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_ SAN JOAQUIN COUNTY <br /> �A�ul1T ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> �� '• Telephone:(209)468-3420 Fax: (209)464-0138 Web:wvvw sjgov.orglehd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Inspection Dat;,,,. 04 �S <br /> Name of Facility: 1`'IE�RJ(,L r/Oj <br /> PE: M900 M <br /> Address: __jj 1�7� �/'Ty V'NjK1'DlJ Z1l� <br /> Phone: Z4.0_ C,41 <br /> Owner/Operator: <br /> Annual Inspection ❑ complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: I # Units Inspected: Reinspection On or About: <br /> The items checked below are violations to be corrected. Room(s): <br /> See Reverse Side of this Form for Detailed Summary of violations and Code References. <br /> ❑ s: Lack of cleanliness&sanitation;Accumulation of debris,trash, <br /> �:= <br /> tible items or similar materials. <br /> ce:General lack of repair or improper maintenance; Broken or non- <br /> F_ toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in <br /> 2. <br /> good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes, water <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture in room. <br /> Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, Zi d <br /> 3_ working condition; Lack of adequate heat(Standard:70°F at 3 feet from floor). <br /> Drinking Utensils&Ice Buckets: Not protected from contamination; Lack of or improper <br /> ❑ 4. washing &sanitizing after each use(multi-use); Lack of or improper protective bagging <br /> (multi-use)or individual protective wrapping (single-use). <br /> ❑ <br /> 5" ? Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or <br /> foul matter; Unsafe; Linens not changed weekly or before new guest. <br /> 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br /> close fitting covers; Garbage receptacles unclean or in disrepair. <br /> ❑ 7" Public Areas: Unsafe or unsanitary conditions in kitchen, hallways,stairways,exits,or other <br /> publicly shared spaces. <br /> ❑ l 8. Pest Control: Infestation of insects,vermin or rodents. <br /> ❑ 9. Other Nuisance:Any other condition which is hazardous to health. <br /> Other Substandard or Unsafe Conditions: Electrical, structural,or plumbing hazards; Lack ;11 2/O ro f 3/2, <br /> 10. of or inadequateke d_etectbr fire extinguishers; Inadequate lighting; Inadequate <br /> protection from weather; ina equate sewage or water facilities. <br /> Pest control Used?XYes ❑ No Company Name: CJr Frequency: oal? <br /> Hotel/Motel Business License? ❑Yes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to:X City Building/Code Enforcement/Fire❑ County Code EnforcementlFire❑ Other <br /> Rooms inspected: Zlj 210 Z011 3)t 6� 3L-,A 0'-f U Z <br /> Comments: 11- Pr1D(G DC-7ri-rC/L ilk- 6t;-Z.:iJ A64jV59 6y 'f r7i3x�ar c /r' <br /> /�tl L�Kltib A�e;1r1 . <br /> .1-210 - PMCKC vz:�Vr,7,YL . WMZc 461t-f' I•l &06 XW. <br /> f - NO 4100 0C7-EC 1x72 , fWAI&AA, fixTj" 14 #>9►.1aWH J1AJK /­r i VOXtf, 115 try/b II'%V" iN <br /> C6 i nl b <br /> All violations in rooms not inspected must also be corrected. <br /> All r -nspections by the 9nvironmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Heafffi Specialist: Phone: Page 1 of Z <br /> EHD 24-01 4-30-12 i HOTELIMOTEL OR <br />