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og8!!tlY. c SAN aJOAQUIN COUNTY <br />?t � •,oc <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />. cdVFAn'a Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: -t. t LOSpl_1510aS <br />Date: O I -06.-20 <br />Address: 30 ( S. S A r P ­fl M F.._e. city, <br />LOO' Zip Code: gS z <br />Owoer/Operator. MAV ILtd AFD R1�9-AA- <br />Telephone: <br />Program Element: 163,5 rogrem Record: <br />Inspection Type: t)%-J1Vt Ne <br />SB180 Posted ❑ Yes IX Permit Posted ❑ Yes ❑ P <br />Re -Inspection on or After: <br />IN = In Compliance N/0 = Not Observed N/A = Not Applicable COS = Corrected on-site MAJ = Major Violation OUT = Not in Compliance <br />See reverse side for code sections and general requirements that correspond to each violation listed below. <br />Major violations Pose a threat to public health and must be corrected immediatel . Non-conpliance may warrant closure of the toaiazi/it <br />iN roo Z Demonstration of Knowledge !. <br />Ma, <br />arr cus <br />Supervision our- <br />' 1 Demonstration of knowledge- food safety certificate <br />24 <br />Person In Charge is present and perforans duties <br />Employee Health and Hygiene <br />Personal Cleanliness -- <br />Communicable disease. reporting. restrictions & exclusions <br />! <br />25. <br />Personal cleanliness and hair restraints <br />3. No discharge from eyes. nose, or mouth; no open wounds <br />General Food Safety Requirements <br />s <br />Proper eating, tasting, drinking, or tobacco use26 <br />Approved thawing methods used <br />Preventing Contamination by Hands <br />27. <br />Food protected from contamination during storage <br />5. Han is clean and properly washed; proper glove use <br />28. <br />Washing fruits and vegetables before use <br />is Handwashing facilities supplied and accessible <br />29. <br />30. <br />Toxic substances properly identified, stored, and used <br />- Food= <br />Food storage; food storage containers labeled <br />- Time and Temperature Relationship ' " <br />7. Proper hot and cold holding temperatures <br />Proper use of time as a public health control <br />31. <br />Customer self-servicefood protected; individual utensils provided <br />Proper cooling methods <br />32. <br />Food drapery labeled and honestly presented <br />10. Proper cooking time and temperatures <br />11. Proper reheating procedures for hot holding <br />12. No re -service of returned food <br />33. <br />4. <br />35. <br />Equipment / Utensils I Linens <br />Nonfood contact surfaces clean <br />Warewashing facilities maintained; test strips available <br />Equipment/utensils approved; installed; clean; good repair <br />13. Food free from contamination and adulteration <br />36. <br />Equipment, utensils and linens: storage and use <br />14. Food contact surface cleaned and sandizedrwarewashing procedures <br />37. <br />Vending machines maintained <br />Food From. Approved Source .- <br />38. <br />Approved and sufficient ventilation and lighting. <br />15. Food obtained from approved source <br />39. <br />Thermometers provided, accurate, and easily visible !! <br />16. Compliance with shell stock regulations; tags/display <br />40. <br />Proper use and storage of wiping cloths !.. <br />17. Compliance with Gulf oyster regulations <br />- Physical Facilities <br />Conformance. With Approved Procedures <br />41. <br />Plumbing inaintamed. proper back flow prevention !i <br />I1 118. Compliance with HACCP plan or variance conditions <br />42. <br />Garbage and refuse properly disposed <br />- Consumer Advisory <br />43. <br />Toilet facilities clean, supplied, and maintained <br />19. Advisory provided for raw or undercooked food <br />44. <br />Premises-. personal/cleaning items-. vermin -proofing <br />Highly Susceptible Populations <br />Permanent Food Facilities. <br />D- Prohloited foods not offered at high risk facilities <br />45. <br />Floors, walls and ceiling are maintained and kept clean <br />Water / Hot Water <br />46. <br />No living or sleeping quarters inside facility <br />�l Hot and cold potable water available. <br />Compliance and Enforcement _- <br />Liquid Waste Disposal <br />47. <br />Signs posted; last inspection report available <br />22 Sewage/wastewater properly disposedtoilet facility useable <br />It. <br />Compliance with plan review requirements <br />Vermin <br />9. <br />Facility operating with a valid health permit <br />i23. No rodents. Insectsbirds or animals Inside facility <br />50. <br />Impoundment <br />51. <br />Permit Suspension <br />Received By/Title: <br />EH Specialist: C_ L R 14 U A0 <br />Phone: Sop C1 Qy� Page 1 of <br />E HE, 1623 list pg) 4/9/12 F000 PROGRAM OR <br />