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SAN JOAQUIN COUNTY <br /> ENVii ONMENTAL HEALTH DEPARTME SIT <br /> (a 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> = � Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.orq!ehd <br /> 9b HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: CJM-T My rc-L Inspection Date: 03 A S <br /> Address: �30� h/ ;V 4_4'0/4 FVM , f7VCKKA.) — � PE: Zy/G PR#: p2-yovZZ. <br /> Owner/Operator: 61WAlZr i P ict pftly Phone: 1j C_ 2Y�/ <br /> P X Annual inspection [] Complaint Inspection [--] Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: #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 /> ❑ 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-1 2 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 /> ❑ 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? &Yes ❑ No Company Name: 610Zrn — Frequency: CAffe /q olVIV <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: 3, cl <br /> Comments: — /J"lNf A00pl SIX' tn�6 fVW4- . <br /> JoWt C 6EWX114c /W"0VCV $ Wlw IQ: /Wr,>tW rrLtvr7DwG 7a 1-�WftCaL •II/2 W AVbtC,' <br /> - AD oh J IV I- /I4PRWI10 0/7 Won q,- A000 P11LI04, 7V /t6MA.a rt- cYr7' CW iAJ <br /> WV/took /J- ar "401vt . <br /> ►wtiK !1�ilP.�1/L �� PA0&A f;:S.f ' y- M1Wlit rA1i1 <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspecti os by the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Heaftfi Specialist. Phone: �/ <br /> 7 6�` � , - Page 1 of <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />