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qN ' <br />Body Art Inspect*Report <br />a ro na e <br />Jewelry, tattoo and piercing equipment - clean and <br />sterilized <br />The above facility is inspected for compliance with Division <br />�! Zv 19 <br />Part 15, <br />Chapter 7 of California Health and Safety Code (HSC). <br />Date: <br />V = Violation <br />San Joaquin County Environmental HealttzDepartment <br />❑ <br />Program <br />Corrected On Site <br />ElPRACTITIONER <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />CLEANING AND STERILIZATION <br />Record: <br />nn ? 2U <br />p <br />(209) 468-3420 <br />® <br />Program <br />Autoclave: approved and effective - passed integrator <br />El <br />www.sjogv_org/ehd <br />L \ _ <br />_ A , <br />Element: <br />U <br />7I Z I <br />Jewelry, Inks, Needles etc approved and used correctly <br />Facility Name <br />Address <br />11. <br />City <br />Zip Code <br />In 2 Skin <br />2738 pacific ave. <br />Cross -contamination avoided during all phases of <br />Stockton <br />95204 <br />Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br />Sandy Aguirre 6/30/2019 Routine <br />a ro na e <br />Jewelry, tattoo and piercing equipment - clean and <br />sterilized <br />The above facility is inspected for compliance with Division <br />104, <br />Part 15, <br />Chapter 7 of California Health and Safety Code (HSC). <br />❑ <br />V = Violation <br />❑ <br />C = <br />Corrected On Site <br />ElPRACTITIONER <br />V <br />CLEANING AND STERILIZATION <br />C <br />V <br />MACHINE SAFETY AND SANITATION (cont.) <br />C <br />® <br />1 <br />Autoclave: approved and effective - passed integrator <br />El <br />❑ <br />22. <br />Parts replaced between clients - grommets, elastic bands, <br />❑ <br />Jewelry, Inks, Needles etc approved and used correctly <br />❑ <br />test <br />11. <br />Handwashing facilities properly supplied and accessible, <br />warm water <br />El <br />❑ <br />etc. <br />Cross -contamination avoided during all phases of <br />❑ <br />2 <br />Items washed, disinfected, packaged, labeled, and <br />El <br />❑ <br />BEST BUSINESS PRACTICES <br />❑ <br />sterilized <br />Bloodborne Pathogen trainingElEl31. <br />CROSS -CONTAMINATION <br />Areas separated/no living or sleeping quarters <br />❑ <br />3. <br />Autoclave loaded correctly/packages allowed to dry <br />❑ <br />❑ <br />23. <br />Workstation/procedure area decontaminated <br />❑ <br />❑ <br />4. <br />Integrators used/monthly spore test/log maintained <br />❑ <br />❑ <br />24. <br />Appropriate chemical disinfectant used <br />ElE] <br />5" <br />Decontamination/sanitation area separated and supplied <br />E] <br />34. <br />Permit/registration posted <br />Chemical used: <br />El <br />15. <br />appropriately <br />El <br />35. <br />Operation and employee training records present <br />El <br />❑ <br />❑ <br />6 <br />Invoices and log kept for disposable, pre -sterilized <br />El <br />El25. <br />Disinfectant used appropriately/sufficient contact time <br />17. <br />Skin adequately prepared for procedure <br />❑ <br />equipment <br />36. <br />Plan(s) submitted for review <br />❑ <br />❑ <br />18. <br />El <br />El <br />37. <br />Permits obtained and available <br />Eland <br />❑ <br />19. <br />® <br />7 <br />Sharps containers labeled, used, and disposed of <br />1-1 <br />11 <br />Impoundment <br />❑ <br />Wet contact time provided: <br />❑ <br />8 <br />a ro na e <br />Jewelry, tattoo and piercing equipment - clean and <br />sterilized <br />El <br />26. <br />Barriers used <br />❑ <br />HEALTH AND HYGIENE <br />❑ <br />27 <br />Products applied to skin are single use/dispensed <br />aseptically <br />ElPRACTITIONER <br />❑ <br />9. <br />No eating, drinking or smoking - clean clothes <br />❑ <br />❑ <br />28. <br />Storage of inks, pigments, needles, tubes, etc. <br />❑ <br />❑ <br />10. <br />Hands washed effectively and timely <br />❑ <br />❑ <br />29. <br />Jewelry, Inks, Needles etc approved and used correctly <br />❑ <br />❑ <br />11. <br />Handwashing facilities properly supplied and accessible, <br />warm water <br />El <br />❑ <br />30' <br />Cross -contamination avoided during all phases of <br />El <br />❑ <br />12. <br />Hepatitis B vaccination <br />❑ <br />BEST BUSINESS PRACTICES <br />❑ <br />13. <br />Bloodborne Pathogen trainingElEl31. <br />Areas separated/no living or sleeping quarters <br />❑ <br />Source: <br />❑ <br />32. <br />Floors and walls clean and in good repair, adequate light <br />❑ <br />❑ <br />14. <br />Appropriate personal protective equipment available and <br />used <br />[I <br />El <br />33. <br />Workstation, surfaces, including chairs, armrests, etc. i <br />good repair <br />E]n <br />CUSTOMERS/CLIENTS <br />1;2 <br />34. <br />Permit/registration posted <br />❑ <br />El <br />15. <br />Branding is completed with no other customers in <br />rocedure area <br />El <br />35. <br />Operation and employee training records present <br />El <br />❑ <br />16. <br />Customers eighteen (18) years of age or older <br />❑ <br />COMPLIANCE AND ENFORCEMENT <br />❑ <br />17. <br />Skin adequately prepared for procedure <br />❑ <br />❑ <br />36. <br />Plan(s) submitted for review <br />❑ <br />❑ <br />18. <br />Client records approved and available - Consent form <br />questionnaire <br />El <br />37. <br />Permits obtained and available <br />Eland <br />❑ <br />19. <br />Appropriate aftercare instructions given to client <br />❑ <br />❑ <br />38. <br />Impoundment <br />❑ <br />MACHINE SAFETY AND SANITATION <br />❑ <br />39. <br />Hearing scheduled <br />❑ <br />❑ <br />20. <br />Safe machine design <br />❑ <br />❑ <br />40. <br />Closure <br />❑ <br />❑ <br />21. <br />Machines cleaned and disinfected between clients <br />❑ <br />❑ <br />41. <br />❑ <br />Received b (Print): Stevie Vasquez Received by (Signature)7 Phonk- 1 <br />Specialist (Print): J.Easter Specialist (Signature): Phone: 209 953-7310 <br />Reinspecion on/about: A reinspection fee of $152 per hour may be charged.A Page 1 of 3 <br />EH -11/17 [j�/�-- <br />