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r.0 , <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ?� <br /> ►: 1868 East Hazelton Avenue, Stockton, CA 95202-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> P <br /> `'FE HOTEL/MOTEL OFFICIAL INSPECTION REPORT <br /> Name of Facility: �CO n-0y- l OJ f Inspection Date: 1Z 2 of l S <br /> G <br /> Address: 4 S4D IV. Z. Paa ( oto -E• StacX6o y,, •gsZo PEZ96S PR#: o -Igol 0 <br /> Owner/Operator: m v6 h o\ Phone: y Z9 4 o9 9-8 <br /> R!jAnnual Inspection ❑ Complaint Inspection ❑ Consultation Inspection ❑ Re-Inspection <br /> #Units in Facility: C) I #Units Inspected: 41D 8 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 /> ❑ 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- 3 11, o 2 er <br /> 2' functioning sink/toilet/bath; Lack of hot water. Floors: Not clean,properly covered or in e 72 va22 <br /> good repair.Walls&Ceilings:Walls/ceilings in need of cleaning or repair: H`I_water <br /> damage, peeling or deteriorating paint; Dampness or excessive moisture In room. <br /> ❑ <br /> 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). <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 /> ❑ s 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 ofWjWZtfa vermin or rodents. <br /> ) )0Z— k o a C17-e S Tt <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 /> 10of or inadequate smoke detectors or fire extinguls ers; Inadequate lighting; Inadequate 3 1Zl f�ch eh fa K� ° coC <br /> protection from weather; Ina e sewage or water facilities. fu'ri Gov'el' <br /> equatr <br /> Pest control Used? XYes ❑ No Company Name: D e v e csf Gohtrof requency: o m C c GA- M o 7t 6 k <br /> Hotel/Motel Business License? Nryes ❑ No <br /> Multi-Jurisdictional Violations to be Referred to: ❑City Building/Code Enforcement/Fire❑County Code Enforcement/Fire❑Other <br /> Rooms inspected: 1 0) 0-2- <br /> Comments: <br /> 2Comments: <br /> d bS rred. 3 Yck >f2oo r f c Ye C�' k CS he r 71�rdSfo be C G <br /> T ('n -wo V K i M o ye ok,_-f e s '1r e nt; a-x s f a V 9rc'tc�Z h <br /> a-h h ►'G od"' M l In A t e e St" c `?'-, <br /> Qec, cmr, -e,n C�' G Sfoc2C ah f-ernc`e- -to oPlera <br /> All violations in rooms not inspected must also be corrected. <br /> All re-ins ections bx the Environmental Health Department will be billed at the current hourly rate. <br /> Received By: Title: <br /> Environmental Health Specialist:S t-- C Z yC l1� ,i Mc' Ce Phone: C7 d It ! —3 y s �j Page 1 of <br /> EHD 24-01 4-30-12 J / ® HOTEUMOTEL OR <br />