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°U`" Body Art Inspeon Report f Date: <br /> San Joaquin County Environmental Health Department Program _ <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: S�.OU�oUS Z <br /> (209)468-3420 Program 103 <br /> cq<1Foaa`"• www.siogv.org/ehd Element: <br /> Facility Name Address City Zip Code <br /> Salon Two Twenty 220 s.church st. Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Celena Phelan Initial Consult. <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, [ <br /> test etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> FI 2' sterilized ❑ PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ El 23. Workstation/procedure area decontaminated [ <br /> El 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied C <br /> ❑ 5' a ro riatel ❑ Chemical used: Barbicide <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6• El ® 25. Disinfectant used appropriately/sufficient contact time <br /> a ui ment <br /> Sharps containers labeled,used,and disposed of [ <br /> ® 7 a pro riatel E] Wet contact time provided: wiped down <br /> -1 F <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8' sterilized El El26. Barriers used [ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27 asepticallyC <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 /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> El 11. 30.warm water ❑ ❑ procedure [ <br /> ❑ 12. Hepatitis B vaccination ❑ I BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodbome Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters [ <br /> Source: Abovetraining.com ❑ 32. Floors and walls clean and in good repair,adequate light E: <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc. in <br /> ❑ 14. used El ® 33' good repair [ <br /> CUSTOMERSICLIENTS ❑ 34. Perm ittregistration posted [ <br /> Branding is completed with no other customers in <br /> ❑ 15. procedure area 1:1 ® 35. Operation and employee training records present [ <br /> ❑ 16. Customers eighteen(18)years of age or older ElCOMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review [ <br /> Client records approved and available-Consent form <br /> ❑ 18. ❑ ❑ 37. Permits obtained and available [ <br /> and questionnaire <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 E] F] 41. [ <br /> Received b `.J�'t <br /> (Print): I �L W V ' Received by(Signature)7 <br /> Specialist Print): Nav'ot Sahota Specialist(Signature): Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of <br /> EH-11/17 <br />