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FOOD INSPECTION REPORT Date: ^ \.

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SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH Time In:
ENVIRONMENTALHEALTH BRANCH Time Out:
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1390 Market Street, Suite 210, San Francisco, CA 94102


www.sfd h.or /d h/eh/food (415)252-3800 Page 1 of.
Location Address: Inspection Type:
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Facility Name. Re-lnspection Date:
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Owner Name: Phone: Location I. D.:
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License Certificate Class No.. Exp. Date:
D Permit Posted D InspectionReport Posted
Person In Charge: Food SafetyManager: Exp. Date:
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SECTION 1: High Risk Violations (HRV) 7 Pts Each The marked violations are California Retail Food Code violations and must be corrected.
HRV disqualifies Symbol of Excellence COS* (FailureToComplyMayResultIna Citationand/orFines)
EMPLOYEE HEALTH / HYGIENE
1 Communicabledisease - Unreported or ^e'-^ dnc^l
unrestricted ill employee
PREVENT CONTAMINATION BY HANDS ^A 'S^-'m \& 6<a\
2 Handsnot clean / improperly washed/ gloves
improperly used s<&^\^
TIME & TEMPERATURE RELATIONSHIPS
3 High risk food holding temperature ~>^^ c<
4 Time as a public health control - Unauthorized or
unsafe use
\J^\!<S
5 Improper cooling methods
6 Improper cookingtime / temperatures .

CV^V?(^ QT-^SO Ot4-<M- ~t-


7 Improper reheatingof food \

PROTECTIONFROMCONTAMINATION '^»i&arTV>-\^>«3^- \<Mft& CQ«^ ^SIQO \^r^ *A OF


8 Contaminated or adulterated food
St-
9 Unclean or unsanitary food contact surfaces
FOOD FROM APPROVED SOURCES
I-^6-^. -YA^^ Aeo A^LCK=- U\fc£*^
10 Unapproved food source Q^^^O T^Ok/ C^j^ftrr\\^
HIGHLY SUSCEPTIBLE POPULATIONS
11 Prohibited food served to sensitive population \<v^& OS^OO&TBC? CffTC^-e<enTr^©Jv
WATER/HOT WATER
12 No hot wateror running water V3UUO^I cue<^»^i^fet \M^A
' i>^- ua^jojt-i^c?
LIQUID WASTE DISPOSAL
13 Sewage or wastewater contamination
VERMIN
o^ eaStnjao vsAf^e^K "2. '^0 ^<^UJ-\f^>
14 Rodents, roaches, flies, or other animals
15 Other high risk violation
On-neo << ^s>
SECTION 2: Moderate Risk Violations 4 Ms Each ift(C>S>^
.

OQ-JTPC^ 'Q<=T \<SAM. ^


DEMONSTRATION OF KNOWLEDGE
16 Inadequatefood safety knowledgeor lack or
certified food safety manager
Co>>sOU ^ ^ \>\r^^ w1-.
EMPLOYEE HEALTH/HYGIENE \
17 Discharge from employee nose, mouth, or eye
18 Employee eating or smoking ^3c Cue^At-^- rr^o sSr^>Al i fTCare>
PREVENT CONTAMINATION BY HANDS
19 Inadequate and/or inaccessible handwashing DEDUCTIONS: f.»C3T51Br3t- ^>&.
facilities High Risk:
TIME & TEMPERATURE RELATIONSHIPS o t^m^- \ ocxtol0~^.
20 Moderate risk food holdingtemperature Mod Risk:
21 Time as a public health control - Inadequate t^
procedures or records
0^ ^
Low Risk:
PROTECTIONFROMCONTAMINATION ^Six>S<°^^. Tlhli^£ . ^rs Qr^-
22 Reservice of previously served foods FINAL
23 Food in poor condition VlOCfe^
24 Inadequately cleaned or sanitized food contact
surfaces This Re Sha I Be Posted In Public View
FOOD FROMAPPROVEDSOURCES
25 Noncompliancewithshell fishtagsor display D Reinspection Fee Applicable For Violations No. 1 Thru 1
26 Noncompliance with Gulf Coast oyster
regulation
R ^g^ Signature:
Phone: ^\ -7p& ' ^0 ^ Received .
*COS-Corrected On Site MiddleCopy - OperatorCopy
^t\ FOOD INSPECTIONREPORT Date:
. -2.
s SAN FRANCISCODEPARTMENTOF PUBLIC HEALTH Time In: 2-
»^-
ENVIRONMENTALHEALTHBRANCH
~^.^. 0^ 1390 Market Street, Suite 210, San Francisco. CA 94102
Time Out: 'S. ~~ r^

