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? Body Art Inspection Report Date: November 9,2023 <br /> San Joaquin County Environmental Health Department Program <br /> 1 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0544020 <br /> (209)468-3420 <br /> www.siogv.orq/ehd Program <br /> Element: 4120 <br /> Facility Na»e Address City Zip Code <br /> Dreamscape Brows 3422 W Hammer Lane#F Stockton 95219 <br /> Name of P-E�rmit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Fong Vang 6/30/24 Routine <br /> The aoove 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 test ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized E] PREVENTING 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 /> Decontam nation/sanitation area separated and supplied El 13 5' a ro riatel ElChemical used: <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6. ❑ El25. Disinfectant used appropriately/sufficient contact time ❑ <br /> equipment <br /> ❑ <br /> Sharps containers labeled, used,and disposed of 7" ro riatel 11 Wet contact time provided: <br /> a <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and 8' ❑ El 26. Barriers used <br /> sterilized ❑ <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27• Products applied to skin are single use/dispensed 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 /> Handwashing facilities properly supplied and accessible, <br /> El 11. El El 30. Cross-contamination avoided during all phases of procedure Elwarm water <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> El 11 <br /> Bloodborne Pathogen training 11 ❑ 31. Areas separated/no living or sleeping quarters El <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in <br /> ❑ 14. used El ❑ 33' ood re air ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> ❑ 15. El 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 /> ® <br /> Client records approved and available-Consent form and 18. ❑ El37. Permits obtained and available <br /> 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 Ly(Print): Fong Vang Received by(Signature): EMAILED Phone:916-715-8401 <br /> Specialist OPrint): Sandip Singh Specialist(Signature): Phone:209-468-3526 <br /> Reinspect on on/about: A reinspection fee of$162 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />