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SAN JOAQUIN COUNTY <br /> .o <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjaov.org/ehd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: 25CsT epi C's <br /> Tcp-N -06-911.-tG6 Il Inspection Date: <br /> Address: ( I l E' .MA" VaGe `� I lJ l f�► + �Q 920 1 PE:240 PR#:� .. <br /> Owner/Operator: U a I U ClI Phone:t� �/' D <br /> Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> # Units in Facility: # Units Inspected.* :3 j 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. Room(s): <br /> ❑ 1 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- -3L}-, hot QrtTvn <br /> functioning sin ilet/bath; Lack of hot water. Floors: Not clean, properly covered or in W quer' nfl�� <br /> 2' good re air a s Ceilin s:Walls/ceilings in need of cleaningor repair: Holes,water <br /> mord <br /> damage, pee Ing or deteriorating paint; Dmpness or excessive moistpure in room. hO e q <br /> Un A. <br /> Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, -.• <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 /> Bedding: Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or <br /> F-1 5. 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 /> ❑ 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 1 <br /> X10. of or inadequate§.moke detectors or fire extinguishers; Inadequate lighting; Inadequate 120 <br /> protection f om weather; Inadequate sewage or water facilities. Grlow_xc ae-mr oe�S <br /> Pest control Used? AYes ❑ No Company Name: fZ A J), Frequency: j Q7 <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: 0 i 01 ?J q .3 2_T � -Z l 3 I33 1 Zq 13C 3'l 3� 3'212 <br /> Comments: 3 . 331 3 Z 4 + 3 S L4& <br /> Ln b <br /> JI <br /> it <br /> a � c� s cK ( Q� <br /> All viola ions in rooms not inspected must also be corrected. <br /> All qp-ipsgWions by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: - _ Title: <br /> Environmental ealt Specialist: Phone: :%L(y . 405 Page 1 of <br /> EHD 24-01 4-30-12 HOTEL/MOTEL OR <br />