www. sfd h. or /d h/eh/food (415)252-3800 Page 1 of


Location Address: Inspection Type:
Facility Name: Re-Inspection Date:
A (J0^-^
Owner Name*- Phone: Location 1. D.:
v 1
License Certificate Class No. Exp. Date:
^^Permit Posted spectio ort Posted
Person In Charge: FoodSafety Manager: Exp. Date:

SECTION 1: High k Viola s (HRV) 7 Each The marked violations are California Retail Food Code violations and must be corrected.
HRV disqualifies Sym llence cos* (FailureToComplyMayResultina Citationand/ or Fines)
EMPLOYEE HEALTH/HYGIENE
1 Communicable disease - Unreported or vn r\
unrestricted ill employee
PREVENTCONTAKfllNATIONBY HANDS ^vc> co^v\ 'Ac ^sn<?n<s^
2 Hands not clean / improperly washed/ gloves
improperly used VA*^er <%c^ cs v\©ce" Qto%jei^-ett> -rr -n-ie'"
TIME & TEMPERATURE RELATIONSHIPS
3 High risk food holdingtemperature <>ee^- -SaKV 6i?^a. swTno^.
4 Time as a public health control - Unauthorized or
unsafe use
5 Improper cooling methods
6 Improper cooking time /temperatures ^
7 Improper reheating of food
PROTECTION FROM CONTAMINATION
0^ -M<£
8 Contaminated or adulterated food
9 Unclean or unsanitary food contact surfaces -^*7
FOOD FROM APPROVED SOURCES
10 Unapproved food source
^ co \& 0
HIGHLY SUSCEPTIBLE POPULATIONS
11 Prohibitedfood served to sensitive population -ST
WATER/HOT WATER
12 No hot water or running water ®-
LIQUID WASTE DISPOSAL
c^
13 Sewage or wastewater contamination ^01 .

&\ *\OT ^«
VERMIN
14 Rodents, roaches, flies, or other animals
15 Other high risk violation
SECTION 2: Moderate Risk Violations 4 Pts Each
DEMONSTRATION OF KNOWLEDGE
16 Inadequatefood safety knowledgeor lack or
certified food safety manager
EMPLOYEE HEALTH / HYGIENE
-<9r Coc^wspe^i it^^Ti-tn
17 Dischargefrom employee nose, mouth, or eye I
18 Employee eating or smoking l^t* ^?ft%rv^ t-ic^- <rtCMS»^16 ^>iSC <^r -n^f^. GW^
PREVENT CONTAMINATION BY HANDS
19 Inadequate and/or inaccessiblehandwashing DEDUCTIONS: Sr/\no\.
facilities High Risk:
TIME & TEMPERATURE RELATIONSHIPS '^\<je- Oeo ^KS^ 'be^-\i<-0
20 Moderate risk food holdingtemperature Mod Risk:
21 Time as a public health control - Inadequate UBTC£>»^- '^-'DOO®. <2^{Ntve©^.rwo<Z-
procedures or records Low Risk:
PROTECTION FROM CONTAMINATION »S4o \<-<»>dc- G0'^> UQrr\ >
22 Reservice of previously served foods FINAL
23 Food in poor condition j^n- ^-f^ \zs^sf % Bi5n<o^,,
24 Inadequatelycleaned or sanitizedfood contact
surfaces This Report Shall Be Posted In Public View
FOOD FROM APPROVED SOURCES
25 Noncompliance with shell fish tags or display a Relnspectlon Fee Applicable For Violations No. 1 Thru
26 Noncompliance with Gulf Coast oyster RE (P' . Signature:
regulation
Phone: Received b

