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Body Art Inspecs Report Date: 1 �3Ia0 <br /> .:� San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: Q2053 73 7 g <br /> (209)468-3420 <br /> www.s'oov.oro/ehd Program <br /> Element: 141 a. <br /> Facility Name Address City Zip Code <br /> Wicked Wayz 920 s cherokee In#a Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Mohamed Abdullah 6/30/20 Reinspection <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 /> D V MACHI.I�B�SANt f�►I�D�SgN1 PRO <br /> ❑ 1. Autoclave:approved and effective-passed integrator Parts replaced between clients-grommets,elastic bands, <br /> test ❑ El 22' Eletc. <br /> [1 2 Items washed,disinfected,packaged, labeled,and ❑ <br /> sterilized r REf I GOS_aCQN., MSI' <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 1:1appropriate) ❑ Chemical used: <br /> ❑ 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment ❑ El 25. Disinfectant used appropriately/sufficient contact time <br /> ❑ ❑ <br /> 7 Sharps containers labeled, used,and disposed of <br /> Elappropriately <br /> [Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> El El 26. Barriers used Elsterilized <br /> s5 tis a `.F !' r <br /> ��� � � Y "" ❑ <br /> 27. Products applied to skin are single use/dispensed ❑ <br /> P„RACTITIONER, EATFIAND..�IYG,IE�IE �.,.: § t , , .Hase 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 properly supplied and accessible, Cross-contamination avoided during all phases of <br /> warm water 1:1 ❑ 30' El <br /> ❑ 12. Hepatitis B vaccination ❑ gES,T�BUSINESS',PRA -,T -,:RS 'w � <br /> ❑ 13. Bloodborne 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 Workstation,surfaces, including chairs,armrests,etc. in <br /> used [I ❑ 33El. good repair <br /> G',Sa LID._,_T.._, $. A El 34. Permit/registration posted El <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area El El 35. Operation and employee training records present El <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ k <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 El <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> L, � fl. ❑ 39. Hearing scheduled <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ <br /> Received b (Print): Terry Minatre Received by(Signature): Phone:209-570-9237 <br /> Specialist(Print): Sandip Singh Specialist(Signature): 4a.,io 614..-.L 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 />