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aaA o SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> ' Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> -F `p HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: j o LA I NN FWK( -C Inspection Date:h�3120)9 <br /> Address: 1 1v N 6SI r I `,!�'►a LAD q�j�ZJ�S S.. I- y q"1 PE: <br /> PR#: CJ ng <br /> Owner/Operator: D n Al`eL K r't/ <br /> I'r�`►1 s_fit0 I <br /> \JoAnnual inspection ❑ Complaint Inspection ❑ Consultation Inspection Re-Inspection <br /> #Units in Facility: #Units Inspected: tv— 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 /> ❑ 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. 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 /> ❑ 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 /> ❑ 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers;Garbage receptacles unclean or in disrepair. <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. � � �t1cXrLd <br /> Other Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazards Lacks 1 0G,12,S�13 <br /> 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate 310 .319 an—lndet�u 1� <br /> protec ion rom weather; Inadequate sewage or water facilities. � smic <br /> Pest control Used? Yes ❑ No Company Name: Frequenc : (0 1 $'1--2- —I(V4- <br /> Hotel/Motel Businesg License? Yes ❑No <br /> Multi-Jurisdictional Violations t be Referred to: ❑City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: 10(p )21:3 'Z7'1 2-2.'3 L <br /> Comment . <br /> +WWWO di I sm o io an rub <br /> W'd G W. <br /> All violations in roo s not inspected must also be corrected. <br /> %'— '—inspections by the Environmental Health Department <br /> De artment will be billed at the current hour) rate. <br /> Recei, By. � r � i ` iS�Titl <br /> Envi nmentA alth (o S cialist: Phone: 20 ' S Page 1 of <br /> EHD 24-01 4-30-12 YJ HOTEUMOTEL OR <br /> i <br />