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)�Po u'N.CO Body Art Inspeon Report ` Date: (��'ll-1 <br /> San Joaquin County Environmental Health Department Program <br /> y Record: <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> c? P (209)468-3420 Program <br /> www.slogv.orplehd Element: <br /> Facility Name Address City Zip Code <br /> Hi Pretty! 510 s.fairmont,suite 8 Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Elisabeth Marie Graffin 6/30/19 Routine/Final <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 /> Items washed,disinfected,packaged,labeled,and <br /> El 2' sterilized El CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated [ <br /> E] 4. Integrators used/monthly spore test/log maintained [I El 24. Appropriate chemical disinfectant used <br /> El 5. Decontamination/sanitation area separated and supplied E] Chemical used: Barbicide,Caviwipes [ <br /> appropriately <br /> Invoices and log kept for disposable,pre-sterilized <br /> ❑ 6. equipment El ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> C <br /> ❑ 7 Sharps containers labeled,used,and disposed of ElWet contact time provided: 2 min <br /> a ro riatel <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8' F1 El26. Barriers used <br /> sterilized [ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. aseptically [ <br /> ❑ 9. No eating,drinking or smoking-clean clothes F1 ❑ 28. Storage of inks,pigments,needles,tubes,etc. C <br /> El 10. Hands washed effectively and timely El r_1 29. Jewelry, Inks,Needles etc approved and used correctly [ <br /> ❑ 11. Handwashing facilities properly supplied and accessible, ❑ [E] 30 Cross-contamination avoided during all phases of [ <br /> warm water procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodbome Pathogen training ® E] 31. Areas separated/no living or sleeping quarters [ <br /> Source: Cathy Montie ❑ 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. Permit/registration posted C <br /> Branding is completed with no other customers in El El 15. 35. Operation and employee training records present <br /> procedure area C <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 C <br /> ❑ 18 Client records approved and available-Consent form ❑ ❑ 37. Permits obtained and available C <br /> and questionnaire <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment C <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled C <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure C <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ [ <br /> Received b Print): Elisabeth Marie Graffin Received b (Signature. one: J 09 -11'a 1 <br /> Specialist Print): Nav'ot Sahota Specialist(Signature): Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of,' <br /> EH-11/17 <br />