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" SAN JOAQUIN COUNTY � oR ufN c ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.si9ov.orq/ehd 9Gi F'd'F� FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: ✓ Date: 3 Address: 5 /, r , City: Zip Code: Owner/Operator• in OV ✓Y1�� Telephone: _3 _7no Program Element: vC Y "` b CV]Program Record: Inspection Type: 6180 Posted Yes 0 Rermit Posted es 0 P 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 public health and must be corrected immediately. Non-compliance may warrant closure of the food facility r`r �n.cl wn - Demonstration of Knowledge I ru.� oar ca Supervision . atii 1. Demonstration of knowledgefood safety certificate 24_ Person In Charge is present and perierms duties Employee Health and Hygiene Personal Cleanliness ,... " Communicable disease, reporting,restrictions&exclusions 1. 25 Personal cleanliness and ha r restraints 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 Preventing Contamination by Hands - 27. Food protected from contamination during storage Hands clean and properly washedproper glove use 23. Washing fruits and vegetables before use Handwashro facilities supplied and air rssible 29. f oxic substances properly identified.stored and used Time and Temperature Relationship FoodStoragetDisplay/Service Proper hot and cold holding temperatures 30. Food storage.food storage containers labeled 8. Proper use of time as a public health control 31. Crstomer self-service food protected;individual utensils provided 9. Proper cooling methods 32. Food properly labeled and honestly presented lo. Proper cooking time and temperatures Equipment!Utensils/Linens _._.___.._... 11. Proper reheating procedures for hot holding 33. Nonfood contact surfaces clean 4. Warewashing facilities maintained;test strips available X 12. No re-service of returned food 35. Equipmentlutensils approved;installed;dean;good repair t 3. Food free from contamination and adulteration 36. Equipment,utensils and linens:storage and use 14. Food..ontact sudec-caned and sane zed'warewashing procedures �� 37. Vending machines maintained Food From Approved Source 38. Approved and sufficient ventilation and lighting X15. 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 Ph,Ysiea{Facilities ._..._ - - Conformance With Approved Procedures 41 PWnmin9 maintained;Prper back flow P revemlon 1118. Compliance vnlh HACCF plan of r lna ice condLmrs 42. Garbage and refuse properly disposed Consumer Advisory 3. Toilet facilities clean,supplied,and maintained 1,q Advisory provided for raw or underrcooked foal 4. Premises'. personal/cleaning items'.vermin-proofing .;Highly S�ble Populations .. Permanent Food Facilities ,. 20. Froh tud foods not oro,red at high nsk facilirics 45. Floors,walls,and ceiling are maintained and kept clean Water/Hot Water 46. No living or sleeping quarters inside facility 121 I lot aril.. Id potable water available. Compliance and Enforcement a Liquid Waste Disposal - Signs posted:last inspection report available 22. Sewage/wastewater properly disposedtoilet facility useable 48_ Compliance with plan review requirements Vermin 49. Facility operating with a valid health permit _23 Nr md,nts ws-!s Luds of animals inside facility 50. Impoundment 51. Permit Suspension Received By/Ti e: - EH Specialist: Phone: / 1 D1n - Page 1 of EHo 16-23(1s1 pg) 419/12 l.Fi! IX- FOOD PROGRAM OIR