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SAN JOAQUIN COUNTY <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �q.., s,.�;;p. Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigcv.orq/ehd <br /> �IFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ,L Date: 2 <br /> Address: City: Zip Co... <br /> caner/Operator: /yll n Telephone: 3 C{ <br /> [program Element: Program Record: Inspection Type: I <br /> 8180 Posted'L <br /> es No Permit Posted Yes No Re-Inspection on or After: <br /> IN=In Compliance N/O=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 /> Ma'or violations eose a threat to Eublic health and must be corrected immediatel . Non-compliance,maX warrant closure of the food facili <br /> q toftstm on of Knowledge tom, our ca5 $upervisian our' <br /> 1. Demonstration\of knowledge;food safety certificate 24. Person In Charge is present and performs duties <br /> Employee Health and Hygiene Personal Cleanliness <br /> Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <br /> Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used <br /> r,M <br /> Preventing Contamination by Hands 27. Food protected from contamination during storage <br /> Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used <br /> Time and Temperature Relationship ? <br /> ;.. <br /> Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled <br /> Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided <br /> Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment],Utensils/Linens <br /> 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean <br /> w �� � 5irtftfo ' t', 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food35. Equipment/utensils approved;installed;clean;good repair <br /> 13. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained <br /> Food From App f Source 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible <br /> Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 7. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approyi d procedures 7 41. Plumbing maintained;proper back flow prevention <br /> 1 . Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> i 99. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent f acyl es <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 6. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available.r gig <br /> Liquid.Waste MApP47. Signs posted;last inspection report available <br /> v 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements <br /> Ve . 9. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> ` 51. Permit Suspension <br /> Received By/Title: <br /> VA <br /> EH Specialist: Phone: r ( Page 1 ofz <br /> EHD 16-23 (1st pg) 4/9/1,21 FOOD PROGRAM OR <br />