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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT y: —�• :y, 1868 East Hazelton Avenue, Stockton, CA 95202-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www slclov.ora/ HOTEL/MOTEL OFFICIAL INSPECTION REPORT Fn+� Name of Facility: H///y,17 Inspection Date: .S Address: .23.2.3 qtr, C C,�-s.-� g�✓� t� � PE: PR� Owner/Operator: Phone: 9.y--7 _ 'FO 70 aAnnual Inspection El Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: 9r # Units Inspected: / if 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- Z' ❑ 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. Ell ~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). ❑ 5' Bedding: Mattress/linens infested with lice, bedbugs, or other insects; Not free from filth or i foul matter; Unsafe; Linens not changed weekly or before new guest. ❑ 16 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 ❑ 1& of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather; Inadequate sewage or water facilities. Pest control Used? Lg Yes ❑ No Company Name: Ec-c!a 6 Frequency: A4,K.oVa 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: l 1, ] 4v 13.- Comments:Comments: y keV s AID 6- dP ';ZeG All violations in rooms not inspected must also be corrected. All r -inspections by the Environmental Health Department will be billed at the current hourly rate. Received By: Title: Environmental ealth Specialist: Phone: L��' .-3�2 Page 1 of EHD 24-01 4-30-12 HOTEL!MOTEL OR