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SAN JOAQUIN COUNTY + ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.orglehd c;FORa FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: f S` Date: Address: �� ty: ` _ �, Zip Code:CO j2 0 ��.5 2 0 OwnerlOperator. �►\ Telephone: Program Element: L Program Record: L3 1 Inspection Type: SB180 Posted ❑Yes CI Rermit Posted ©Yes ❑ P Re-Inspection on or After: IN=In Compliance NIO=Not Observed NIA=Not Applicable COS=Corrected on-site MAJ=Major Violation OUT=Not in Compliance See reverse side for code sections and general requirements that correspond to each violation listed below. Major violations aose a threat to public health and must be corrected immediatel . Non-compliance mag warrant closure of the food facilit W too. Demonstration of Knowledge Mkt OUT cos 4111111W Supervision eu' 1. Demonstration of knowledge:food safely certificate 24. Person In Charge is present and performs duties Employee Health and Hygien, Personal Cleanliness 2. Communicable disease;reporting,restrictions&exclusions 25 Personal cleanliness and hair restraints 3 No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requlr�ements Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used Preventing Contamination by Han 7. Food protected from contamination during storage 5. Hands clean and properly washed.proper glove use 8. Washing fruits and vegetables before use - Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used Tittle and TernperatureRelatiogship Food StoragairDisplaylService Proper hot and cold holding Temperatures 0. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided Proper cooling methods l 2. Food properly labeled and honestly presented 10. Proper cooking time and temperatures - 11. Proper reheating procedures for hot holding H-I 33. Nonfood contact surfaces clean P on From Conta. 34. Warewashing facilities maintained;test strips available 12. No re-service of retumed food 35. Equipmentlutensils approved;installed:dean;good repair 13. Food free from contamination and adulteration 36. Equipment.utensils and linens:storage and use 14. Food contact surface cleaned and sanitizedlwarawashing procedures 37. vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 16. Compliance with shell stock regulations;tags/display 40 Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations - Physical Facillti Conformance With Approved ProceduTm 41 Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer Advisory 13 Toilet facilities clean,supplied.and maintained 19. Advisory provided for raw or undercooked food 4 Premises:personalldeaning items.vermin-proofing Highly Susceptlble Populations Permanent Food Facilities 0 Prohibited foods not efft!red at hiyh risk facilines 5. Floors,walls and ceiling are maintained and kept clean Water I Hot Water 46 No living or sleeping quarters inside facility 1 I tot and cold poiahlF watt,: availahlr• Compliance and Enforcertiii;fnt Liquid Waste Disposal 47. Signs posted:last inspection report available _ 2. Sewagerwastewater properly disposed toilet facility useable 48 Compliance with plan review requirements Verrnin 49. Facility operating with a valid health permit r23 No rodents,insects.birds or animals inside facility 50, Impoundment � . ` �t 51 Permit Suspension Received Byrritle: �� ' M e EH Specialist: C - Phone: ��c_ 16` r3�-ti -Page 1 of EHD 1fr23 (1st pg) 419112 FOOD PROGRAM OIR Dl 1 (00 15