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Body Art Inspec Report Date: <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: Srt.005 3Q <br /> (209)468-3420 Program 1 <br /> Q<,FOR�`P www.siogv.orq/ehd Element: LA 101, <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 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 /> El 1 Autoclave:approved and effective-passed integrator E] E] 22 Parts replaced between clients-grommets,elastic bands, El <br /> test etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> F-1 2' sterilized El 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 Chemical used: El <br /> 5' <br /> appropriately <br /> El <br /> ® 6 Invoices and log kept for disposable,pre-sterilized ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> equipment ❑ <br /> ® 7 Sharps containers labeled,used,and disposed of ❑ [Wet contact time provided: <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> F1 8' En El 26. Barriers used El <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. aseptically ❑ <br /> F] 9. No eating,drinking or smoking-clean clothes E03 ® 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 /> ® 11 Handwashing facilities properly supplied and accessible, ❑ ❑ 30 Cross-contamination avoided during all phases of ❑ <br /> warm water I procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodbome Pathogen trainingIE] ElEl31. Areas separated/no living or sleeping quarters <br /> Source: ® 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14 Appropriate personal protective equipment available andWorkstation,surfaces,including chairs,armrests,etc.in E]used E] ❑ 33. ood repair <br /> CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> ❑ 15. ❑ ❑ 35. Operation and employee training records present F1rocedure 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. iE] [_137. Permits obtained and available El <br /> duestionnare <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 b (Print): Tina Phon Received by(Signature): Phone: 209 642-6866 <br /> Specialist(Print): Benjamin Escotto,Sr REHS S ecialist(Signature): Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />