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orc fl bb Body Art Inspection Report Date: March 15, 2022 mya San Joaquin County Environmental Health Department Program 4 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR052i375 (209)468-3420 vw.w.sioay.ora/ehd Program Element: 4120 Facility Name Address City Zip Code Lin Permanent Makeup 6020 N. Pacific Ave Stockton 95207 Name of PermiURegistration Holder Permit Exp. Date Time In Time Out Inspection Type Linh Vu 6/30/22 Routine The above facility is inspected for compliance with Division 1042 Part 15, Chapter 7 of California Health and Safety Code (HSCj approved and effective -passed integrator test ❑ rV V = vinlaflnn El n = nnrtarted nn gift Items washed, disinfected, packaged, labeled, and sterilized El V CLEANING AND STERILIZATION C per hour may be charged. MACHINE SAFETY AND SANITATION (cont.) C EH -11/17 1Autoclave: approved and effective -passed integrator test ❑ rV 22. Parts replaced between clients - grommets, elastic bands, El El2 El Items washed, disinfected, packaged, labeled, and sterilized El PREVENTINGCROSS-CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 4. Integrators used/monthly spore tesUlog maintained ❑ ❑ 24. Appropriate chemical disinfectant used Elappropriately ❑ 5 Decontamination/sanitation area separated and supplied ❑ 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 ofEl❑ a ro riatel ❑ Wet contact time provided: ❑ 8 Jewelry, tattoo and piercing equipment - clean and sterilized El El 26. Barriers used El 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 ❑ ❑ 11 Handwashing facilities properly supplied and accessible, hot water ❑ ❑ 30. Cross -contamination avoided during all phases of procedure ❑ ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES F113. 13. Bloodborne Pathogen training El Areas separated/no living or sleeping quarters El Source: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 14 Appropriate personal protective equipment available andWor El Elused 33'good surfaces, including chairs, armrests, etc. in repair Elkstation, CUSTOMERS/CLIENTS ❑ 34. Permit'registration posted ❑ ❑ 15 Branding is completed with no other customers in rocedure area 11 El 35. Operation and employee training records present El ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s) submitted for review ❑ ® 18. Client records approved and available - Consent form and El [137. Permits obtained and available Eluestionnaire ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACHINE SAFETYAND SANITATION ❑ 39. Hearing scheduled ❑ ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients I ❑ ❑ 41. ❑ Received by (Print): Linh Vu Received by (Signature): EMAILED Phone 209-478-5912 Specialist (Printf: Pinne Chao Specialist (Si nature): Phone 209-468-3854 Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH -11/17