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a"A"'"'•� SAN JOAQUIN COUNTT l:�.reso'•.o ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.org/ehd �IadA FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: Address: city: Zip Code: s, Owner/Operator: Telephone: nta Program Element: Program Record: Inspection Type: SB180 Posted L es D No Permit Posted YYes D 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 i2se a threat to public health and must be corrected Immediately. Non-compliance may warrant closure of the food facility N ax) uu Demonstration of Knowledge wru our 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 No discharge from eyes,nose,or mouth;no open woundsGeneral Food Safety Requirements Proper eating,tasting,ddnking,or tobacco use 6. Approved thawing methods used Preventing Contamination by Hands 27. Food protected from contamination during storage Hands clean and properly washed;proper glove use 28. Washing fruits and vegetables before use Handwashing facilities supplied and accessible 29. Toxic substances properly Identified,stored,and used _ Time and Temperature Relationship Food Storage/Display/Servlce _ 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 ! Equipment I Utensils I Linens 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean Protection From Contamination _ 4. Warewashing facilities maintained;test strips available 12. No re-service of returned food 35. Equipmentlutensils approved;installed;clean;good repair Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food 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 16. 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 __ 1. 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 dean,supplied,and maintained J( 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing Highly Susceptible Populations Permanent Food Facilities - 0. Prohibited foods not offered at high risk facilities ! 5. Floors,walls and ceiling are maintained and kept dean Water/Hot Water _ 6. No living or sleeping quarters inside facility 1.Hot and cold potable water available. Compliance and Enforcement Liquid Waste Disposal 7. Signs posted;last inspection report available 2. Sewage/wastewater properly disposed;toilet facility useable 48. Compliance with plan review requirements Vermin _ _ 9. Facility operating with a valid health pemklt 3. No rodents,insects,birds or animals inside facility 50. Impoundment 1. Permit Suspension Received By/ritle: x EH Specialist: Phone: Page 1 of aV b i EHD I&23 (1st pg) 1/18x12 FOOD PROGRAM OIR