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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.slgov.orq/ehd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: arc clale A Inspection Date: <br /> Addr-es s: ,_!S7D4 ! � G 4phone: <br /> PR#DOwner/Operator: 9 zzl& <br /> 121 Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: 7 # Units Inspected: 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 /> ❑ Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, <br /> 1 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 <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 /> ❑ 6 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? ' Yes ❑ No Company Name: Frequency: A,4a,,1-4 <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: ZZ"' Z Z y- ZZU, -3 Z 3 ✓ 3 •j I L <br /> Comments: ,h-1 <br /> Y/� �• <br /> All violations in rooms not inspected must also be corrected. <br /> All r -inspections by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By Title: <br /> Environmental Health Specialist: i Phone: page 1 of ' <br /> EHD 24-01 4-30-12 (! HOTEUMOTEL OR <br />