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"a"+" SAN JOAQUIN COUNT <br />0: X <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.orq/ehd <br />�+FOR <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: A A 1 4 <br />L , 4 C <br />Date: /,w, I <br />Address: ++ •• , 6r -in I L #It&yCity: 7v F <br />` Zip Code: 5 3 1 ;7 <br />Owner/Operator: <br />V L a r ; 1 c• C . 96 : I( ce n �/ q <br />Telephone: <br />Y.2i%, 247'7J <br />Program Element: Program Record: c. ,2 <br />Inspection Type: <br />SB180 Posted es No Permit Posted viles No <br />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 />Major violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility <br />^: Nio wn Demonstration of Knowledge MAJ OUT ods <br />Supervision OUT <br />1. Demonstration of knowledge: food safety certificate <br />24. <br />Person In Charge is present and performs duties <br />Employee Health and Hygiene <br />Personal Cleanliness <br />. Communicable disease; reporting, restrictions & exclusions <br />25. <br />Personal cleanliness and hair restraints <br />,. No discharge from eyes, nose, or mouth; no open wounds <br />General Food Safety Requirements <br />E43.. <br />Proper eating, tasting, drinking, or tobacco use <br />26. <br />Approved thawing methods used <br />Preventing Contamination by Hands <br />27. <br />Food protected from contamination during storage <br />5. Hands clean and properly washed; proper glove use <br />28. <br />Washing fruits and vegetables before use <br />6. Handwashing facilities supplied and accessible <br />29. <br />Toxic substances properly identified, stored, and used <br />Time and Temperature Relationship <br />Food Storage/Display/Service <br />V 7. Proper hot and cold holding temperatures <br />30. <br />Food storage; food storage containers labeled <br />. Proper use of time as a public health control <br />31. <br />Customer self-service food protected; individual utensils provided <br />Proper cooling methods <br />32. <br />Food properly labeled and honestly presented <br />0. Proper cooking time and temperatures <br />11. Proper reheating procedures for hot holding <br />Equipment / Utensils / Linens <br />33. <br />Nonfood contact surfaces clean <br />Protection From Contamination <br />34. <br />Warewashing facilities maintained; test strips available <br />12. No re -service of returned food <br />35. <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 />u 14. Food contact surface cleaned and sanitized/warewashing 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 maintained: proper back flow prevention <br />18. 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 />20. Prohibited foods riot 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 />21. 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 disposed; toilet facility useable <br />48. <br />Compliance with plan review requirements <br />Vermin <br />49. <br />Facility operating with a valid health permit <br />i. 3. No rodents, insects, birds or animals inside facility <br />50. <br />Impoundment <br />51. <br />Permit Suspension <br />Received By/Title: <br />- <br />EH Specialist: <br />Phone:Page 1 of <br />�- I/ 6r <br />EHD 16-23 (1st pg) 4/9/12 FOOD PROGRAM OIR <br />