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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT .w: 1868 East Hazelton Avenue, Stockton, CA 95202-6232 ' Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.or /q ehd r HOTEUMOTEL OFFICIAL INSPECTION REPORT Name of Facility: o�c4 , ' k(A-f r1 a*- Inspection Date: / �! Address: PE: PR#. Owner/Operator: ad cb67— Phone: . 11.-T700 Annual Inspection [I Complaint Inspection ❑ Consultation Inspection ElRe-inspection / # Units in Facility: # Units Inspected: I Reinspection On or About: The items checked below are violations to be corrected. _ See Reverse Side of this Form for Detailed Summary f Violations and Code References. Room(s): ❑ Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, 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 Z' good repair. Walls& Ceilings:Walls/ceilings in need of cleaning or repair: Holes,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). ❑ Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or 5. foul matter; Unsafe; Linens not changed weekly or before new guest. ❑ 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 ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather; Inadequate sewage or water facilities. Pest control Used? es ❑ No Company Name: '' Frequency: P�Oti" 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: 10( C o 2 •Z r•- • -09' Zoq �7V (p 2 j v Comments: 0 �) ;Pee • rte �� All violations in rooms not inspected must also be corrected. 4 rd-inspeqjLqns by the Environmental Health Department will be billed at the current hourly rate. Received B E I I L--1+ Title: Environmental FiealtciaTist: t,,.�- Phone: Pa e 1 of EHD 24-01 4-30-12 HOTEUMOTEL OIR