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"n Body Art Inspec* Report • A/17 <br /> - <> <br /> Date: <br /> San Joaquin County Environmental Health Department Program CC <br /> i 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: J�©� <br /> ® .s (209)468-3420 <br /> Program - <br /> www.siogv.org/ehd g <br /> Element: <br /> Facility Name Address City Zip Code <br /> Makeup Mau Loa 539 w. 11th st. Tracy 95376 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Briana Gonzales 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 /> ❑ 1 Autoclave:approved and effective-passed integrator Parts replaced between clients-grommets,elastic bands, Eltest El ❑ 22" 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 /> ❑ 5 Decontamination/sanitation area separated and supplied ❑ <br /> a ro riatel E] Chemical used: Barbicide <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment ❑ El25. Disinfectant used appropriately/sufficient contact time <br /> ❑ 7 Sharps containers labeled, used,and disposed of <br /> appropriately ❑ Wet contact time provided: 3 minutes <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and ❑8. El El 26. Barriers used <br /> sterilized <br /> ❑ 27 Products applied to skin are single use/dispensed ❑ <br /> PRACTITIONER HEALTH AND HYGIENE ase tical) <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 /> ® 11 Handwashing facilities properly supplied and accessible, 1:1 ❑ Cross-contamination avoided during all phases of Elwarm water 30. procedure <br /> ® 12. Hepatitis B vaccination ❑ <br /> BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingEl ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Above training ® 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 ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Perm ittregistration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area ❑ ® 35. Operation 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 /> ® 18 Client records approved and available-Consent form ❑ <br /> i ❑ F137. Permits obtained and available <br /> and questionnaire <br /> ® 19. 1 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): Briana Gonzales Received by(Signature): 0 Phone: 408 648-5713 <br /> Specialist(Print): Har rit Mattu,Sr REHS Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />