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SAN JOAQUIN COUN) . y� ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd �lFOR FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ! o. / Date: Address: -/ r City: 71.0 Zip Code: Owner/Operator: be b r Telephone: Program Element: Program Record: 05 G Inspection Type: SB180 Posted Yes No Permit Posted Yes Y, No Re-Inspection on or After: IN=In Compliance WO=Not Observed WA=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 public health and must be corrected immediately. Non-compliance may warrant closure of the food facility w wn Demonstration of Knowledge aw bur cos Supervision our 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 v 3. No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements Proper eating,tasting,drinking,or tobacco use 26. Approved thawing methods used 7. Food protected from contamination during storage . Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use 6. Handwashing facilities supplied and accessible 29. Toxic substances properly identified,stored,and used �. Temperature Relationship Storage/Display/Service v . 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 0. Proper cooking time and temperatures Equipment/Utensils/Linens v 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination 34. Warewashing facilities maintained;test strips available t/ t12. o re-service of returned food35. EquipmenUutensils approved;installed;clean;good repair ood free from contamination and adulteration 36. Equipment,utensils and linens:storage and use ood contact surface cleaned and sanitized/warewashing procedures 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting 15. Food obtained from approved source 39. Thermometers provided,accurate,and easily visible 6. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths 17. Compliance with Gulf oyster regulations Physical Facilities 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 Advisory 43. Toilet facilities clean,supplied,and maintained 9. Advisory provided for raw or undercooked food 771- 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities 0. Prohibited foods not offered at high risk facilities 45. 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 Enforcement Liquid Waste Disposal 47. Signs posted;last inspection report available Y.- 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit No rodents,insects,birds or animals inside facility 50. Impoundment 51. Permit Suspension Received By/Title: _/ ` tIl EH Specialist: Phone: Page 1 of 2. '0��,,c�Lv1 `f 3 EHD 16-23 (1st pg) 12/15/09 FOOD PROGRAM OIR