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SAN JOAQUIN COUNTY ap"�f '•O 2 �t� ENVIRONMENTAL HEALTH DEPARTMENT 1. .� 1868 East Hazelton Avenue, Stockton, CA 95202-6232 q 41 Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.si_qov.org/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: 1•�1— 1 c1 � a wt Inspection Date:Irl Address: C��ARM JL�1I,- clG r' PE: �_ To9 PR#`O 240 Owner/Operator: BRAN p15 [f^, (� Phone: � nnual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: IM 4 #Units Inspected: p I Reinspection On or About: The items checked below are violations to be corrected. See Reverse Side of this Form for Detailed Summary of Violations and Code References. Room(s): ❑ Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, garbage,combustible items or similar materials. Room Maintenance: General lack of repair or improper maintenance; Broken or non- lam- ote ct1✓l,tncj a r"�'t'1• 1 t� 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair' ole water damage, peeling or deteriorating paint; Dampness or excessive moisture in om. ❑ Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, 3' working condition; Lack of adequate heat(Standard:70°F at 3 feet from floor). Drinking Utensils&Ice Buckets: Not protected from contamination; Lack of or improper ❑ 4. washing &sanitizing after each use(multi-use); Lack of or improper protective bagging (multi-use)or individual protective wrapping(single-use). ❑ Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or 5. foul matter; Unsafe; Linens not changed weekly or before new guest. ❑ 6 Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate close fitting covers;Garbage receptacles unclean or in disrepair. 7.❑ Public Areas: Unsafe or unsanitary conditions in kitchen, hallways, stairways,exits,or other publicly shared spaces. ❑ 8. Pest Control: Infestation of insects,vermin or rodents. ❑ 9. Other Nuisance:Any other condition which is hazardous to health. Other Substandard or Unsafe Conditions: Elect' I tructural,or plumbing hazards; �- 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequat 1 _ * protection from weather; Mae -0 a sewage or water facilities. t tpose Pest control Used? Yes ❑ No Company Name: Frequency: Hotel/Motel Business License? XYes ❑ No Multi-Jurisdictional Violations to be Referred to:❑City Building/Code Enforcement/Fire❑County Code Enforce ment/Fire❑ Other Rooms inspected: O 22e� 32J.0 Comments-.2W i9i 3 i2 i n' v v --nW1W to m All violations i rooms not inspected must also be corrected. re-inspectione/Dy the Environmental Health Department will be billed jjt the current hourly rate. Receive B Title: _- Environmental-Valth Specia ist: hone: ;Pn 1 ftm Page 1 of EHD 24-01 4-30-12 `'T HOTEUMOTEL OR