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aq��n SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ka, 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.segov.org/ehd <br /> >t <br /> HOTEUMOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: Inspection Date: <br /> Wl r 22 I g <br /> Address: S PE: PR#: <br /> Owner/op WIL. C"1 P Phone: <br /> `-t 9 '-(30 C <br /> �c Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection M Re-Inspection <br /> #Units in Facility: 122 #Units Inspected: 5 Reinspection On or About: !J A <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 /> ❑ 1 Room Cleanliness: Lack of cleanliness&sanitation;Accumulation of debris,trash, <br /> garbage,combustible items or similar materials. <br /> Room Maintenance:General lack of repair or improper maintenance; Broken or non- g In - nolo �l <br /> functioning sink/toilet/bath; Lack of hot water. Floors: Not clean,properly covered or in °SS <br /> 2' good repair. Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water Z wy 21)2.)Z 1 Zi&pl lit (whjow x 6 s) <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture in room. i-igN.1W Hoc 1A jade) :Se <br /> e+ .� <br /> Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, <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 /> ❑ 5 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 /> ❑ <br /> 6' Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate 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 /> ❑ 10. of or inadequate smoke detectors or fire extingwshers; Inadequate lighting; Inadequate 1 <br /> protection from weather: Inadequate sewage or water faciliti <br /> Pest control Used? 0 Yes ❑ No Company Name: eFrequency: /wjuw j'WLy <br /> Hotel/Motel Business License? K Yes [] No <br /> Multi-Jurisdictional Violations to be Referred to:❑City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: 31 krg6A ' <br /> C ents: 2 s kele t�cen5 IJ <br /> ».a <br /> 6a h LUOf ktn 215 h 64VW%"-* <br /> a� <br /> 'A — Cha vu 1 1 d a Oo Var orK <br /> �n �+kt� RO r aT <br /> All violations in rooms not inspected must also be corrected. <br /> All r - ti8nA by the ErpArpnVne2pWealth Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Heal cialist: Phone: /g. 14 33 9 <br /> t� 7 7 Page 1 of <br /> EHD 24-01 4-30-12 HOTEUMOTEL OR <br />