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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd OR`` HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: ' ` I 1 ,-1 .0 1 ,, I Inspection Date-9/1) Address: ( a I V1-- 11�LI) 5 PR#O;L L(o0a j Owner/Operator: A Phone: nnual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: #Units Inspected: 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): ❑ 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- 00VNS-v�-_-44 1 functioning sink/toilet/bath;Lack of hot water. Floors: Not clean, properly covered or in h)-Ad 5 im, V J A."e- 2' good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water T 1 O o damage, peeling or deteriorating paint; Dampness or excessive moisture In room. v ❑ 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?Wes ❑ No Company Name:0 Y ILirl. Frequency: Hotel/Motel Business License? poes ❑ No Multi-Jurisdictional Violations to be Referred to:❑ City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other Rooms inspected: 5 Comments: T!W^t d-0 uY 1% -44 6 e±±p v'v--\- 1 All violations in rooms not inspected must also be corrected. All re-inspections bX the Environmental Health De artment will be billed at the current hourly rate. Received 13y. ' , V Title: mam, Environmental Health pec list: iPhone: Page 1 of Lt=avAntyy_ _ J6 5 EHD 24-01 4-30-12 j HOTEUMOTEL OR