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/a'q_. PC, <br /> aG SAN JOAQUIN COUNTY <br /> 2: z ENVIRONMENTAL HEALTH DEPARTMENT <br /> y: 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: .:,ww.sipov.ora%ehd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: t A / (_ , ` Inspecti n ate: <br /> Address. Ila <br /> PE�2 q PR S6 6 <br /> K z <br /> Owner/Operator: �"Vatb Phone: DD <br /> EiAnnual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: D #Units Inspected: 1 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 /> I Ell 1- 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- <br /> 2. <br /> on-2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in 5(.o,,V� <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. 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 /> ❑ Bedding: Mattress/linens infested with lice, bedbugs, or other insects; Not free from filth or <br /> s. foul matter; Unsafe; Linens not changed weekly or before new guest. <br /> ❑ <br /> 6' Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers; Garbage receptacles unclean or in disrepair. <br /> ❑ Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits, or other <br /> _ publicly shared spaces. _ <br /> ❑ 8. Pest Control: Infestation of insects,vermin or rodents. <br /> ❑ 9. Other Nuisance:Any other condition which is hazardous to health. <br /> Other Substandard or Unsafe Conditions: Electrical, structural,or plumbing hazards; Lack , G, <br /> io. of or inadequate smoke detectors or fire extinguishers-, Inadequate lighting; Inadequate S WXOf N 0444 <br /> protection from weather; Inadequate sewage or water facilities. <br /> Pest control Used? Yes ❑ No Company Name: Frequency: <br /> Hotel/Motel Business License? ❑ Yes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑Other <br /> Rooms inspected: (,-> -)�- b <br /> Comments: <br /> All violations in rooms not inspected must also be corrected. <br /> r inspections by OM En ironmental Health Department will be billed at the current hourly rate. <br /> Received Byn Title: <br /> Environmental Health peciaiist: / 1' . `�3� � Phone: L ly , C 3 3 � 1 <br /> EHD 24-d" 4-30-12 Page 1 of <br /> L•tvL HOTEUMOTEL OR <br />