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SAN JOAQUIN COUNT y ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.orq/ehd '9CjFORi� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facilit) f_ t Q n - 1-b �S Date: ,� I Address: __7rV, t`n -1 G!_)_Z7G City: V Zip Code: Owner/Operator: W Cin o -1 Telephone: Program Elemen Program Record Inspection Type: 8180 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. Major violations pose a threat to ublic health and must be corrected immediatel . Non-compliance ma warrant closure of the food facility Iwo wA Demonstration of Knowledge iU our COS Supervision out 1. Demonstration of knowledge;food safety certificate 24. Person In Charge is present and performs duties _ Employee Health and Hygiene Personal Cleanliness Communicable disease;reporting,restrictions&exclusions 25. Personal cleanliness and hair restraints No discharge from eyes,nose,or mouth;no open wounds GeneCl+l Dd Safety'Requirements Proper eating,tasting,drinking,or tobacco use 6. Approved thawing methods used preventing Contamtnatioq y Hands 7. Food protected from contamination during storage 15- Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use mti Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used ... ate...- wtx ............-„_,.... ._ ,.�.: .'.u..,e , t,rt . Proper hot and cold holding temperatures 30. Food storage;food storage containers labeled Proper use of time as a public health control 31. Customer self-service food protected;individual utensils provided Proper cooling methods 32. Food properly labeled and honestly presented 10. Proper cooking time and temperatures :: �' E ui +Pt�t Utensils 1 Linens ��.. % P��ti - _�,.�.. . q_ tie., � �. ill. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean wagw" COrCEB s 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/warewash ing procedures 37. Vending machines maintained =Food From ApprovnlRourm, _ ago 38. Approved and sufficient ventilation and lighting 15. 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 Conformance With Approved Procedures 41. Plumbing maintained;proper back flow prevention 18. Compliance with HACCP plan or variance conditions 42. Garbage and refuse properly disposed Consumer'Advisocjf'4 3. Toilet facilities clean,supplied,and maintained rY , 9. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing lighly,;Susceptible Populations Perma 0. Prohibited foods not offered at high risk facilities 5. Floors,walls and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcerty y �a °, 7. Signs posted;last inspection report available s:. 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements WN Yertrut3 . 9. Facility operating with a valid health permit x ,_ .. 3. No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title EH Specialist: Phone: /�(t�� L Page 1 of -� p`1/ EHD 16-23(1st pg) 4/9/z7 FOOD PROGRAM OIR