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Facility Name Address City Zip Code Canvas Tattoo 304 w. harding way #b Stockton 95204 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Melissa Santos 6/30/18 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, El test Body Art Inspects Report etc. f1 2' Date: E]I San Joaquin County Environmental Health Department Program M � 2 1868 E. Hazelton Ave., Stockton, CA 95205 Record: R —0 52- 319 ❑ (209) 468-3420 Program 1 Z 1 ❑ 1 w. wwsiogv org/ehd Element: ❑ Facility Name Address City Zip Code Canvas Tattoo 304 w. harding way #b Stockton 95204 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Melissa Santos 6/30/18 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, El test I etc. 2' Items washed, disinfected, packaged, labeled, and E]I sterilized PREVENTING CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 1 23. Workstation/procedure area decontaminated ❑ ® 4. Integrators used/monthly spore test/log maintained ❑ [1 24. Appropriate chemical disinfectant used ❑ ® 5. Decontamination/sanitation area separated and supplied E] Chemical used: Madacide appropriately Ej 6. Invoices and log kept for disposable, pre -sterilized ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time equipment ® 7 Sharps containers labeled, used, and disposed of ❑ [Wet contact time provided: appropriately ❑ 8 Jewelry, tattoo and piercing equipment - clean and ❑ ❑ 26. Barriers used ❑ sterilized F1 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. E] ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ❑ Handwashing facilities properly supplied and accessible, ❑ ❑ 30 Cross -contamination avoided during all phases of ❑ 11. warm water procedure ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ® 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ ❑ Source: Above Training, Cathy Montie ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ Appropriate personal protective equipment available and ❑ ® 33 Workstation, surfaces, including chairs, armrests, etc. in ❑ 14. usedgood repair Perm it/registration posted ❑ CUSTOMERS/CLIENTS ❑ 15. Branding is completed with no other customers in ❑ Operation and employee training records present16. procedure area Customers eighteen (18) years of age or older ❑LIANCE k34 AND ENFORCEMENT 17. Skin adequately prepared for procedure ❑ Plan(s) submitted for reviewClient 18. records approved and available - Consent form ❑ its obtained and available ❑ and uestionnaire ® 19. Appropriate aftercare instructions given to client ❑ ❑Impoundment ❑ ❑Hearing scheduled ❑ MACHINE SAFETY AND SANITATION ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received b (Print): Melissa Santos Received b Si ure : Phone: 209 941 - 0875 Specialist Print): Harprit Mattu, Sr REHS Specialist (Signature): dPhone: 209 468-3284 Reinspecion on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 3 EH -11/17