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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-6232 �J Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: CO On�,A�M� {D�-C /� (� Inspection Date: © �� Address: i i 40 1 \N t WDA \N 0 J tD(IVr I 52DS PE:•!Iu+0 PR*0 2 j,.��. 0 Hy Owner/Operator: L Phone: J., nual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: #Units Inspected: 5 1 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): ❑ 1 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- 2. on- 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: Holes,water damage, peeling or deteriorating paint; Dampness or excessive moisture in room. ❑ 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. ❑ s 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. d Other Substandard or Unsafe Condition�ex lectric ,structural,or plumbing hazards; Lack 10. of or inadequate smoke detectors or fire I gulshers; Inadequate lighting; Inadequate 4tift protection from weather; Inadequate sewage or water facilities. Imo— yL U rd Flop Pest control Used?19 Yes ❑ No Company Name: requency: bw- Hotel/Motel Business License? Yes ❑ No Multi-Jurisdictional Violations to be Referred to:❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑Other Rooms inspected: D u� Comments: r6 a a v All violations in rooms not inspected must also be corrected. All re-inspoctions by th nvironmental Health De artment will be billed at the current hourly rate. Received By: J�. Title: Gr � Environmental Health Specialist: Phone: Page 1 of EHD 24-01 4-30-12 HOTEL/M EL OIR