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Body Inspect* Re / <br /> Y Art Ins P Port Date: <br /> �' San Joaquin County Environmental Health Department Program <br /> l � < 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: ©S 3 2 Z 6c� <br /> � <br /> (209)468-3420 <br /> Program <br /> mmLssjogv.ora�end Element: 412-1 <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.Nguyen 6/30/16 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 Eletc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized 1:1PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry [:1 ❑ 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 E] Chemical used: Madacide <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment El El25. Disinfectant used appropriately/sufficient contact time <br /> ❑ Sharps containers labeled, used,and disposed of E]7 <br /> appropriately ❑ [Wet contact time provided: 10 mins <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> El 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 ® 30El. procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Cathie Montie ® 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 El ® 33El. good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Perm it/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area ❑ El 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 /> El El37. Permits obtained and available <br /> and questionnaire ❑ <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): hone: 209 365-1455 <br /> Specialist(Print): Harprit <br /> /Mattu,Sr[REHS Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion oniabout: f�/ {O A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />