Laserfiche WebLink
U.1 Body Art InspectieReport Date: �Z�l <br /> .'::•.,po <br /> Q �a San Joaquin County Environmental Health Department Program <br /> Record: <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 j (�G '72-921 <br /> (209)468-3420 <br /> cq``'"•'�'• • www.slogy.org/ehd Program t' CO <br /> < FOR Element: "L <br /> Facility Name Address City Zip Code <br /> The Top Story 104 n.school st. Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Teri L.Turrentine-Eisert Initial Consult. <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 /> V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont.) C <br /> ® 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22J Parts replaced between clients-grommets,elastic bands, ❑ <br /> test etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> El 2' sterilized E3PREVENTING CROSS-CONTAMINATION <br /> ® 3. Autoclave loaded correctly/packages allowed to dry [I ❑ 23. 1 Workstation/procedure area decontaminated El® 4. Integrators used/monthly spore test/log maintained El F1 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ® 5• appropriately ❑ Chemical used: Opticide <br /> Invoices and log kept for disposable,pre-sterilized® 6' El El 25. Disinfectant used appropriately/sufficient contact time <br /> equipment E]Sharps containers labeled, used,and disposed of <br /> ❑ 7' appropriately ElWet contact time provided: 2 mins <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8' sterilized El ❑ 26. Barriers used ❑ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27. asepticallyEl <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ [j 29. Jewelry,Inks,Needles etc approved and used correctly ❑ <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> F1 11. warm water 1:1 El 30' rocedure E] <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Cathie Montle ® 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and ❑ ❑ 33 Workstation,surfaces, including chairs,armrests,etc.in ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> ❑ 15. rocedure area El ® 35. Operation and employee training records present ❑ <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ® 36. Plan(s)submitted for review ❑ <br /> Client records approved and available-Consent form <br /> ® 18. and uestionnaire [I ® 37. Permits obtained and available El <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment El <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 4 Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 1. c ❑ <br /> Received b (Print): Teri L.Turrentine-Eisert Received b (Sign Phone: <br /> Specialist(Print): Har rit Mattu,Sr REHS Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 3 <br /> EH-03/2015 <br />