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Body Art Inspec4b Report / p <br /> Date: t l� / <br /> San Joaquin County EnvironmenIal Health Department <br /> Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> Record: pG -s62- <br /> (209) <br /> r0(209)468-3420 Program <br /> wwwioqCZoW)Uz6iil"' <br /> Element: <br /> Facility Name Address City Zip Code <br /> Flying Crow Tattoo 245 w.yosemite ave. Manteca 95336 <br /> Name of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Shawn Edwards 6/30/20 11:11 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 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 El <br /> ❑ 5' appropriatelyEl Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized <br /> F-1 6. El El 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled,used,and disposed of <br /> -1 F <br /> ❑ 7. ap ro riatel El et contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and ❑ ❑ 26. Barriers used ❑ <br /> sterilized <br /> ❑ 27 Products applied to skin are single use/dispensed E]PRACTITIONER HEALTH AND HYGIENE 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 Ell ❑ 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' Elwarm water ❑ 30El. procedure <br /> ❑ 12. Hepatitis B vaccination ElBESTBUSINESS PRACTICES <br /> El 13. Bloodborne Pathogen training ❑ 31. 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 and ❑ ❑ 33 Workstation,surfaces, including chairs,armrests,etc. in Elused good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> procedure area El ® 35. Operation and employee training records present E] <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. El ® 37. Permits obtained and available Eland questionnaire <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): Shawn Edwards Received by(Signature): aPhone: (209)629-8177 <br /> Specialist(Print): Jesse Easter,EHS Specialist(Signature): /. Phone: (209)468-3284 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />