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,Q!"y SAN JOAQUIN COUNTY 2' —T ENVIRONMENTAL HEALTH DEPARTMENT :Z 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd HOTEUMOTEL OFFICIAL INSPECTION REPORT Name of Facility: Vllli I r-6 I"oirF (aO rEs, Inspection Date: 0 Address: 2305 J' GZ Ou&aOoj JT- -Cr CX. NA) PE:2Y/6 PR#: E7SJ3 62 2- Owner/Operator: Owner/Operator: ftj uy`� w)n TEPhone: ,Sly - 1 "to Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection # Units in Facility: # 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, 1 garbage, combustible items or similar materials. Room Maintenance: General lack of repair or improper maintenance; Broken or non- functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in 2. good repair. Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Hales,water damage, peeling or deteriorating paint; Dampness or excessive moisture in room. ❑ 3 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). 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). ❑ 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. j ❑ 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 F-110. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather, Inadequate sewage or water facilities. Pest control Used? N Yes ❑ No Company Name: &1,61 L7E 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: 3q 6 Comments: All violations in rooms not inspected must also be corrected. All re-inspections by the Environmental Health Department will be billed at the current hourly rate. Received By: A /-D Title: Environmental Hea Sbeciahst: �1 Phone: Page 1 of ; I EHD 24-01 4-30-12 HOTEL/MOTEL OR