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Aa�ln. 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 HOTEUMOTEL OFFICIAL INSPECTION REPORT Name of Facility: � //v1,! $ VIU1TIS Inspection Date: p6 30 �y Address: 311):t_3 tN ttem nf& rrN . u"Xock PE: zwo Owner/Operator: 'jz l i c tprn' 1Nt-j Phone: ❑Annual Inspection K Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection # Units in Facility: I # Units Inspected: 2 1 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): ❑ 1 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- l23 & 333 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in 000AI dvtollUly 44X_�l good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water damage,peeling or deteriorating paint; Dampness or excessive moisture in room. ❑ 3 Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, working condition; Lack of adequate heat(Standard:70OF 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). ❑ Bedding: Mattress/linens infested with lice,bedbugs,or other insects; Not free from filth or 5. 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 covm"il� 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather; Inadequate sewage or water facilities. Pest control Used? Yes ❑ No Company Name: Ofi, 1/4 Frequency: Hotel/Motel Business License? ❑Yes ❑ No Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other Rooms inspected: Comments: 001410&07NT f i✓60 ZN 06 2 741.1 1�t7 /LOOM' cocktwmW /jraj7r-0 ' l�7IL16&W7oAC A/ld95J , w0 VV101 ~A1_1_ ° Aor0 jr 1.21 DOQ2 Nitv NOT txck 00/v'f AN, 1W Z7i J1J 1M. ,9/17t'7_ Lr_6e fax All violations in rooms not inspected must also be corrected. All re-inspections by the Environmental Health Department will be billed at the current hourly rate. Received By: Title: Environmental Health Specialist: v� Phone: c/6 Page 1 of v' EHD 24-01 4-30-12 HOTEL/MOTEL OR