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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br />'r Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br />Name of Facility: I✓1 ✓1 Z pa k uDa 0'0 <br />Inspection Date: <br />�q <br />Address: L 11 VV ( M A ,(I ON� <br />van <br />PE1 1 U1 <br />7 <br />PR#: �.Z �i I C, <br />ner/ <br />OwOperator: Pion �rnolrn r t f <br />/�3 <br />Phone:/� -I— Lt 13 -LfOO <br />Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re -Inspection <br /># Units in Facility: <br />#Units Inspected: <br />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. <br />Room(s): <br />❑ <br />1 <br />Room Cleanliness: Lack of cleanliness & sanitation; Accumulation of debris, trash, <br />garbage, combustible items or similar materials. <br />.r -A <br />2. <br />Room Maintenance: General lack of repair or improper maintenance; Broken or non- <br />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 />t ' <br />❑ <br />3 <br />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 />❑ <br />4. <br />Drinking Utensils & Ice Buckets: Not protected from contamination; Lack of or improper <br />washing & sanitizing after each use (multi -use); Lack of or improper protective bagging <br />(multi -use) or individual protective wrapping (single -use). <br />❑ <br />5 <br />Bedding: 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 />❑ <br />s <br />Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br />close fitting covers; Garbage receptacles unclean or in disrepair. <br />❑ <br />_ <br />7. <br />Public Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways, exits, or other <br />publicly shared spaces, <br />8. <br />Pest Control: Infestation of insects, vermin or rodents. <br />6e.� r <br />❑ <br />9. <br />Other Nuisance: Any other condition which is hazardous to health. <br />10. <br />Other Substandard or Unsafe Conditions: Electrical, structural, or plumbing hazards; Lack <br />of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br />protectio` n from weather; Inadequate sewage or water facilities. <br />W(r S <br />o KA -p—, <br />Pest control Used? Yes Ea No Company Name:=4 Frequency: 9, ELce�;��'fir` <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: jQq. f.) 3 s2322C1 2 .:?:[ S <br />Comments: Z <br />- Five � l <br />- l 1n 01 <br />Sjueeoan III�(Z <br />Iii Elf O� Cf <br />12rKffljj'j:LLT)7-fC?4e <br />All s in rooms not inspected must also be corrected. <br />ILLIpections by he En ironmental Health Department will be billed at the current hour) rate. <br />Received By: Title: <br />r (11 - �_41 <br />�,,� <br />Environmental Hea h Specialist: Phone:L)&( <br />L U� . "_' I <br />Page 1 of <br />EHD 24-01 4-30-12 HOTEUMOTEL OIR <br />a <br />