*COS-Corrected On Site Middle Copy - Operator Cop


^age '^- ui
^. ^ -»^^ , 3»^.. ^S^.., S.. P-OC^,.. , 41^-3.00 Inspection Date:
5ECTC^2cS^OAPPKOVEOPROCEOUPES- L,»,^^
<2ASO^l?^<^0r^
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27 Noncompliance with HACCP plan orvariance Business Name:


Re-lnspection Date:
CONSUMER ADVISORY <<£5^- ^te0
28 Consumer advisory notprovided forrawor ThemarkedEolationsar ahtarniaRetailFoodCodeviolationsandmustbecorrected.
undercooked foods (FailureToComply MayResultina Citationand/ orFines)
WATER/HOT WATER
29 Insufficienthotwaterorrunningwater %Ul 2^*
LIQUIDWASTEDISPOSAL/ VERMIN v
30 Inadequate sewage / wastewater disposal IS^T^IOST^ -e^a*-A rvvesr-rx"
^^0&<Z/ .03^ r^OJT /0^
Rodents,roaches,flies,orotheranimals
GENERAL FOODSAFETY REQUIREMENTS <3 -°rr <S»&AA^, sviomcA.
32 Improperthawingmethods
33 Foodsnotprotectedfromcontamination
34 Other moderate risk violation
SECTION 3: LowRiskViolations 2 Pts Each s^fe
SUPERVISION
35 Noperson in charge offoodfacility 0 0^ AT- -^^ <seA^- .a'wic^
PERSONAL CLEANLINESS
36 Unsanitaryemployee garments/ hair/_na^ls^ Q^S -v3 ^ i>^\wi-eo\
GENERALFOODSAFETYREQUIREftflENTS
37 Improperly washed fruits andvegetables t3r
^ OPOCA- TV-<^~ -F=ftc<
38 Improper storage, useoridentification oftoxic
substances
-^.^7 -(OUU&AJV>^6».
FOODSTORAGE/ DISPLAY/ SERVICE
vesisov-yr^
39 Improperfood storage v
40 Improperfoodlabelingormenumisrepresented
EQUIPMENT/ UTENSILS/ LINBNS ^U\i^^t*-ir^~S
41 Uncleannonfoodcontactsurfaces
42 Inadequate warewashing facilities / equipment V^0r\ rA^dC. A>>»0
Ar^
43 Unapproved / unmaintained equipment or
utensils
\/^
44 Improperstorage ofequipment utensilsor
linens
45 Inadequateventilationorlighting
46 Nothermometers or uncalibrated
47 Wiping cloths notclean orproperly stored or
inadequatesanitizer
PHYSICAL FACILITIES
48 Improper ordefective plumbing OCx^v t(U©r<.-0^&M^
49 Inadequateorunsanitary refusecontainersor
area or no garbage service c^t-F^. '. '\eCM_'<e®^A
50 Unclean, unmaintained orimproperly constructed
toilet facilities Cu^ftv\ ^SlA- YO\C»5
51 Inadequate dressing rooms or ir
personal items
PERMANENT FOODFACILITES
52 Uncleanordegradedfloors,wallsorceilings
53 Unapproved livingquartersinfoodfacility
SIGNS& OTHERREQUIREMENTS
54 Permit/ license/ inspection reportnotposted
55 Foodsafetycertificateorfoodhandlercard
not available
56 Unpermitted food facility
57 Workersafetyhazards
58 Inadequate HACCP plan record keeping
VERMIN
59 Rodents, roaches, flies, or other animals
OTHER
60 Non-service animal
61 NoncompliancewithCottageFoodOperation ^^ermit Suspension D CitationIssued D Impoundment/VCD
6?, \ planreviewand/orBuildingPermit REHS:
r law notifications not posted
iw risk violation
Received By:
\