Infestation of insects,vermin or rodents. gem 1,,, Ewfi'oz, voev❑ 9her Nuisance:Any other condition which is hazardous to health. <br /> her Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazards; Lack <br /> ❑ 10. 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: �►rj-)I'''t Frequency: rCe_^ t l o v f K <br /> Hotel/Motel Business License? es ❑ No 1 W <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other <br /> Rooms inspected: l0 <br /> Comments: <br /> • 3 Ir A n- Ye► Te <br /> • 0(/a( -Y r1 jM p� Sf [c�i Lei` i ItK <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: l C� ,,1 <br /> Environmental Health Specialist: C� cr �// Phone: 1 y3�' 2p Page 1 of <br /> EHD 24-01 4-30-12 J J IV J HOTEUMOTEL OR <br />