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BodyArt Ins eca Re <br /> p port <br /> 40 Date: 3/!0/l d' <br /> San Joaquin County Environmental Health Department Program <br /> l 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: f R US•2 3�,T <br /> \, (209)468-3420 <br /> www.sioov.org/ehd Program <br /> 4iFOR- Element: W90 <br /> Facility Name Address City Zip Code <br /> Danvi Salon 6020 n. pacific ave. Stockton 95207 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Linh Thuy Vu 6/30/18 Routine <br /> The above facility is inspected for compliance with Division 104, Part 15,Chapter 7 of California Health and Safety Code(HSC). <br /> V=Violation C=Corrected On Site <br /> sf > ,. k <br /> ❑ 1 Autoclave: approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, E]test etc. <br /> El 2 Items washed,disinfected, packaged, labeled,and El ,' 3, < ' <br /> r � �u N <br /> sterilized . ,PR, ,ENTIN � 03S .QNTAAkJNATION , <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ [:1 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5. appropriately ❑ Chemical used: LaRocide <br /> ® <br /> Invoices and log kept for disposable, pre-sterilized 6. ElEl25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> E]Sharps containers labeled, used,and disposed of <br /> El 7� ElWet contact time provided: 10 min <br /> aro riatel <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. sterilized El El 26. Barriers used El <br /> ❑ 27 Products applied to skin are single use/dispensed ❑ <br /> I?RACTITIt2NERHEALIH ANL)„H1fGIENIr °>„ �.,. aseptically <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments, needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> El 11. warm water El ❑ 30' procedure E] <br /> ❑ 12. Hepatitis B vaccination ❑ BESEBUSINESS.PRA�C`FICES,.. <br /> ® 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Cathy Montie ® 32. Floors and walls clean and in good repair, adequate light ❑ <br /> ❑ <br /> Appropriate personal protective equipment available and El 33surfaces, including chairs,armrests,etc. in 14. used ❑ 33. good repair <br /> E] <br /> DINERS/C-ENT �:.; a _ ® 34. Permit registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. ❑ ® 35. Operation and employee training records present Ellrocedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ PL , , ,E ANL'ENFOR ENT. . <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ <br /> ® <br /> Client records approved and available-Consent form 18. questionnaire <br /> El 37. Permits obtained and available E]and <br /> ® 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ <br /> Received by(Print): Linn Thuy Vu Received by(Signature): Phone:(209)478-5912 <br /> Specialist(Print): Navjot Sahota Specialist(Signature): LPhone: (209)468-3178 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />