Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> w 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> `• '• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> q�%FOR�'4 HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility Inspection ate: <br /> Address:3252 W� ! LM 5;21 "7 <br /> P : R#- <br /> 0 P SO?ul <br /> [Owner/Operator: Phone: <br /> � � 2d7 'f7 _oF>'►1 <br /> Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-inspection <br /> # Units in Facility: I # Units Inspected: 1 3 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 /> r❑ 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 /> 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 /> ❑ <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 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 /> ❑ s Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers;Garbage receptacles unclean or in disrepair. <br /> ❑ <br /> 7' 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 <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? g Yes ❑ No Company Name: ; �t hf Frequency: ""I <br /> Hotel/Motel Business License? OYes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to:❑ City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other tIt2— <br /> Rooms <br /> Rooms inspected: J Dk )a 7 p J6_y 97P,0 ZZ 4r2 S 3 <br /> Comments: 1yo <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 rv� �-s/_ C1Lyeevtsgnr <br /> Enviro ntal 1p Specia Phone q�k1. Page 1 of 1 <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />