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'``"' ' BodyArt Ins ectilpRe ort <br /> P P Date: ,21.2812 a <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> c'a (209)468-3420 Record: y e0S y 16 e2 1 <br /> ! Program <br /> ,vv .s v_.a /e,sa <br /> Element: <br /> Facility Name Address City Zip Code <br /> Versailles Salon 1010 n central ave. Tracy 95376 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Erica Green-Frese 6/30/20 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 El ❑ 22' etc. El <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized E] PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry [j ❑ 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 Elappropriately <br /> ❑ Chemical used: <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6' ElEl25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ® E]a 7 Sharps containers labeled, used,and disposed of <br /> appropriately ❑ Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> El El 26. Barriers used Elsterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27. ase ticall ❑ <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 ❑ 30. rocedure El <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodbome Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in <br /> used [1 ❑ 33' good repair ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. rocedure area El ® 35. Operation and employee training records present El <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 /> ® <br /> Client records approved and available-Consent form 18. questionnaire <br /> F1 El 37. Permits obtained and available Eland <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 ❑ [:141. El <br /> Received b (Print): Erica Green-Frese Received by(Signature): -t-A&%L Phone:209-275-9133 <br /> Specialist(Print): Sandip Singh Specialist(Signature): Y Phone: 209-468-3526 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />