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CO0055177 (2)
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4100 – Safe Body Art
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CO0055177 (2)
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Last modified
11/30/2022 1:33:06 PM
Creation date
11/30/2022 1:25:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
RECORD_ID
CO0055177
PE
4100
FACILITY_ID
FA0026880
FACILITY_NAME
IT'S JUST A POKE (MEJIA, SINTIA)
STREET_NUMBER
239
Direction
N
STREET_NAME
PILGRIM
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15116013
ENTERED_DATE
8/29/2022 12:00:00 AM
SITE_LOCATION
239 N PILGRIM ST
RECEIVED_DATE
8/29/2022 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Body Art Inspection Report <br />San Joaquin County Environmental Health Department <br />1868 E. HazeIton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />www.sjocw.orq/ehd <br />Date: September 1, 2022 <br />Program <br />Record: PR0547312 <br />Program <br />Element: 4121 <br /> <br />Facility Name Address City Zip Code <br />Its Just a Poke 239 N Pilgrim St. Stockton 95204 <br />Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br />Sintia Mejia 6/30/23 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 V MACHINE SAFETY AND SANITATION (cont.) <br />Autoclave: approved and effective - passed integrator test 22. Parts replaced between clients - grommets, elastic bands, <br />etc. 0 <br />0 Items washed, disinfected, packaged, labeled, and <br />sterilized 0 PREVENTING CROSS-CONTAMINATION <br />0 Autoclave loaded correctly/packages allowed to dry 0 23. Workstation/procedure area decontaminated <br />4. Integrators used/monthly spore test/log maintained <br />0 <br />24. Appropriate chemical disinfectant used <br />LI <br /> Decontamination/sanitation area separated and supplied <br />appropriately LI Chemical used: <br />0 Invoices and log kept for disposable, pre-sterilized <br />equipment 25. Disinfectant used appropriately/sufficient contact time <br />7. Sharps containers labeled, used, and disposed of <br />appropriately 0 Wet contact time provided: <br />8 Jewelry, tattoo and piercing equipment - clean and <br />sterilized 26. Barriers used 0 <br />PRACTITIONER HEALTH AND HYGIENE 0 27. Products applied to skin are single use/dispensed aseptically <br />0 9 No eating, drinking or smoking - clean clothes 0 28. Storage of inks, pigments, needles, tubes, etc. <br />0 10. Hands washed effectively and timely 0 29. Jewelry, Inks, Needles etc approved and used correctly 0 <br />E 1 1 . Handwashing facilities properly supplied and accessible, <br />warm water D 30. Cross-contamination avoided during all phases of procedure <br /> Hepatitis B vaccination 0 BEST BUSINESS PRACTICES <br /> Bloodborne Pathogen training Z 31. Areas separated/no living or sleeping quarters <br />Source: 32. Floors and walls clean and in good repair, adequate light <br />0 14. Appropriate personal protective equipment available and <br />used LI 0 33. Workstation, surfaces, including chairs, armrests, etc. in <br />good repair 0 <br />CUSTOMERS/CLIENTS 34. Permit/registration posted <br />15. Branding is completed with no other customers in <br />procedure area 0 35. Operation and employee training records present <br /> Customers eighteen (18) years of age or older 0 COMPLIANCE AND ENFORCEMENT <br /> Skin adequately prepared for procedure 36. Plan(s) submitted for review <br />Z 18. Client records approved and available - Consent form and <br />questionnaire 37. Permits obtained and available <br />19. Appropriate aftercare instructions given to client 0 38. Impoundment <br />MACHINE SAFETY AND SANITATION 39. Hearing scheduled 0 <br />20. Safe machine design 0 40. Closure CI <br />21. Machines cleaned and disinfected between clients 41. 0 <br />Received by (Print): Sintia Mejia Received by (Signature): Phone: 510-588-6059 <br />Specialist (Print): Sandip Singh Specialist (Signature): 5a4,644- c.51;tiA Phone: 209-468-3526 <br /> <br />Reinspection on/about: . A reinspection fee of $156 per hour may be charged. Page 1 of 3 <br />EH-11/17
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