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o,gV!y SAN JOAQUIN COUNTY <br /> ENV t'ONMENTAL HEALTH DEPARTMLKT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> ' Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sigov.orq/ehd <br /> HOTEUMOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: 0R-/,r fN Ij Inspection Date: 03 <br /> /D / <br /> Address: <br /> SSO y� D2 . MRfLnN Lv77tW, tomb Jl2 . PE: ,G�� PR#:OZ yCv'91 <br /> Owner/Operator: J`In4 pk f) P11 TIL Phone: <br /> fkry >jrAnnual Inspection ❑ Complaint inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: 70 #Units Inspected: / 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- <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. 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 /> ❑ 4. washing &sanitizing after each use(multi-use); Lack of or improper protective bagging <br /> (multi-use)or individual protective wrapping (single-use). <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 /> ❑ 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 <br /> ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br /> protection from weather; Inadequate sewage or water facilities. <br /> Pest control Used?Im Yes ❑ No Company Name: Frequency: now 140AIN <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: 1SQ I ysh H I I I 5j IA41 N4 7AI 6 1 ZAR- N 2y 5 <br /> Comments: 10 11 0 d5-4 <br /> flF 141 01Ar Jt1M- 9 /Al Cf1l i4rr M7%4�J Ooo2 9- tv <br /> - 41" C4,61b-� l L6T 6 OWL, <br /> 2"1b- A►1vl 1-Iftj / �_T Iu #*# Ibol- 1llti`F14 /ffl1CW-r . <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: Aoe�!� Title: <br /> Environmental He Specialist: Phone: Page 1 of j <br /> EHD 24-01 4-30-12 ) V HOTEUMOTEL oIR <br />