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�f SAN JOAQUIN COUNTY <br />�4• ly. <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />q ono =__4 L-1---14-- n..,,.... oa....f.a,... I - n ncnnn neon <br />HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br />Name of Facility: 'n, V.0 + f 1 A -Cis-- O <br />Inspection Date: I / IAd <br />Address:�l <br />YC 0�1 t OL to `Y1 <br />PE: ZUaq <br />PR#: 05?T5S <br />, c�t. <br />Owner/Operator: octyT CY i f r11 <br />Phone:: IC, <br />Annual Inspection ❑Complaint Insp tion ❑ Consultation Inspection ❑ Re -Inspection <br /># Units in Facility: <br /># Units Inspected: 16 1 <br />Reinspection On or About: <br />The items checked below are violations to be corrected. <br />See Reverse Side of this Form for Detailed Summary of Violations and Code References. <br />Room(s): <br />❑ <br />1 <br />Room Cleanliness: Lack of cleanliness & sanitation; Accumulation of debris, trash, <br />garbage, combustible items or similar materials. <br />Room Maintenance: General lack of repair or improper maintenance; Broken or non- <br />F-] <br />2 <br />functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in <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 />❑ <br />3. <br />Heating: Lack of approved heating in each unit; Approved heater not maintained in a safe, <br />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 />❑ <br />4. <br />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' <br />Beddin : 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 />❑ <br />6 <br />Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate <br />close fitting covers; Garbage receptacles unclean or in disrepair. <br />❑ <br />7. <br />Public Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways, exits, or other <br />publicly shared spaces. <br />❑ <br />8. <br />Pest Control: Infestation of insects, vermin or rodents. <br />❑ <br />9. <br />Other Nuisance: Any other condition which is hazardous to health. <br />Other Substandard or Unsafe Conditions: Electrical, structural, or plumbing hazards; Lack <br />Zv S� d K� ccft, <br />10. <br />of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br />protection from weather; Inadequate sewage or water facilities. <br />Pest control Used? KYes ❑ No Company Name: 0 Y j t) Frequency: Tc- aAo <br />Hotel/Motel Business License?,KYes ❑ No 11 3 ZOT3 <br />Multi -Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire ❑ County Code Enforcement/Fire ❑ Other <br />Rooms inspected: 203 2 tLo uL: 3 12- 310 3O 30r 30c5 20 11111,1 U 3 S'f 9 33 <br />Comments: <br />ec0n n a ro t;Ye <br />rocs N tnVk 14 1 e -'o C C—A-c r <br />All violations in rooms not inspected must also be corrected. <br />A1104e ' by the Environmental Health Department will be billed at the current hourly rate. <br />Received B Title: <br />Environmental Healt pecialisfi one: 5� - 0 I <br />Page 1 of <br />EHD 24-01 4-30-12 HOTEUMOTEL OR <br />