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0. a�rN • SAN JOAQUIN COUNT <br /> a a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: CizDate: <br /> ddress: r S City: I Zip Code: <br /> Owner/Operator: 7 b d 6S [- Telephone: <br /> Program Element: I(� Pr ram Record: W Inspection Type: 7 G <br /> SB180 Posted s ❑ No Permit Posted V,,Yes ❑No Re-Inspection on or After: <br /> 1N=In Compliance N1O=Not Observed NIA=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 /> lyra or violations 12ose a threat to public health and must be corrected immediately. Non-compliance may warrant closure of the food facility <br /> ori r+/o WA <br /> Demonstration of Knowledge Hvu our cos Supervision OUT <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 j General Food Safety Requirements j <br /> Proper eating,tasting,drinking,or tobacco use 26, Approved thawing methods used <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 Food Storage/Display/Service <br /> Proper hot and cold holding temperatures 0. Food storage;food storage containers labeled <br /> 8. Proper use of time as a public health control 31, Customer self-service food protected;individual utensils provided <br /> 9. Proper cooling methods 32. Food properly labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment 1 Utensils 1 Linens <br /> 1. Proper reheating procedures for hot holding 33, Nonfood contact surfaces clean <br /> Protection From Contamination 34. Warewashing facilities maintained;test strips available <br /> 12. No re-service of returned food _ 35. Equipment/utensils approved:installed;dean;good repair <br /> 113. Food Free from contamination and adulteration 36, Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and senitized/warewashing procedures 37. Vending machines maintained <br /> Food From Approved Source 38. Approved and sufficient ventilation and lighting <br /> 15. Food obtained from approved source �; 39. Thermometers provided,accurate,and easily visible <br /> 16. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 17. Compliance with Gulf oyster regulations I. _ Physical Facilities <br /> Conformance With Approved_ Procedures r 1. Plumbing maintained;proper back flow prevention <br /> 18. Compliance with HACCP plan or variance conditions 42, Garbage and refuse properly disposed <br /> Consumer Advisory 43. Toilet facilities clean,supplied,and maintained <br /> 11 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities _ <br /> j 0. Prohibited foods not offered at high risk facilities j 5. Floors.walls and ceiling are maintained and kept clean <br /> Water!Hot Water 46. No living or sleeping quarters inside facility <br /> 1.Hot and cold potable water available. Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 2. Sewagelwastewater property disposed;toilet facility useable 8. Compliance with plan review requirements <br /> Vermin 49. Facility operating with a valid health permit <br /> 3. No rodents,insects,birds or animals inside facility 50. Impoundment <br /> 1. Permit Suspension <br /> Received BytTitle: <br /> EH Specialist: Phone: �! Page 1 of <br /> EHD 16-23(1st pg) 4MIU FOOD PROGRAM 0[R <br />