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9. <br /> "r Body Art Inspe&n Report <br /> Date: 3fZ� <br /> } San Joaquin County Environmental Health Department Program m p <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: AZ <br /> (209)468-3420 <br /> Msiow-org/ehd Program <br /> Element: <br /> Facility Name Address City Zip Code <br /> Wicked Wayz 920 s.cherokee In.#a Lodi 95240 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Mohamed Abdullah 6/30/17 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 integratorE] Parts replaced between clients-grommets,elastic bands, ❑ <br /> test ❑ 22' etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized ❑ 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 /> ® 5 Decontamination/sanitation area separated and supplied Ela ro riatel 13 Chemical used: <br /> ❑ 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment El El25. Disinfectant used appropriately/sufficient contact time <br /> ❑ 7 Sharps containers labeled,used,and disposed of Ela ropriatel El Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized ❑ El26. Barriers used El <br /> ❑ 27 Products applied to skin are single use/dispensed ❑ <br /> PRACTITIONER HEALTH AND HYGIENE ase tical) <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 /> ❑ 11. Handwashing facilities property supplied and accessible, Cross-contamination avoided during all phases of ❑ <br /> warm water ❑ ❑ 30' I procedure <br /> ❑ 12. Hepatitis B vaccination ❑ <br /> BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodbome Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14 Appropriate personal protective equipment available and 11El33 Workstation,surfaces,including chairs,armrests,etc.in ❑ <br /> used ood reair <br /> CUSTOMERS/CLIENTS ❑ 34. Perm ittregistration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area El ® 35. Operation and employee training records present E] <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 /> ❑ 18 Client records approved and available-Consent form <br /> and uestionnaire ❑ El 37. 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. Ster'ie Dressing ❑ <br /> Received b (Print): Terry Minatre Received by(Signature): Phone: 209)339-1779 <br /> Specialist(Print): Benjamin Escotto,Sr REHS Specialist(Signature): Phone: 209 468-3178 <br /> Reinspecion oniabout: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />