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a <br /> Body Art Inspecti eport • Date: <br /> �q,• cpG <br /> San Joaquin County Environmental Health Department Program Sf�VVt7I (yam <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 Program i 1 1 0 3 <br /> cgt�F6R`'�p www-Siogv.org/ehd. Element: -1 <br /> Facility Name Address City Zip Code <br /> The Loft 1110 w.kettleman lane Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Consultation <br /> Taylor Mulrooney <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 /> Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> ❑ 1. test etc. <br /> ❑ <br /> 2. Items washed,disinfected,packaged,labeled,and E3PREVENTING CROSS-CONTAMINATION <br /> sterilized <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 El Chemical used: <br /> El 5. appropriately <br /> Invoices and log kept for disposable,pre-sterilized E] El 25. Disinfectant used appropriately/sufficient contact time <br /> ® 6. equipment <br /> ❑ <br /> ® 7 Sharps containers labeled,used,and disposed of ❑ Wet contact time provided: <br /> appropriately <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean andrE3 <br /> El26. Barriers used ❑ <br /> sterilized <br /> F127 Products applied to skin are single use/dispensed ❑ <br /> PRACTITIONER HEALTH AND HYGIENE aseptically <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ 28. Storage of inks,pigments,needles,tubes,etc. El <br /> ❑ 10. Hands washed effectively and timely ❑ ❑ 29, Jewelry, Inks,Needles etc approved and used correctly ❑ <br /> ❑ 11 Handwashing facilities properly supplied and accessible, 11 ❑ 30 Cross-contamination avoided during all phases of ❑ <br /> warm waterprocedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> El31. Areas separated/no living or sleeping quarters 130 13. Bloodborne Pathogen training El <br /> Source: ® 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 El good repair <br /> CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in ❑ ❑ 35. Operation and employee training records present ❑ <br /> procedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure E] ❑ 36. Pian(s)submitted for review ❑ <br /> ® 18 Client records approved and available-Consent form ❑ 37. Permits obtained and available ❑ <br /> and uestionnaire <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): Taylor Mulrooney Received by(Signature): Phone:(209)712-8345 <br /> Specialist(Print): Mai Vue Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br />