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Pq��y SAN JOAQUIN COUNTY <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> 4C,FORH�P HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: ���� _�'�` -tfj Inspection Date: l z/ZIAO&O <br /> Address: l n r VStOCK&0� PE: 290 PR#:O <br /> Owner/Operator: I W '�v 'f ryX s Phone:0- <br /> 00 Z Z /._er1 <br /> Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> # Units in Facility: t 10 1 # Units Inspected: 9 1 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 /> ❑ <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- 0 S wtl L.a({dw-r-: <br /> 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in tv9 sh tire y Fa4c et <br /> good repair. Walls&Ceilings:Walls/ceilings in need of cleaning or repair: Holes,water 372 L ;jh-t c,-.d h-0 <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture in room. &, low) <br /> ❑ 3. Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, <br /> 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' 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. 21 L cavyVY <br /> 001 L <br /> ❑ 9. Other Nuisance:Any other condition which is hazardous to health. <br /> Other Substandard or Unsafe Conditions: Electrical,structural,or plumbing hazards; Lack 109 Sne free J11.6te c4-0 je <br /> 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate 5 t24 fut-v if i r'e cxyi-.64 <br /> protection from weather; Inadequate sewage or water facilities. 03 f u si <br /> Pest control Used? Xf Yes ❑ No Company Name: (G., Frequency: n v�fk.l <br /> Hotel/Motel Business License? Wes ❑ No Z,01.1 <br /> Multi-Jurisdictional Violations to be Referred to: ❑ City Building/Code Enforcement/Fire❑ County Code Enforcement/Fire❑ Other <br /> Rooms inspected: lU� 3L 3 9 _ 7v <br /> Comments: <br /> n �✓ rV1 b E"t w I-e- for F ern; <br /> All violations in rooms not inspected must also be corrected. <br /> All re-inspecti ns b the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Health Specialis . 77, Phone: / Za Page 1 of <br /> EHD 24-01 4-30-12 HOTEL/MOTEL OR <br />