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i <br /> ora"•" SAN JOAQUIN COUNTY <br /> 1�my(I!i'FA <br /> a ENVIRONMENTAL HEALTH DEPAH I MENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax.(209)464-0138 Web:www.s*gov.org/ehd <br /> �l'f 6b <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ,Cu Date: 2 <br /> Address: /I / /094- City: Zip Code: <br /> wner/Operator: ( V v Telephone: <br /> Program Eleme Program Record: Inspection Type: <br /> 8180 Poste 7 Yes O No Permit Posted ❑Yes 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 /> Ma or violations pose a threat to public health and must be corrected immediately. Non-compliance may warrant closure o/the food lacil/ <br /> NJ Re I WA I Demonstration of Knowledge w.i out cos Supervision our <br /> it. Demonstration of knoWedge;food safety certificate 24. Person In Charge is present and performs duties <br /> _ Employee Health and Hygiene Personal Cleanliness <br /> Communicable disease;reporting,restrictions 8 exclusions 25. Personal cleanliness and hair restraints <br /> No discharge from eyes,nose,or mouth;no open wounds General Food Safety Requirements <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 dean and properly washed;proper glove use 28. Washing fruits and vegetables before use <br /> Handwashing facilities supplied and accessible 9. Toxic substances properly identified,stored,and used <br /> _ Time and Temperature Relationship Food Storage/Display/Service <br /> Proper hot and mid holding temperatures 30. Food storage;food storage containers labeled <br /> B. Proper use of time as a public health control 31. Customer sell-service food protected;individual utensils provided <br /> 9. Proper cooling methods 32. Food property labeled and honestly presented <br /> 10. Proper cooking time and temperatures Equipment/Utensils/Linens <br /> 11. 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;clean;good repair <br /> KI-L-11 <br /> 13. Food free from contamination and adulteration36-Equipment,utensils and linens:storage and use <br /> 14. Food contact surface cleaned and sanitlzeC/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 /> JY116. Compliance with shell stock regulations;tags/display 40. Proper use and storage of wiping cloths <br /> 7. Compliance with Gulf oyster regulations Physical Facilities <br /> Conformance With Approved Procedures 41. 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 /> 19. Advisory provided for raw or undercooked food 44. Premises;personal/cleaning items;vermin-proofing <br /> Highly Susceptible Populations Permanent Food Facilities <br /> 0. Prohibited foods not offered at high risk facilities 45. Floors,walls and ceiling are maintained and kept clean <br /> Water/Hot Water 46. No living or sleeping quarters Inside facility <br /> i <br /> 1.Hot and cold potable water available. Compliance and Enforcement <br /> Liquid Waste Disposal 47. Signs posted;last inspection report available <br /> 2. Sewage/wastewater properly disposed;toilet facility useable . 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 0. Impoundment <br /> 1. Permit Suspension <br /> Received By/Title: <br /> EH Specialist: - p� Phone: ,/n Page 1 of <br /> EHD 16-23 list pg) 4MI12 FOOD PROGRAM OIR <br />