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Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Melissa Santos 6/30/20 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.) C ❑ 1 Autoclave: approved and effective - passed integrator ❑ ❑ 22 Parts replaced between clients - grommets, elastic bands, ❑ test �j� ❑ '. Items washed, disinfected, packaged, labeled, and sterilized ❑ V.iN.._.c-. o� Body Art Inspectii2eport Autoclave loaded correctly/packages allowed to dry ❑ ❑ 4. Date: ❑ I San Joaquin County Environmeatal Health Department Decontamination/sanitation area separated and supplied appropriate) ❑ =� 1868 E. Hazelton Ave., Stockton, CA 95205 Program Record: n �iC G S Z.3 q S 2- ❑ (209) 468-3420 www.siogv.org/ehd 6/1WVA S._ %4 'T e& Se,C 6l.l?fif_)d_. Program Element: C El Facility Name Address City Zip Code Canvas Tattoo 304 west harding way #b Stockton 95204 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Melissa Santos 6/30/20 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.) C ❑ 1 Autoclave: approved and effective - passed integrator ❑ ❑ 22 Parts replaced between clients - grommets, elastic bands, ❑ test �j� ❑ 2 Items washed, disinfected, packaged, labeled, and sterilized ❑ ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 5 Decontamination/sanitation area separated and supplied appropriate) ❑ ® 6 Invoices and log kept for disposable, pre -sterilized equipment ❑ ❑ 7 Sharps containers labeled, used, and disposed of a ro riatelJewelry, No El 8. tattoo and piercing equipment - clean and ...,,.:1:_,.a ❑ PRACTITIONER HEALTH AND HYGIENE ❑ 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 El ❑ 26. Source: El ❑ 14. Appropriate personal protective equipment available and used ❑ ❑ CUSTOMERSICLIENTS Storage of inks, pigments, needles, tubes, etc. ❑ 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 by (Print): Melissa Santos J. Easter PREVENTING CROSS -CONTAMINATION ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 24. Appropriate chemical disinfectant used ❑ ❑ 33. Chemical used: ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ ® 35. Wet contact time provided: El ❑ 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 ® 31. 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. Permittregistration 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 ❑ ❑ 40. Closure ❑ ❑ 41. ❑ Phone: Z 7 e�kl - dSl Reinspecion onlabout: A reinspection fee of $152 per hour may be charged. Page 1 of 3 EH -11 /17 k