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u'" <br /> Body eeDn Re • <br /> Y Art Ins P Port Date: E 4Z4`l <br /> 2 San Joaquin County Environmental Health Department Program <br /> h 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: J'1QGa �2 <br /> P (209)468-3420 Program <br /> www.siogv.org/ehd Element: <br /> Facility Name Address City Zip Code <br /> Flow Yoga&Weliness Studio 145 w. 101"St. Tracy 95376 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Silvia Kruse Routine/Final <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 /> ❑ 2. sterilized E]I PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated [ <br /> [j4. Integrators used/monthly spore test/log maintained El ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied E:aro <br /> appropriately El 5. El Chemical used: Sanicloth wipes,Dicide,Caviwipes <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6. ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> [ <br /> Sharps containers labeled,used,and disposed of <br /> ❑ 7" a ro riatel El Wet contact time provided: 1 min,3 min, 1 min <br /> Jewelry,tattoo and piercing equipment-clean and <br /> 7 <br /> E] 8. ❑ El 26. Barriers used [ <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27' ase ticali [ <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, 30. Cross-contamination avoided during all phases of <br /> ❑ 11. warm water ❑ ❑ procedure [ <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters [ <br /> Source: Biologix Solutions,Protraining ❑ 32. Floors and walls clean and in good repair,adequate light [ <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in <br /> ❑ 14. used ❑ ❑ 33. good repair C <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted [ <br /> ❑ <br /> Branding is completed with no other customers in 15. El ® 35. Operation and employee training records present <br /> procedure area (x <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 /> Client records approved and available-Consent form <br /> ❑ 18. and uestionnaire ® ❑ 37. Permits obtained and available [ <br /> ❑ 19. Appropriate aftercare instructions given to client El El 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 I ❑ rEj17417 [ <br /> Received b (Print): Silvia Kruse Received b . <br /> �i nature ' Phone: a- <br /> Specialist(Print): Nav'ot Sahota Specialist(Signature : Phone: 209 468-3178 <br /> Reinspecion onlabout: A reinspection fee of$152 per hour may be charged. Page 1 of <br /> EH-11/17 <br />