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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-6232 F. Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: eInspection Date: t I 12'J Address: %2T S. T rn '1k . `(S ZD PE: 2PR#:0 NO\�I %,Z Owner/ p rator: Sa to ir� V-l. Phone:_111A 11 -b1-+ ,1-4 'Annual Inspection ❑ mplaint Inspection ❑ Consultation Inspection ❑ Re-Inspection 1 #Units in Facility: _lK a5 #Units Inspected: I HReinspection 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, O5 garbage,combustible items or similar materials. Room Maintenance: General lack of repair or improper maintenance; Broken or non- 01 `Vc, i �No ❑ 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 '7-3s! 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. ❑ 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. 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. Pest control Used? ®.Yes ❑ No Company Name: Frequency: n Hotel/Motel Business License? gYes ❑ No Z - Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other Rooms inspected: 103i 11,06, W 1 204 1 Z0 2 Z Comments: kl7`J m` f V-C>PRI i bi L h; �rl� J1I 're �-C'h i Q ✓ �- lcf r-'° k <" rc31�i ter :'-� IN. 1 02 IDLh h-vto reell c� a_ All vl ati ns in ro s not ins ected must also be corrected. All re=inspections byjfhe EmAronniAntal Health epartment ill be billed at the current hour) rate. Rec ' ed Title: C � f VAall Envirental pecialist: Phone: �O _� IC,30 Page 1 of 19 1 EHD - 1 4-30-12 HOTEVMOTEL OIR