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Pq�, y SAN JOAQUIN COUNTY �o ` .caG ENVIRONMENTAL HEALTH DEPARTMENT ..,� 1868 East Hazelton Avenue , Stockton , CA 95202-6232 � • Telephone: (209 ) 468 - 3420 Fax: ( 209 ) 464-0138 Web : www . slgov . org /ehd �4�'rFo HOTEL/ MOTEL OFFICIAL INSPECTION REPORT Name of Facility: ( ILA m S e�t OL Inspection Date :�d Address : 3 d 5 s • vV i � ' • 7 W S � OC fktO 'Yl ,�s PR# : 0 2 Y00 U Owner/Operator: Dara- C� Phone : 205 ZZI O Annual In pection ❑ ompla Inspection ❑ Consultation Inspection ❑ Re- Inspection # Units in Facility : 8 # Units Inspected : 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 ) . ❑ Room Cleanliness : Lack of cleanliness & sanitation ; Accumulation of debris , trash , 1 garbage , combustible items or similar materials . Room Maintenance : General lack of repair or improper maintenance ; Broken or non- functioning sink/toilet/bath ; Lack of hot water. Floors : Not clean , properly covered or in 2 ' 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 . ❑ 6 . Garbage Receptacles : Inadequate number of garbage receptacles ; Lack of or inadequate close fitting covers ; Garbage receptacles unclean or in disrepair. ❑ Public Areas : Unsafe or unsanitary conditions in kitchen , hallways , stairways , exits , or other 7 . publicly shared spaces . ❑ 8 . Pest Control : Infestation of insects , vermin or rodents . ❑ 9 . Other Nuisance : Any other condition which is hazardous to health . Other Substandard or Unsafe Conditions : Electrical , structural , or plumbing hazards ; Lack ❑ 10 , of or inadequate smoke detectors or fire extinguishers ; Inadequate lighting ; Inadequate protection from weather; Inadequate sewage or water facilities . tPL Pest control Used ? Yes ❑ No Company Name : , C CM . Frequency : o � Hotel/Motel Business License? NVYes ❑ No Ingi . rch 3 t, Multi-Jurisdictional Violations to be Referred to : ❑ City Building/Code gEnforcement/ Fire ❑ County Code Enforcement/Fire ❑ Other Rooms inspected : jqq IqV7i✓ 3 Comments : - f i r e CAJ I ��s evs Ms ► t K00^1 All violations in rooms not inspected must also be corrected . All re - inspections by the Environmental Health Department will be billed at the current hourly rate . Received By : n / v Ai J em Title : Environmental Health Specialist: � � cJ �S G Phone: ( L� n0) �,Q 3Y�/� Page 1 of EHD 24-01 4-30- 12 �-Vd U HOTEUMOTEL OR