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SAN JOAQUIN COUNTY <br />y� ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />�q..; -;..�P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />�/FaRN <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Date: /J <br />Name of Facility: Vn <br />Address: 2 n 0 W. G r � k L•n Pd City: Tri Zip Code: <br />/ <br />/3G2 <br />OwnerlOperator: G Telephone: �'3 6 - J � 3Z <br />ne�; � GrC l h <br />v <br />V "� <br />Program Element: ' 'Program Record: 5 3 7551 Inspection Type: Ro L4 <br />SB180 Posted J Yes NO Permit Posted 1 -Yes C 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 />Major violations pose a threat to public health and must be corrected immediately. Non-compliance ma warrant closure of the food facility <br />F, wo Nin Demonstration of Knowledge nnnd our cos <br />Supervision OUT <br />1. Demonstration of knowledge; food safety certificate <br />24. Person In Charge is present and performs duties <br />Employee Health and Hygiene <br />Personal Cleanliness <br />t/ 2. Communicable disease; reporting, restrictions & exclusions <br />25. Personal cleanliness and hair restraints <br />3. No discharge from eyes, nose, or mouth; no open wounds <br />General Food Safety Requirements <br />4. Proper eating, tasting, drinking, or tobacco use <br />26. Approved thawing methods used <br />Preventing Contamination by Hands <br />27. Food protected from contamination during storage <br />✓ <br />5. Hands clean and properly washed; proper glove use <br />28. Washing fruits and vegetables before use <br />6. Handwashing facilities supplied and accessible <br />129. <br />Toxic substances properly identified, stored, and used <br />Time and Temperature Relationship <br />Food Storage/Display/Service <br />Proper hot and cold holding temperatures <br />30. Food storage; food storage containers labeled <br />8. Proper use of time as a public health control <br />31. Customer self-service food protected; individual utensils provided <br />9. Proper cooling methods <br />32. Food properly labeled and honestly presented <br />10. Proper cooking time and temperatures <br />Equipment / Utensils / Linens <br />4 11. Proper reheating procedures for hot holding <br />33. Nonfood contact surfaces clean <br />Protection From Contamination <br />34. Warewashing facilities maintained; test strips available <br />\J 12. No re -service of returned food <br />35. Equipmentlutensils approved; installed; clean; good repair <br />13. Food free from contamination and adulteration <br />36. Equipment, utensils and linens: storage and use <br />14. Food contact surface cleaned and San itized/warewash ing procedures <br />37. Vending machines maintained <br />Food From Approved Source <br />38. Approved and sufficient ventilation and lighting <br />15. Food obtained from approved source <br />39. Thermometers provided, accurate, and easily visible <br />16. Compliance with shell stock regulations; tags/display <br />40. Proper use and storage of wiping cloths <br />17. Compliance with Gulf oyster regulations <br />Physical Facilities <br />Conformance With Approved Procedures <br />41. Plumbing maintained; proper back flow prevention <br />18. Compliance with HACCP plan or variance conditions <br />42. Garbage and refuse properly disposed <br />Consumer Advisory <br />43. Toilet facilities clean, supplied, and maintained <br />19. Advisory provided for raw or undercooked food <br />44. Premises; personal/cleaning items; vermin -proofing <br />Highly Susceptible Populations <br />Permanent Food Facilities <br />20. Prohibited foods not offered at high risk facilities <br />45. Floors, walls and ceiling are maintained and kept clean <br />Water / Hot Water <br />46. 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. Signs posted; last inspection report available <br />22. Sewage/wastewater properly disposed; toilet facility useable <br />48. Compliance with plan review requirements <br />Vermin <br />49. Facility operating with a valid health permit <br />23. No rodents, insects, birds or animals inside facility <br />50. Impoundment <br />51. Permit Suspension <br />Received By/Title: ) lore <br />r <br />EH Specialist: hone: 46k' -_31W Page 1 of 21 <br />EHD 16-23 (1st pg) 419/12 FOOD PROGRAM OR <br />