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Pq��y SAN JOAQUIN COUNTY <br /> r.' :-rr-• .�Z ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> t' Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.or /q ehd <br /> "F' p HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: 44 ol-e % #/3 Z3 Inspection Date: <br /> Address: /�l 0.� ��/ s����07 �pe PR#OZ< 92 <br /> Owner/Operator: � � ASh;s k) Phone: 7-0 9, <br /> Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> # Units in Facility: 7 fo # 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 /> ❑ <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- 11014 ev <br /> 2' ecc <br /> functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in 2�Z!�I to <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 Garbaqe 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. <br /> Other Substandard or Unsafe Conditions: Electrical, structural,or plumbing hazards; Lack yl a - /a <br /> 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate 100 €elty lXe`/ <br /> protection from weather; Inadequate sewage or water facilities. <br /> Pest control Used? Yes ❑ No Company Name: lovez"111 'Tc L Frequency: on• ! <br /> Hotel/Motel Business License? es ❑ No <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other <br /> Rooms inspected: ;WZ Z 671, Z.17 Z z Z l -3 7 /_3 Z/ v !3 Z Z-(-- Z <br /> Comments: ,r j., �%��•�<= zv <br /> /— G ssry �:-c. l ! "c 1 ccsti C. d e <br /> All violations in rooms not inspected must also be corrected. <br /> All re-' ections by t nvironmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Hea h Sp cialist: " Phone: Z Page 1 of ` <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />