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l <br /> Paul" Body Art Inspect* Report Date: ^] S 9 <br /> San County Environmental Health Department <br /> Joaquin De <br /> m; q P Program 6�" t' <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 Program <br /> d< F6R`' www.sjogv.org/ehd 912-0 <br /> Element: <br /> Facility Name Address City Zip Code <br /> Tall Tales Tattoo 7170 west lane ste 4 Stockton 95210 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Christina N.Ramirez Consultation <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 integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, Eltest etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized ❑ PREVENTING 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 ❑ ❑ 24. Appropriate chemical disinfectant used <br /> El5 Decontamination/sanitation area separated and supplied ❑ <br /> appropriately ❑ Chemical used: Cavicide <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment El El 25. Disinfectant used appropriately/sufficient contact time <br /> ® El7 Sharps containers labeled,used,and disposed of <br /> ElWet contact time provided: <br /> appropriately <br /> E] 81 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized E] El 26. Barriers used El <br /> ❑ 27 Products applied to skin are single use/dispensed ❑ <br /> 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: Cathy Montie ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and ❑ ❑ 33 Workstation,surfaces, including chairs,armrests,etc.in ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area 1:1 ® 35. Operation and employee training records present ❑ <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 questionnaire <br /> ❑ ❑ 37. Permits obtained and available Eland <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 by(Print): Christina Ramirez Received b (Signature): ^n 4� Phone:(209)670-4452 <br /> Specialist(print): Mai Vue Specialist(Signature): 1�1c�C�/ Phone: (209)468-3284 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />