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�oG Body Art Inspection Report Date: January 18 2022 a San Joaquin County Environmental Health Department Program 1969 E. Hazelton Ave., Stockton, CA 95205 Record: PR0545020 (209)468-3420 w .sioay.om/ehd Program L oo w Element: 4120 Facility Name Address City Zip Code JB's Ink Therapy 222 N EI Dorado St#F Stockton 95202 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Jeston Barnett 6/30/22 Reinspection The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health ano Saieiv Code (HSC) V =Violation C =Corrected On Site V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION (cont.) C El 1, Autoclave: approved and effective - passed integrator test El E]22 Parts replaced between clients -grommets, elastic bands, Eletc. El 2' Items washed, disinfected, packaged, labeled, and sterilized ❑ PREVENTING CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used ❑ ❑ 5 Decontamination/sanitation area separated and supplied appropriately ❑ Chemical used: ® 6. Invoices and log kept for disposable, pre -sterilized equipment ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ ❑ 7 Sharps containers labeled, used, and disposed of appropriately ❑ Wet contact time provided: ❑ 8 Jewelry, tattoo and piercing equipment - clean and El El 26. Barriers used Elsterilized PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ IN if. Handwashing facilities properly supplied and accessible, warm water El El30. Cross -contamination avoided during all phases of procedure El ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ Source: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ El 14. Appropriate personal protective equipment available and used El [1 33' Workstation, surfaces, including chairs, armrests, etc. in good repair El CUSTOMERSICLIENTS ❑ 34. Permil/registration posted ❑ ❑ 15 Branding is completed with no other customers in area ❑ El 35. Operation and employee training records present Elrocedure ❑ 16. Customers eighteen (18) years of age or older Ell COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plans) submitted for review ❑ ❑ 18. Client records approved and available - Consent form and El El 37. Permits obtained and available El ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received by (Print): Jeston Barnett Received by (Signature): Emailed Phone: 301-462-9784 Specialist (Print): Sandip Singh Specialist (Signature): 5 0 a #/ Phone: 209-468-3526 v i Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH -11/17