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�PPu. o .., ,...... �k \ o� Body Art Inspec& Report s Items washed, disinfected, packaged, labeled, and ❑ ❑ Date: sterilized San Joaquin County Environmental Health Department ❑ 3. 1868 E. Hazelton Ave., Stockton, CA 95205 Program Record: ❑ (209) 468-3420 Program ❑ www.siogv.org/ehd Element: Facility Name Address City Zip Code Madtatter Tattoos 2714 country club dr. Stockton 95204 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Steven Bowers 6/30/14 Routine The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safety Code (HSC). V = Violation C = Corrected On Site V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION (cont.) ❑ 1 Autoclave: approved and effective - passed integrator❑ ❑ 22 Parts replaced between clients - grommets, elastic bands, e t f --- ❑ 2 s Items washed, disinfected, packaged, labeled, and ❑ ❑ 10. sterilized ❑ ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 5 Decontamination/sanitation area separated and supplied ❑ Cross -contamination avoided during all phases of appropriately El ® 6 Invoices and log kept for disposable, pre -sterilized ❑ 4 . Closur equipment ® 7 Sharps containers labeled, used, and disposed of Elappropriately ❑ 8 Jewelry, tattoo and piercing equipment - clean and ❑ sterilized PRACTITIONER HEALTH AND HYGIENE ❑ 1 9. No eating, drinking or smoking - clean clothes ❑ ❑ 10. Hands washed effectively and timely ❑ ® 11 Handwashing facilities properly supplied and accessible, warm water ❑ ❑ 12. Hepatitis B vaccination ❑ ® 13. Bloodborne Pathogen training 30. Cross -contamination avoided during all phases of Source: El ❑ 14. Appropriate personal protective equipment available and used Ell ❑ 15. Branding is completed with no other customers in procedure area ❑ 16. Customers eighteen (18) years of age or older ❑ 17. Skin adequately prepared for procedure ® 18 Client records approved and available - Consent form and questionnaire ❑ 19. Appropriate aftercare instructions given to client MACHINE SAFETY AND SANITATION ❑ 20. Safe machine design ❑ 21. Machines cleaned and disinfected between clients Received Afonso Arambula Received ❑ 23. 1 Workstation/procedure area decontaminated ❑ 24. Appropriate chemical disinfectant used Chemical used: ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ ❑ Wet contact time provided: ❑ 26. Barriers used ❑ 27 Products applied to skin are single use/dispensed aseptically ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ 30. Cross -contamination avoided during all phases of BEST BUSINESS PRACTICES C u 1 0131. Areas separated/no living or sleeping quarters ❑ ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 33. Workstation, surfaces, including chairs, armrests, etc. in good repair ❑ ❑ 34. Permit/registration posted ❑ ® 35. Operation and employee training records present ❑ '—' COMPLIANCE AND ENFORCEMENT ❑ ❑ 36. Plan(s) submitted for review ❑ ❑ 37. Permits obtained and available ❑ ❑ 38. Impoundment ❑ 39. Hearing scheduled ❑ ❑ 4 . Closur Reinspecion on/about: A reinspection fee of $125 per hour may EH -04/2014 U t., / Phone: (209) 467-8287 0 0 0 Page 1 of 2