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4100 – Safe Body Art
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PR0546901
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COMPLIANCE INFO
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Entry Properties
Last modified
3/5/2025 3:49:54 PM
Creation date
5/16/2023 11:58:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0546901
PE
4120
FACILITY_ID
FA0026577
FACILITY_NAME
LUCKY YOU TATTOO (MENDOZA, ESAU)
STREET_NUMBER
1138
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
1138 N MAIN ST
P_LOCATION
04
QC Status
Pending
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SJGOV\cfield
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EHD - Public
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Body Art Inspe n Report Date: 10114I1H <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 <br /> \4 Program <br /> RNiwww.sjogv.orq�end <br /> -___0___ <br /> Element: <br /> Facility Name Address City Zip Code <br /> Lucky You Tattoo 181 w alameda st. Manteca 95336 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Esau Mendoza Complaint <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 /> F1 1 Autoclave:approved and effective-passed integrator ❑ E] 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test etc. <br /> ❑ <br /> Items washed,disinfected,packaged,labeled,and 2. sterilized 1:1PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry [EEI <br /> El 23. Workstation/procedure area decontaminated El[:14. Integrators used/monthly spore test/log maintained El 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied El <br /> El appropriately Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6. El El 25. Disinfectant used appropriately/sufficient contact time <br /> a ui ment <br /> ElSharps containers labeled,used,and disposed of <br /> El 7 appropriately E] Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized ❑ El26. Barriers used El <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27 asepticall ❑ <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 /> Handwashing facilities properly supplied and accessible, 30. Cross-contamination avoided during all phases of <br /> ❑ 11. warm water ❑ ❑ procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training El ❑ 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 El ❑ 33' good repair El <br /> CUSTOMERS/CLIENTS ❑ 34. Permitiregistration posted ❑ <br /> ❑ 15 Branding is completed with no other customers in <br /> rocedure area El El 35. Operation and employee training records present ❑ <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 /> ❑ 18 Client records approved and available-Consent form <br /> questionnaire <br /> El El 37. Permits obtained and available <br /> and ❑ <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 ❑ ❑ 41. 1:1n <br /> Received b (Print): Esau Mendoza Received b (Signature): S kAdO Phone: 9 i6 !� <br /> Specialist(Print): Benjamin Escotto Specialist(Signature)7 Phone:(209)468-3178 <br /> Reinspecion on/about: A reinspection fee of$125 per hour may charged. Page 1 of 2 <br /> EH-04/2014 <br />
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