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Body Art Inspec Report Date: J 'j <br /> San Joaquin Coun Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: �yCt,r .� _ <br /> (209)468-3420 <br /> .fF O'Ra*P`• www.Sloyv.org/ehd Program 7�/ /z <br /> Element: <br /> Facility Name Address City Zip Code <br /> Living Water Studio 1371 e.yosemite ave. Manteca 95336 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Thomas Shea 6/30/19 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 ❑ ❑ 713arts replaced between clients-grommets,elastic bands, Eltest etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> Fl 2. sterilized 11PREVENTING 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 El <br /> 5' ❑ Chemical used: <br /> appropriately <br /> 6. <br /> ro riatel <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6- El 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled,used,and disposed of <br /> ❑ 7' appropriately ❑ Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8. sterilized ❑ ❑ 26. Barriers used ❑ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27. asepticallyF1 <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 /> ® 11. warm water El ❑ 30. procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training ❑ El31. Areas separated/no living or sleeping quarters ❑ <br /> Source: PF oors and walls clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available andorkstation,surfaces,including chairs,armrests,etc.in <br /> ❑ 14. used ood re air ❑CUSTOMERS/CLIENTS ermit/registration posted ❑Branding is completed with no other customers in15. rocedure area ❑ peration 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 /> El 18. and uestionnaire ❑ El El <br /> Permits obtained and available 1:1❑ 19. Appropriate aftercare instructions given to client ❑ El38. Impoundment 1:1 <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): �/V�U i1 ) , Received b (Signature): -- �~"' Phone: <br /> Specialist(Print): J.Easter Specialist(Signature): Phone: (209)953-7310 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />