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SAN JOAQUIN COUNT`. " ?< ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 "42iPaRa(a Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sioov.org/ehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: -t' Min Y-Y�fi ddress: k- City: L Zip Code: wner/Operator: Telephone: Program Element: Lt Program Record: Inspection Type: U B180 Posted),-Yes No Permit Posted*Yes No Re-Inspection on or After: IN=In Compliance N/O=Not Observed N/A=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. Ma'or violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility 1. Demonstration of knowledge;food safety certificate 4. Person In Charge is present and performs duties Communicable disease;reporting,restrictions 8 exclusions . Perso7protededfmm cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds Proper eating,tasting,drinking.or tobacco use 6. Apprmethods used ntamination by Hands - 7. Foodm contamination during storage Hands clean and properly washed" proper glove use 8. Washvegetables before use Handy ashing facilities supplied and accessible 29. Toxicproperly identified,stored,and used e and Temperature Relationship Food Storage/Display/Service Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer sell-service food protected;individual utensils provided ✓ Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures Equipment/Utensils/Linens 11. Proper reheating procedures fo-not holding 33. Nonfood contact surfaces clean ' tion From Contamination 34. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipment(utensils approved;installed;clean;good repair 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained EMNIElVApproved Source 38. Approved and sufficient ventilation and lighting V11111115. 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 Facilities Approved Procedures 41. Plumbing maintained,proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed v onsumer Advisory 41 Toilet facilities clean,supplied,and maintained Iiii'lig. Advisory provided for raw or undercooked food 44. Premises,personal/cleaning Items:vermin-proofing Oceptible Populations Permanent Food Facilities . Prohibited foods notoffered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean Niiiiiiiiiiii 46- No living or sleeping quavers inside facility 1.Ha and cold potable water available. Compliance and Enforcement ' 47. Signs posted;last inspection report available . Sewage/Wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements - _ 9. Facility operating with a valid health permit r--M-23. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received Byfritle: EH Specialist: 1_ .1 Phone: $ Page 1 of EHD 16-23 hst pg) 4/9112 G�� I FOOD PROGRAM DIP