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" on Report f'}'� Body Art Ins Y b <br /> P P Date: 112R/1� <br /> "Z San Joaquin County Environmental Health Department 9 <br /> Pro ram <br /> rn <br /> _ 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 <br /> • c9`•••••'.••c+`o- www.siogv.org/ehd Program <br /> FO Element: N I Z® <br /> Facility Name Address City Zip Code <br /> The Lush Studio 7475 murray drive#5 Stockton 95210 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Tina Phon 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 /> Items washed,disinfected,packaged,labeled,and <br /> El 2. sterilized ❑ 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' a ro riatel ❑ Chemical used: Caviiwipes,Cavicide spray <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6. El El 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> [ <br /> Sharps containers labeled,used,and disposed of <br /> El 7• <br /> appropriately <br /> ❑ [Wet contact time provided: <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and 8' El 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 /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> El 11. warm water El ❑ 30' procedure [ <br /> ❑ 12. 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 /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc. in <br /> El 14. used ❑ ❑ 33' good repair [ <br /> CUSTOMERSICLIENTS ❑ 34. Perm ittregistration posted [ <br /> Branding is completed with no other customers in <br /> El 15. [I 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 /> Client records approved and available-Consent form <br /> ❑ 18. questionnaire <br /> El El 37. Permits obtained and available [ <br /> and <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 ❑ ❑ 41. [ <br /> Received by(Print): Tina Phon Received b (Signature): Phone: 209)642-6866 <br /> Specialist(Print): Navjot 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 />