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�op.000 o SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1, 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br />Name of Facility:Inspection <br />.��;5 fi , � 4C� a��q `.ice r1 <br />Date: <br />3tvz; ze`z"�-i <br />Address: C—, <br />M r`ft, ��t <br />PE 7_qb 1 <br />PR#: 07- yal <br />Owner/Operator: T'L\\ . -,e4 S ��1 � /� '3moi. <br />Phone: ZG _ Zx _ <br />Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re -Inspection <br /># Units in Facility: ?L3 <br /># Units Inspected: 30 <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 />1 <br />Room Cleanliness: Lack of cleanliness & sanitation; Accumulation of debris, trash, <br />M u1. r'tt-kr"W\ .'Sot l <br />garbage, combustible items or similar materials. <br />Zi'S <br />Room Maintenance: General lack of repair or improper maintenance; Broken or non- <br />kx' m eiww e -r e <br />® <br />2 <br />functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in <br />13�c EIM�. <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 />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 />F-1 <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 />r- %uC VVI ! C3'Z- I <br />�5 <br />10. <br />of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br />protection from Bather; Inadequate sewage or water facilities. <br />Pest control Used? Yes ❑ No Company Name: ,,.04ie ttfL Frequency: LU;T <br />Hotel/Motel Business License? Yes ❑ No <br />Multi -Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire ❑ County Code Enforcement/Fire ❑ Other <br />Rooms inspected: IC -L i CG' i 1�. i Z z 2/ 2_ZC 1 I Z L v c j3a : lai��•t ' I L7 j <br />Comments: rI -1 -2 3�' -L3� 1�' 2- q2- _3�t(v t 3 �" �1 �^: ��_ 2 - <br />COW rg-Coy, r►,V . r (t" Yo"4- J'3 fir' : �s �' �,. �x� qk�.>� e' o -t z 4r j oe <br />All violations in rooms not inspected must also be corrected. <br />All re -inspections by the Environmental Health Department will be billed at the current hourly rate. <br />Received By: Title: <br />Environmental ldealt cialist: S �j,L Phone: <br />Page 1 of <br />EHD 24-01 4-30-12 HOTEUMOTEL OR <br />