Laserfiche WebLink
0 <br />Body Art Inspection Report Date (MM/DD/YY) 5-q-0 <br />y y County of San Joaquin County, Environmental Health Department <br />a Permit Number /1 T <br />j( < 1868 E. Hazelton Ave., Stockton CA 95205 <br />l.. (209) 468-3420 www.sigov.org/ehd <br />Permit Type <br />Facility Name Address city Zip Code CT <br />fz!A\rC VICVvt 1c,4c, f P% -r u.,vtG. or. -1-106 da.e'nA. - -1fCce-c_,f <ZS3`7 -'-C,,n X ! %_ <br />Permit/Registration Holder Name Permit Exp. Date Total Time Inspection Type <br />RISK FACTORS AND INTERVENTIONS <br />Risk factors are improper practices or procedures identified <br />as contributing factors of cross -contamination. <br />Interventions are control measures to prevent cross -contamination <br />and transfer of pathogens from one person to another. <br />In = In Compliance Out = Not in Compliance N/0 = Not <br />Observed <br />NIA = Not Applicable COS = Corrected On Site <br />- CLEANING AND STERILIZATION= our cos <br />TATTOO AND PERMANENT COSMETICS MACHINE <br />SAFETY AND SANITATION our cos <br />In NIO <br />N/A <br />1. Autoclave is approved and effective - passed <br />integrator test <br />Jr- <br />NIO <br />N/A <br />18. Safe machine design <br />❑ <br />❑ <br />In N10 <br />NIA <br />2. Process of cleaning, labeling, packaging and <br />sterliziin items correctlyA <br />N/0 <br />19. Machines cleaned and disinfected between <br />clients <br />11 <br />In N/0 <br />NIA <br />3. Autoclave loaded correctlylpackages allowed to <br />d <br />13 <br />N/O <br />N/A <br />20. Parts replaced between clients - grommets, <br />elastic bands, etc. <br />1 <br />In N/O <br />NIA <br />4. Integrators used/monthly spore test/log <br />maintained <br />0 <br />PREVENTING CROSS -CONTAMINATION <br />In NIO <br />NIA <br />5. Decontamination/sanitation area separate and <br />supplied * <br />0 <br />EI <br />In21. <br />N1 <br />Workstation/procedure area decontaminated <br />In N/0 <br />N/A <br />6. Invoices and log kept for disposable, pre- <br />sterilized equipment, backu supplies available * <br />n /0 <br />N/A <br />22. Chemical disinfectant used <br />Chemical used: c. - <br />0 <br />El <br />In NIO <br />NIA <br />7. Sharps containers supplied, labeled, used and <br />disposed of correctly " <br />0 <br />►n <br />N/A <br />23. Disinfectant used sufficient contact time Wet <br />contact timeprovided: <br />171 <br />13 <br />In N/0 <br />N/A <br />8. Jewelry, tattoo and piercing equipment - storagen <br />and use <br />NIO <br />N/A <br />24. Barriers available and used as part of <br />procedure <br />El <br />11 <br />PRACTITIONER HEALTH AND HYGIENE <br />In N/0 <br />N/A <br />25. Products applied to skin are single <br />useldis ensed aseptically <br />In N/0 <br />N/A <br />9. No eating, drinking or smoking - clean clothes <br />In N/0 <br />26. Storage of inks, pigments, needles, tubes, etc., <br />In N/0 <br />N/A <br />10. Hands washed effectively and timelyn <br />13 <br />013 <br />/0 <br />N/A <br />27. Jewelry, Inks, Needles etc approved and used <br />0 <br />In NIO <br />N/A <br />11. Handwashing facilities properly supplied and <br />accessible, warm potable water <br />In 10 <br />N A <br />28. Cross -contamination avoided during all phases <br />of procedure <br />11 <br />0 <br />In N/0 <br />NIA <br />12. Personal protective equipment available and <br />used, a ewash station available <br />BEST Btl$%ESS'GGPRAGTIGES <br />CUSTOMERS(CLIENiS� fi <br />, � 81CL <br />d . <br />irk <br />n N/O <br />NIA <br />29. Areas separated/no living or sleeping <br />quarters/no animals <br />❑ <br />❑ <br />In <br />L4procedure <br />13. Branding is completed with no other customers in <br />area <br />In N/0 <br />30. Floors and walls clean and in good repair, <br />adequate light <br />El <br />In /0 <br />14. Customers eighteen (18) years of age or older <br />&AIO <br />N/A <br />31. Workstation, surfaces, including chairs,, etc. in <br />good repair; trash removed frequently " <br />❑ <br />❑ <br />In <br />15. Skin prepared for procedure. <br />13 <br />13 <br />In N/O <br />N/A <br />32, Perm it/registration and required signs posted <br />In NIO <br />NIA <br />16. Client records available - Consent form & <br />questionnaire <br />13 <br />In N/0 <br />NIA <br />33. IPCP and employee training records and <br />He atitiis B vaccination status present <br />El <br />In WO <br />NIA <br />17. Aftercare instructions given to client <br />13 <br />In N/0 <br />NIA <br />34 Restrooms available, stocked <br />Received by (Print): Received by (Signature): Phone: <br />Specialist (Print): Specialist (Signature): Phone: <br />❑This report is an Official Notice of Violation. Corrections must be completed in the time specified. <br />A reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. <br />Page 1 -of - <br />Reinspection Date (on or about) <br />