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" 7 <br /> BodyArt InsP P ectio Report <br /> 2 X02 Date: 11 k 1 <br /> San� Joaquin County Environmental Health Department q � P Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> P (209)468-3420 Program <br /> www.sjogv.orq/ehd <br /> Element: <br /> Facility Name Address City Zip Code <br /> Versailles Salon 1010 central ave Tracy 95376 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Erica-Green-Frese 6/30/18 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 integratorParts replaced between clients-grommets,elastic bands, <br /> test E] ❑ 22. El etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized El 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 /> ❑ 5 Decontamination/sanitation area separated and supplied E]appropriately <br /> ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment <br /> ❑ El 25. Disinfectant used appropriately/sufficient contact time <br /> El 7. Sharps containers labeled,used,and disposed of El <br /> a ro riatel ❑ Wet contact time provided: <br /> ❑ 8. Jewelry,tattoo and piercing equipment-clean and <br /> El El 26. Barriers used ❑ <br /> sterilized <br /> ❑ 27 Products applied to skin are single use/dispensed ElPRACTITIONER 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 El 30. El <br /> ❑ 12. Hepatitis B vaccination ❑ <br /> BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light El <br /> ❑ 14. Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in Elused E] ❑ 33' ood re air <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> El 15. Branding is completed with no other customers in <br /> procedure area ❑ ❑ 35. Operation and employee training records present ❑ <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ I 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 ❑ <br /> iEl El 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 ❑ ❑ 41. ❑ <br /> Received b Print): Erica Green-Frese Received by(Signature): /1/` Phone: 209 275-9133 <br /> Specialist(Print): Lor Xion ,REHS Specialist(Signature): Phone: 209 468-2807 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 e <br />