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`''" Body Art Inspect* Report j� Date: / / /' ✓ .� San Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: T e d 5Z 6 7 9 3 (209) 468-3420 Program www.siogv.org/ehd �t Zo Element: Facility Name Address City Zip Code Madtatter Tattoos 2714 country club blvd. Stockton 95204 Name of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Steven Bowers 6/30/15 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 (cant.) C ❑ 1 Autoclave: approved and effective - passed integrator El ❑ 22. Parts replaced between clients - grommets, elastic bands, E] test etc. ❑ 2' Items washed, disinfected, packaged, labeled, and E]PREVENTING sterilized CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used ❑ ❑ 5 Decontamination/sanitation area separated and supplied 11 Chemical used: Madacide, Dexol appropriately ❑ Invoices and log kept for disposable, pre -sterilized ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time equipment El ❑ 7.1 Sharps containers labeled, used, and disposed of ElWet 7 contact time provided: 5 mins a ro appropriately 1 ❑ 8' Jewelry, tattoo and piercing equipment - clean and El 26. Barriers used Elsterilized ® 27. Products applied to skin are single use/dispensed PRACTITIONER HEALTH AND HYGIENE aseptically❑ ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ® 11. Handwashing facilities properly supplied and accessible, El ❑ 30' Cross -contamination avoided during all phases of E] warm water procedure ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ❑ 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters El Source: B.A.P. ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 14. Appropriate personal protective equipment available and El El 33' Workstation, surfaces, including chairs, armrests, etc. in ❑ used ood repair CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ ❑ 15. Branding is completed with no other customers in [_1❑ 35. Operation and employee training records present ❑ procedure area ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s) submitted for review ❑ ® 18. Client records approved and available - Consent form El❑ 37. Permits obtained and available El and uestionnaire ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment El MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ gb U Received b (Print): V Q.V\ W e..( Received b Si nature): Phone: ,7 Q19,29 Specialist (Print): Specialist (Signature): Phone: Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 1 of 2 EH -03/2015