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Body Art Inspect Report • , - Date: '51 h 9 Y San Joaquin County Environmental Heath Department Program(� 7 J , 1868 E. Hazelton Ave., Stockton, CA 95205 Record: �Q �Y`U c7 .J >� c� `' -P (209) 468-3420 Program www.siogv.org/ehd LI I '7074% Element: Facility Name Address City Zip Code In 2 Skin 2738 pacific ave. Stockton 95204 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Sandy Aguirre 6/30/2019 Routine The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safety Code (HSC). V = Violation C = Corrected On Site V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION (cont.) C ❑ 1 Autoclave: approved and effective - passed integrator ❑ ❑ 22 Parts replaced between clients - grommets, elastic bands, ❑ test etc. El 2' Items washed, disinfected, packaged, labeled, and E]PREVENTING sterilized CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dryE01F123. Workstation/procedure area decontaminated Elr-14. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used ❑ ® 5' Decontamination/sanitation area separated and supplied ❑ Chemical used: ro riatel appropriately [:1 [:1 6. 6' Invoices and log kept for disposable, pre -sterilized El 25. Disinfectant used appropriately/sufficient contact time equipment El® 7. Sharps containers labeled, used, and disposed of E]Wet contact time provided: a ro riatel ® 8 Jewelry, tattoo and piercing equipment - clean and ❑ ❑ 26. Barriers used ❑ sterilized [I 27' Products applied to skin are single use/dispensed PRACTITIONER HEALTH AND HYGIENE asepticallyE] ❑ '9. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ❑ 11. Handwashing facilities properly supplied and accessible, E] ❑ 30. Cross -contamination avoided during all phases of El warm water procedure ❑ 12. 1 Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ® 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ ❑ Source: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 14. Appropriate personal protective equipment available and E3 ❑ 33' Workstation, surfaces, including chairs, armrests, etc. in ❑ used ood repair CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ El 15. Branding is completed with no other customers in El El 35. Operation and employee training records present ❑ procedure area ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s) submitted for review ❑ ® 18. Client records approved and available - Consent form El El 37. Permits obtained and available El and ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 47. ❑ 97 7 z% Received b (Print): Received b (Si nature : Phone(2) - Specialist (Print): J. Easter Specialist(Signature): Phone: 209 953-7310 Reinspecion on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 3 EH -11/17