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AQ IN SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N? a 1868 East Hazelton Avenue , Stockton, CA 95202-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www sigov.org/ehd <br /> HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: dro Inspection Date: <br /> /nq A44* <br /> Address: / / i/ `amnio � 7 PE: PR2`��2�0 <br /> Owner/Operator: Phon ., {J 3 � <br /> /iUa Qr wr <br /> Annual Insi1bction ❑ Complaint Inspection ❑ Consultation Inspection ❑ e-Inspection he: <br /> # Units in Facility: IS2 # 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 /> rRoom Cleanliness: Lack of cleanliness & sanitation; Accumulation of debris, trash, <br /> garbage, combustible items or similar materials.Room Maintenance: General lack of repair or improper maintenance; Broken or non- �— i >N �"fw'functioning sink/toilet/bath; Lack of hot water. Floors: Not clean , properly covered or ino®/ �y dPal� �r+2' good repair. Walls & Ceilings: Walls/ceilings in need of cleaning or repair: Holes, water �"'' cor dW �damage, peeling or deteriorating paint; Dampness or excessive moisture in room. hie �x - o 4- AwQ.E.L w <br /> Heating: Lack of approved heating in each unit; Approved heater not maintained in a safe, K <br /> ❑ 3. 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 /> F-1 6 <br /> 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 /> ❑ Public Areas: Unsafe or unsanitary conditions in kitchen , hallways, stairways, exits, or other <br /> 7. publicly shared spaces. <br /> [Pest <br /> s. 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 / —Sw��✓�n <br /> t0. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate <br /> protection from weather; Inadequate sewage or water facilities.control Used? WYes ❑ No Company Nam cy, f11v - <br /> Hotel/Motel Business License? fYes ❑ No sUp f 1zf A P7 <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building ode Enforcement/Fire ❑ County Code Enforcement/Fire ❑ Other <br /> Rooms inspected: 2w wed ( <br /> Comments: <br /> 000k 11�0- <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: Mot 012 Title: <br /> Environmental Health Specialist: Phone: � r Page 1 of <br /> EHD 24-07 4-30-12 <br /> HOTEUMOTEL OIR <br />