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oPn.U`� Body Ins eAn Re <br /> �,•.-. . ��,;�� Y Art P Port <br /> � Date: <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> Record: <br /> (209)468-3420 (w Sy/ILK <br /> cd�;Fo a`P www.siogv.org/ehd Program <br /> Element: w <br /> Facility Name Address City Zip Code <br /> Colorful Addictions 450 e. 10th St. Tracy 95376 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> William J. Huggins 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 /> V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont. C <br /> ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, [ <br /> test etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized E] PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated [ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied [ <br /> ❑ 5' E] Chemical used: Madacide <br /> appropriately <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6. a ui ment E] ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled, used,and disposed of [ <br /> ® 7' ElWet contact time provided: 10 min <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. ❑ El 26. Barriers used [ <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27' 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 /> ❑ <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of 11. warm water El ❑ 30" procedure E: <br /> ❑ 12. 1 Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters [ <br /> Source: Biologix ❑ 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 /> F1 15. El El 35. Operation and employee training records present [ <br /> procedure area <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 /> ® <br /> Client records approved and available-Consent form 18. ❑ El37. Permits obtained and available [ <br /> andquestionnaire <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment [ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled [ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure [ <br /> ❑ 21. Machines cleaned and disinfected between clients I ❑ I ❑ 1 41. 1 [ <br /> Received b (Print): William J. Huggins Received b (Signature): Phone: 925 518-6573 <br /> Specialist(Print): Nav of Sahota Specialist(Signature): Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of; <br /> EH-11/17 <br />