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Body Art Inspection Report Date: a aJ <br /> h....., co <br /> y/a ? San Joaquin County Environmental Health Department Program c <br /> l 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> P v (209)468-3420 Program (� <br /> www.siogv.oro/ehd Element: 1 V <br /> Facility Name Address City Zip Code <br /> One Time Tattoo 407 n main st Manteca 95336 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Jesus Garibay 6/30/21 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 ❑ ❑ 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 /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied Elaro riatel❑ 5' ElChemical used: <br /> Invoices and log kept for disposable, pre-sterilized <br /> ® 6. El El25. Disinfectant used appropriately/sufficient contact time <br /> a ui ment <br /> ElSharps containers labeled, used,and disposed of <br /> ❑ 7' ❑ Wet contact time provided: <br /> appropriately <br /> F1 8. <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El ❑ 26. Barriers used <br /> sterilized ❑ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27' asepticallyEl <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,❑ Cross-contamination avoided during all phases of 11. warm water El ❑ 30. procedure171 <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces, including chairs,armrests,etc. in 14. used El ❑ 33. go repair <br /> El <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El El35. Operation and employee training records present <br /> procedure area ❑ <br /> ❑ 16. Customers eighteen(18)years of age or older ri <br /> COMPLIANCE AND ENFORCEMENT <br /> r❑ ❑17. Skin adequately prepared for procedure 36. Plan(s)submitted for reviewClient records approved and available-Consent form❑ 18. and uestionnaire El37. Permits obtained and available ❑ <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 by(Print): Jesus Garibay-Emailed Received by(Signature): Phone: <br /> Specialist(Print): Sandip Singh Specialist(Signature): 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 />