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°yBody Art Inspection Report <br />Date: June 8, 2022 <br />a. San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0547735 <br />(209)468-3420 <br />�4 vov .siaay.om/ehd Program <br />T+ uo Element: 4120 <br />Facility Name Address city Zip Code <br />Cactus Flower Tattoo Studio 1012 W Lodi Ave Lodi 95240 <br />Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br />Paul Marquez 6130122 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 integrator test ❑ ❑ 22 Parts replaced between clients - grommets, elastic bands, Eletc. <br />❑ <br />Items washed, disinfected, packaged, labeled, and 2' sterilized El CROSS -CONTAMINATION <br />❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ [1 23. Workstation/procedure area decontaminated ❑ <br />❑ 4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used <br />Decontamination/sanitation area separated and supplied ❑ ❑ <br />❑ 5'appropriately ❑ Chemical used: <br />Invoices and log kept for disposable, pre -sterilized <br />El 6' ❑ 25. Disinfectant used appropriately/sufficient contact time <br />equipment <br />El ElSharps containers labeled, used, and disposed of <br />El 7' <br />aDoroDriatelv ❑ Wet contact time provided: <br />❑ 8 Jewelry, tattoo and piercing equipment - clean and ❑ ❑ 26. Barriers used ❑ <br />sterilized <br />PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed 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 />Handwashing facilities properly supplied and accessible, <br />El 11. warm water El 30. Cross -contamination avoided during all phases of procedure ❑ <br />❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br />El13. Bloodborne Pathogen training ❑ El 31. Areas separated/no living or sleeping quarters El <br />Source: El 32. Floors and walls clean and in good repair, adequate light ❑ <br />Appropriate personal prolective equipment available and Workstation, surfaces, including chairs, armrests, etc. in <br />El 14. used ❑ ❑ 33' good repair <br />El <br />CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br />Branding is completed with no other customers in <br />El 15. rocedure area E] El 35. Operation and employee training records present ❑ <br />❑ 16. Customers eighteen (18) years of age or older ElCOMPLIANCEAND ENFORCEMENT <br />❑ 17. Skin adequately prepared for procedure El 36. Plan(s) submitted for review El® <br />Client records approved and available - Consent form and 18. ❑ ❑ 37. Permits obtained and available <br />questionnaire <br />❑ <br />❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br />MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br />❑ 20.Safe machine design ILI ❑ 40. Closure ElEl21. Machines cleaned and disinfected between clients ❑ 41. ❑ <br />Received by (Print): Paul Marquez Received by (Signature): EMAILED Phone: 209-747-9009 <br />Specialist (Print): Sandip Singh Specialist (Signature): l"19L aAff ,£ Phone: 2094188-3526 <br />Reinspection onlabout: A reinspection fee of $152 per hour may be charged. Page 1 of 2 <br />EH -11/17 �!'\J <br />l� <br />