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Body Art Inspect*Report Date: (4 /9/1S <br /> San Joaquin County Environmental Health Department Pro ram <br /> 9 �'` <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: ?OO C J 5 / y 70 <br /> (209)468-3420 <br /> • cq<iFo>z"`�P wwsiogv.org/ehd Program <br /> w. t� �7 <br /> Element: -1 I Civ <br /> Facility Name Address City Zip Code <br /> Lucky You Tattoo 181 w.alameda st. Manteca 95336 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Esau Mendoza 6/30/15 Routine <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 /> ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, Eltest etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> ❑ 2' sterilized f_1PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> El 5 Decontamination/sanitation area separated and supplied El <br /> appropriately ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> ❑ <br /> ® 7 Sharps containers labeled,used,and disposed of <br /> ❑ Wet contact time provided: <br /> appropriately <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> El ® 26. Barriers used Elsterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE [j 27" aseptically ❑ <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 /> ® 11 Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> warm water El ❑ 30" El <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ® 32. Floors and walls dean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and ❑ ❑ 33 Workstation,surfaces,including chairs,armrests,etc.in Elusedgood repair <br /> CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area F1 ® 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 /> and uestionnaire El ® 37. Permits obtained and available El <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 ❑ r[Il 41. ❑ <br /> Received b Print): Esau Mendoza Received by(Signature): 7� Phone: 209 629-8321 <br /> Specialist Print): Harprit Mattu,Sr REHS -Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion onlabout: /15 A reinspection fee of$130 per hour may be charged. Page 1 of 3 <br /> EH-03/2015 <br />