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SAN JOAQUIN COUNTY <br />a� P�f '•.OGS <br />—�-� . •..Z, ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br />•,i Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www sigov or /g ehd <br />HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br />inspection uaLe. 4C-- Ij <br />Ila <br />Name of Facility: �P � Rah j,,,�- <br />y�0 <br />Address: J 7 �. C.t+•cry-;�07 <br />PR <br />Ph /ry OS Z�S2 <br />Owner/Operator:' <br />Phone: <br />Annua_I Inspection ❑ Complaint Inspection ❑ Consultation Inspection <br />❑ Re -Inspection <br /># Units in Facility: /3 # Units Inspected: Reinspection On or About: <br />The items checked below are violations to be corrected. <br />Room(s): <br />See Reverse Side of this Form for Detailed Summary of Violations and Code References. <br />Room Cleanliness: Lack of cleanliness & sanitation; Accumulation of debris, trash, <br />❑ 1 garbage, combustible items or similar materials. i <br />_W <br />�� .kms do�.rh <br />Room Maintenance: General lack of repair or improper maintenance; Broken or non- <br />functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in <br />❑ 2. 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 />Lack of approved heating in each unit; Approved heater not maintained in a safe, <br />AS ` t�t� wsr <br />E]Heating: <br />s 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 />❑ Bedding: Mattress/linens infested with lice, bedbugs, or other insects; Not free from filth or <br />5. <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 />k3 — wo Sw+tit 4w -^S <br />10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br />V'1;3r <br />�t �"aO�`C °&u0 S%e#Ac IOA i <br />I protection from weather: Inadequate sewage or water facilities. <br />Pest control Used? XYes ❑ No Company Name: t, a epj, Go Frequency: <br />X40.•A:i <br />Hotel/Motel Business License? ❑ Yes ❑ No <br />Multi -Jurisdictional Violations to be Referred to: ❑ City Building/Code EnforcementlFire ❑ County Code Enforcement/Fire ❑ Other <br />Rooms inspected: A3 1 IZ <br />Comments: elf— <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: Title <br />Environmental qealth Specialist. Phone: <br />2 Page 1 of <br />EHD 24-01 4-30-12 r �� U HOTEUMOTEL OR <br />