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oP Body Art Inspect Report <br /> 2 2 I� <br /> San Joaquin County Environmental Health Department Paogram C <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: Pit b S 3437-Y <br /> P / <br /> (209)4 68-3420 Program <br /> �4c;FQRaj www.siogv.org/ehd Element LI ' Z <br /> Facility Name Address City Zip Code <br /> Wicked Wayz 920 s. cherokee In. Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Mohamed Abdullah 6/30/18 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 /> _ , <br /> V CLEANING AND STERItf9TIOI >. C<; ` <br /> Y MACHINE SAF' TY A R SANITATlSN <br /> ❑ 1 Autoclave: approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, Eltest etc. <br /> ❑ 2 Items washed,disinfected, packaged, labeled,and ❑ <br /> sterilized , .Pf2EVERTING GROSS C.ONTAMINI�TION; ' <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 ❑ <br /> El 5. ❑ Chemical used: Cavicide <br /> aro riatel <br /> Invoices and log kept for disposable, pre-sterilized <br /> F-1 6. equipment El F125. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled, used,and disposed of ❑ <br /> ® 7' appropriately ❑ Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. El El 26. Barriers used ElsterilizedEl <br /> Products applied to skin are single use/dispensed <br /> :"PRACTITIONER F ALTCANDHYGIENE , <br /> '0527. 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 <br /> El warm water El ❑ 30. procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ <br /> B1=ST IN PRACTICES ';" <br /> ® 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> El <br /> Source: Cathy Montie ® 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 ❑ ❑ 33. good repair <br /> El <br /> CUSTOIIA`ERS/IrL TENTS .' El34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El El 35. Operation and employee training records present <br /> procedure area ❑ <br /> El16. Customers eighteen(18)years of age or older El . <br /> •COMPLIANCE AND ENk3RCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ <br /> ® <br /> Client records approved and available-Consent form ❑18. El El 37. Permits obtained and available <br /> and questionnaire <br /> 0El <br /> 19. Appropriate aftercare instructions given to client El El38. Impoundment ElINE Sp�FE AN20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. �j❑ <br /> Received b (Print): Received b (Signature Phone: <br /> Specialist(Print): J. Easter Specialist(Signature): < Phone: (209)953-7310 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />