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} Body Art Inspection Report Date: June 8, 2022 ( San Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0537413 (209)468-3420 C �P www.siogv.org/ehd Program Element: 4121 Fa.:iity 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 Sa-i3y Aguirre 6/30/2022 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 F-11. Autoclave: approved and effective - passed integrator test ❑ El22. Parts replaced between clients - grommets, elastic bands, El etc. E) 2' Items washed, disinfected, packaged, labeled, and E]PREVENTING sterilized CROSS -CONTAMINATION ❑ 3. Autoclave Icaded correctly/packages allowed to dry [:1 ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used El El❑ El 5. Decontamination/sanitation area separated and supplied El used: appropriately El 6. Invoices and log kept for disposable, pre -sterilized ❑ 25. Disinfectant used appropriately/sufficient contact time a ui ment E] E]Sharps ® 7' containers labeled, used, and disposed of E]Wet contact time provided: appropriately F-1 8. Jewelry, tattoo and piercing equipment - clean and ❑ ❑ 26. Barriers used Elsterilized PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ ❑ 9. No eating, crinking 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, El F130. Cross contamination avoided during all phases of procedure ❑ warm water ❑ 12. 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 El ❑ 33' Workstation, surfaces, including chairs, armrests, etc. in E] used good repair CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ 15. Branding is completed with no other customers in ❑ ® 35. F_ 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 ❑ C 18. Client records approved and available - Consent form and Client El 37. Permits obtained and available questionnaire [ '9. 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 ❑ ❑ 41. ❑ Received by (Print): Phillip Vasquez Received by (Signature): EMAILED Phone: 209-406-8852 Spec alist 'Print): Sandip Singh Specialist (Signature): �'duc�sp 1 Phone: 209-468-3526 111Yinspec-ion on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 E+11/17