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�CLu. SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT ri. 1868 East Hazelton Avenue, Stockton, CA 95202-6232 • Y. Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.or /q ehd. HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of.Facility: TO ictoL v reds Inspection DateR Address: SO y J X I M °l, , �6L�1 `:1J I PE: Zf oy Paw r Owner/Operator: ' D�A�_ L, ,-n Phone: Annua Inspection t❑l Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: �-3 #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 of Violations and Code References. Room(s): ❑ 1. 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- 3c:S h,oI e 2' functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in WOU14 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). ❑ 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. ❑ 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? Yes ❑ No Company Name: 6,1'i * y1 Frequency: 7. 77, .' t Hotel/Motel Business License?- Yes ❑ No /_'V f Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other Rooms inspected: Ui �. }O ; _ L5 >2/ Comments: tV C r bserve,C v�fiia^� c- All viola ,t)ons in rooms not inspected must also be corrected. All re-i ions by th4AEfivyonme2jl Health Department will be billed at the current hourly rate. Received By: ! Title:66-:26-,r-O�_1 G Environmenta ealt Specialist: C '_ ne: l J� —� Z0 Page 1 of J HOTEUMOTEL OR EHD 24-01 4-30-12