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U r' goy Body Art Inspection Report Date: September 1 2021 w San Joaquin County Environmental Health Department Program 1866 E. Hazelton Ave., Stockton, CA 95205 Record: PR0541150 (209)466-3420 a• .sioov.om/ehe Program g�rFORa Element. 4120 Facility Name Address City Zip Code Living Water Studios 210 N Main St. Manteca 95336 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Thomas Shea 6/30/22 Routine The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safety Code (HSC) C ❑ 1. V = Violation ❑ C = Corrected On Site Parts replaced between clients - grommets, elastic bands, etc. ❑ El V Received by (Print): Thomas Shea Received by (Signature): CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont. C ❑ 1. Autoclave: approved and effective - passed integrator test ❑ ❑ 22. Parts replaced between clients - grommets, elastic bands, etc. ❑ 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 ❑ El ElEla 24. Appropriate chemical disinfectant used ❑ 5 Decontamination/sanitation area separated and supplied ro riatel El 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 sterilized ❑ ❑ 26. Barriers used ❑ 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, warm water El El30. Cross -contamination avoided during all phases of procedure El ❑ 12. Hepatitis B vaccination ❑ HEST BUSINESS PRACTICES ® 13. Bloodbome Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ Source: ® 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 14 Appropriate personal protective equipment available and 0El33 Workstation, surfaces, including chairs, armrests, etc. in ood repair El CUSTOMERSICLIENTS 34. Permittregistration posted ❑ ❑ 15 Branding is completed with no other customers in procedure area ❑ ® 35. Operation and employee training records present ❑ ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ® 36. Plan(s) submitted for review ❑ 0 18 Client records approved and available - Consent form and uestionnaire 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. ❑ Emailed Phone 209-696-0713 Specialist (Print) Sandip Singh Specialist (Signature) ��tczroo- cSzrt4%G Phone 209-468-3526 Reinspection A reinspection fee of $152 per hour may be charged. Page 1 of 3 EH -11/17