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Body Art Inspect Report <br /> � Date: 9 <br /> San Joaquin County EnvironmentaC Heaft Department Program P(� <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 1 I1 CJ <br /> (209)468420 �I v l V .q YAC �J tt� S' /! Program Z� <br /> YYFoa www.siogv.org/ehd l /'�1.�,t`�1t1 1'( g <br /> Element: til <br /> vLr <br /> Facility Name Address City Zip Code <br /> Quarter Horse Tattoo 916 yosemite street Stockton 95203 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Geoff Rogers 6/30/19 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 integratorParts replaced between clients-grommets,elastic bands, Eltest F1 ❑ 22' etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized El CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 1 23. 1 Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> El 5. Decontamination/sanitation area separated and supplied E] <br /> appropriately ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment ElEl25. Disinfectant used appropriately/sufficient contact time <br /> El <br /> ❑ 7 Sharps containers labeled,used,and disposed of <br /> ElWet contact time provided: <br /> appropriately <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and ❑ ❑ 26. Barriers used ❑ <br /> sterilized <br /> ❑ 27 Products applied to skin are single use/dispensed ElPRACTITIONER HEALTH AND HYGIENE ase tical) <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" procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light E]❑ 14. Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in Elused ❑ ❑ 33' Qood re air <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 El <br /> and <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): Received b Si nature): Phone: <br /> 60 Z, <br /> Specialist(Print): J.Easter Specialist(Signature): 7 Phone: 209 953-7310 <br /> Reinspecion onlabout: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />