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a,q�l SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95202-6232 ' Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd •4�/FOR�`4 HOTEL/MOTEL OFFICIAL INSPECTION REPORT Name of Facility: ��n (�. t&d i UJ Inspection Date: 1 1 O Z Z Address: ,r L O Y, -EI �a� Jt. ��OC/Ct� PE:21)L,,g PR#: 2 yb (7 Owner/Operator: (1� eet- rU` Phone: Annual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection #Units in Facility: 6o I #Units Inspected: 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, garbage,combustible items or similar materials. Room Maintenance:General lack of repair or improper maintenance; Broken or non- C-Ah voc, 1 2 functioning sink/toilet/bath; Lack of hot water. Floors: Not clean, properly covered or in (Uy b 1(4)1D,-1 Cei11 �4�y 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. ❑ 3 Heating: Lack of approved heating in each unit;Approved heater not maintained in a safe, 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). ❑ Beddin : Mattress/linens infested with lice, bedbugs,or other insects; Not free from filth or 5' foul matter; Unsafe; Linens not changed weekly or before new guest. Garbage Receptacles: Inadequate number of garbage receptacles; Lack of or inadequate ❑ 6' 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. LX_ K'k—L PL ❑ 9. Other Nuisance:Any other condition which is hazardous to health. Other Substandard or Unsafe Conditions: Electrical, structural,or plumbing hazards; Lack ❑ 10. of or inadequate smoke detectors or fire extinguishers; Inadequate lighting; Inadequate protection from weather; Inadequate sewage or water facilities. Pest control Used?JKYes ❑ No Company Name: 'W' ,✓ ' Frequency: 7777701-CULly Hotel/Motel Business License? [RYes ❑ No 3 p Ca to ' . Multi-Jurisdictional Violations to be Referred to:❑ City Building/Code Enforcement/Fire❑ County Code EnforcemenYFire❑ Other Rooms inspected: o8 01 p Comments: 2k P14 e Pte. All violations in rooms not inspected must also be corrected. All re-inspections by the Environmental Health Department will be billed at the current hourly rate. Received By: Title: m Am Environmental Health Specialist: Phone: Page 1 of EHD 24-01 4-30-12 ' / HOTEUMOTEL OR