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/G1UIIy-- <br /> °p•.•••. caG\ Body Inspection Art Ins ti Report <br /> p Date: June 24,2021 <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 4120 <br /> (209)468-3420 Program <br /> www.siogv.org/ehd <br /> 9t.�FOR Element: PR0524524 <br /> Facility Name Address City Zip Code <br /> Hard Luck Tattoo 1 W Pine St. Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Bao Nguyen 6/30/21 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 /> Parts replaced between clients-grommets.elastic bands, <br /> El 1. Autoclave:approved and effective-passed integrator test El El22. etc. El <br /> ❑ <br /> Items washed,disinfected, packaged, labeled,and 2. 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 /> Decontamination/sanitation area separated and supplied El Chemical 5" appropriately ❑ Chemical used: <br /> Invoices and log kept for disposable, pre-sterilized <br /> ® 6. ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time 1-1equipment <br /> Sharps containers labeled, used, and disposed of <br /> ❑ 7. a ro riatel ❑ Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8. El El26. Barriers used Elsterilized <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ <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, <br /> ® 11. El El30. Cross-contamination avoided during all phases of procedure <br /> warm water ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> El13. Bloodborne Pathogen training ❑ ❑ El31. Areas separated/no living or sleeping quarters <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ <br /> Appropriate personal protective equipment available and El Workstation, surfaces, including chairs,armrests,etc. in 14. used ❑ 33' good repair ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El El35. Operation and employee training records present Elrocedure area <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 /> ❑ <br /> Client records approved and available-Consent form and El <br /> 18. ® ❑ 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. ❑ <br /> Received by(Print): Bao Nguyen Received by(Signature): Emailed Phone:209-663-2001 <br /> Specialist(Print): Sandip Singh Specialist(Signature): Phone:209-468-3526 <br /> Reinspection on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />