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,oA4U`" Body Art InspectifOReport <br /> Date: 314,1;_O <br /> rr San Joaquin County Environmental Health Department <br /> Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PRv $L/3 LN a <br /> (209)468-3420 <br /> cgt,F'pRa`P www.sioay.org/ehd Program <br /> Element: L/1,2 Q <br /> Facility Name Address City Zip Code <br /> Makeup Mau Loa 241 a loth street#b Tracy 95376 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Briana Sepulveda 6/30/20 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 Parts replaced between clients-grommets,elastic bands, Eltest El ❑ 22' etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> 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 /> ❑ 5 Decontamination/sanitation area separated and supplied ❑ <br /> appropriately ❑ Chemical used: <br /> ❑ 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment El El25. Disinfectant used appropriately/sufficient contact time <br /> ❑ 7 Sharps containers labeled,used,and disposed of El <br /> appropriately ❑ Wet contact time provided: <br /> ❑ 8. Jewelry,tattoo and piercing equipment-clean and <br /> El El 26. Barriers used Elsterilized <br /> ❑ 27 Products applied to skin are single use/dispensed ElPRACTITIONER 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 ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ <br /> ❑ 11. Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of ❑ <br /> warm water El ❑ 30' procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingElF131. 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 Workstation,surfaces,including chairs,armrests,etc. in E]used ❑ ❑ 33' good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> El ® 35. Operation and employee training records present Elrocedure 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 /> ❑ 18 Client records approved and available-Consent form <br /> questionnaire <br /> 1:1 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 b Print): Briana Sepulveda Received by(Signature): Phone:408-648-5713 <br /> Specialist(Print): Sandip Singh Specialist(Signature): &A1110 Phone: 209-468-3526 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />