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Body Art Inspecto Report Date: <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: FRO 53,Z3% <br /> (209)468-3420 <br /> \c.,< ¢Sg` vnnvvvsiogv..1q hd Program <br /> f!Z <br /> iFElement: 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 6/30/17 Re-inspection <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 /> El 1 Autoclave:approved and effective-passed integrator E] ❑ �aPairts replaced between clients-grommets,elastic bands, E]test etc. <br /> ❑ 2 Items washed,disinfected,packaged, labeled,and <br /> sterilized 11PREVENTING 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 [:1 ❑ 24. Appropriate chemical disinfectant used <br /> ❑ 5 Decontamination/sanitation area separated and supplied ❑ <br /> El Chemical used: Madacide <br /> appropriately <br /> ❑ 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> ❑ 7 Sharps containers labeled, used,and disposed of ❑ <br /> Ela ro riatel Wet contact time provided: 10 mins <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized El El26. Barriers used El <br /> ❑ 27 Products applied to skin are single use/dispensed E]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 ❑ <br /> BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodbome 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 /> ❑j 14. Appropriate personal protective equipment available and El 33. surfaces,including chairs,armrests,etc.in ❑ <br /> used ❑ 33' good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <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 ❑ 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 El 37. 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): Phone: 209)365-1455 <br /> Specialist(Print): Harprit Mattu,Sr REHS Specialist Si nature. Phone: 209 468-3284 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />