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Body AInsp ect� Report Date: alsb-015 <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 5 7 /G L <br /> c P (209)468-3420 Program <br /> 9L%Fp. pf� www.siogv.org/ehd g <br /> Element: <br /> Facility Name Address City Zip Code <br /> Hard Luck Tattoo 7 n.sacramento st. Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Bao T. Nyguyen 6/30/15 1:35pm 3:OOpm 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 integrator Parts replaced between clients-grommets,elastic bands, El[I F122. etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized El 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 Elappropriately ❑ Chemical used: Madacide <br /> Invoices and log kept for disposable,pre-sterilized <br /> F1 6. equipment El El25. Disinfectant used appropriately/sufficient contact time <br /> ❑ 7 Sharps containers labeled,used,and disposed of Elappropriately <br /> ❑ Wet contact time provided: 10 mins <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> ❑ El 26. Barriers used Elsterilized <br /> ❑ 27 Products applied to skin are single use/dispensed ❑ <br /> PRACTITIONER HEALTH AND HYGIENE 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 /> ❑ 11. Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> warm water El ❑ 30" El <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingEl ❑ El31. Areas separated/no living or sleeping quarters <br /> Source: Cathie Montie ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces, including chairs,armrests,etc. in El❑ 14. used E] El 33' ood re air <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted El <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area E] ❑ 35. Operation and employee training records present El <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 F1 El 37. Permits obtained and available E] <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 b (Print): Daniel Kraft Received by(Signature): Phone: 7.?Z--ef 8 3 d <br /> Specialist(Print): Har rit Mattu Specialist(Signature): Phone:Zd I 1 b8 ZO 1 <br /> Reinspecion on/about: A reinspection fee of$125 per hour may charged. Page 1 of 2 <br /> EH-04/2014 <br />