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Jc A N t O An U I N Environmental Health Department C t.}U N I Y 'v Body Art Inspection Report Facil ty Narre: Date: DREAMSCAPE BROW/S(VANG, FONG) July 12, 2021 Facil ty Add,ess: Facility Phone: Program Record: 3422 W HAMMER LN, STOCKTON, CA 95219 (916)715-8401 PR0544020 Perrrit Holdar: Permit Expiration Date: VANG, FONG June 30, 2022 Inspection Type: Program: ROUTINE INSPECTICN-Ooerating Permit 4120-BODY ART FACILITY-SINGLE USE The above facility is inspected for compliance with Division 104,Part 15,Chapter 7 of the California Health and Safety Code(HSC). V=Violation COS=Corrected on site Cleaning and Sterilization 1 HSC 119315(b) Autoclave:approved and effective-passed integrator test Z011 R E OS 2 HSC 119309, Items washed,disinfected,packaged,labeled,and sterilized C-0M P L F-R. :OS 119315(a) 3 HSC 119315(b) Autoclave loaded correctly/packages allowed to dry :OS 4 HSC 119315(b) Integrators used/monthly spore test/log maintained .c ;OS 5 HSC 119314(c) Decontamination/sanitation area separated and supplied appropriately 6 HSC 119315(f) Invoices and log kept for disposable,pre-sterilized equipment ❑V ❑COS 7 HSC 119314(e) Sharps containers labeled,used,and disposed of appropriately ❑V ❑COS 8 HSC 119310 Jewelry,tattoo and piercing equipment-clean and sterilized ❑V ❑COS Practitioner Health and Hygiene 9 HSC 119309 No eating,drinking or smoking-clean clothes V ❑COS 10 HSC 119338(a) Hands washed effectively and timely ❑V ❑COS 11 HSC 119314(b) Handwashing facilities properly supplied and accessible,warm water ❑V ❑COS 12 HSC 119306(c) Hepatitis B vaccination ❑V ❑COS 13 HSC 119307 Bloodborne Pathogen training V ❑COS 14 HSC 119308(a) Appropriate personal protective equipment available and used I V ❑COS Customers/Clients 15 HSC 1193090) Branding is completed with no other customers in procedure area ❑V ❑COS 16 HSC 119302 Customers eighteen(18)years of age or older ❑V ❑COS 17 HSC 11930E(a) Skin adequately prepared for procedure ❑V ❑COS 18 HSC 119302 Client records approved and available-Consent form and questionnaire ❑V ❑COS 19 HSC 11930E(b) Appropriate aftercare instructions given to client V -COS Machine Safety and Sanitation 20 HSC 119311(i) Safe machine design V -COS 21 HSC 119311(h) Machines cleaned and disinfected between clients ❑V ❑COS 22 HSC 119311(g) Parts replaced between clients-grommets,elastic bands,etc. c V ❑COS Preventing Cross Contamination 23 HSC 119309 Workstation/procedure area decontaminated V ._ COS 24 HSC 11920-(k) Appropriate chemical disinfectant used ❑V ❑COS 25 HSC 119309(b) Disinfectant used appropriately/sufficient contact time ❑V ❑COS FA0025032 PRO544020 SC001 07/12/2021 EHD Rev.6/15/2021 Pagel of 3 Body Art OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD