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Body Art Inspection Report Date: May 12, 2021 <br /> HSan Joaquin County Environmental Health Department Program <br /> 1868 E. Hazelton Ave., Stockton, CA 95205 Record: New PR# <br /> +k (209) 468-3420 <br /> •,'(". ,.ra w w.sioay.omlehd Program <br /> Element: 4120 <br /> Facility Name Address City Zip Code <br /> Lucky You Tattoo 1138 N Main St. Manteca 95336 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Esau Mendoza Final Inspection <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 test ❑ ❑ P2, Parts replaced between clients - grommets, elastic bands, ❑ <br /> etc. <br /> ❑ 2 Items washed, disinfected, packaged, labeled, and <br /> sterilized El 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 /> ❑ 5 Decontamination/sanitation area separated and supplied El ❑ <br /> appropriately <br /> El El <br /> used: <br /> ❑ 64 Invoices and log kept for disposable, pre-sterilized <br /> equipment ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> ❑ 7 Sharps containers labeled, used, and disposed of ❑ ❑ <br /> a ro riatel ❑ Wet contact time provided: <br /> ❑ 8 Jewelry, tattoo and piercing equipment - clean and <br /> sterilized f <br /> El 26. Barriers used El <br /> PRACTITIONER HEALTH AND HYGIENE El27. Products applied to skin are single use/dispensed aseptically El <br /> single <br /> No eating, drinking or smoking - clean clothes El28. Storage of inks, pigments, needles, tubes, etc. ElEl10. Hands washed effectively and timely El29. Jewelry, Inks, Needles etc approved and used correctlyEl11Handwashing facilities properly supplied and accessiblwarm water [j30. Cross-contamination avoided during all phases of procedure El <br /> ❑ 12. Hepatitis B vaccination ❑ <br /> BEST BUSINESS PRACTICES <br /> F113. Bloodborne Pathogen training ElEl31 . 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 El 33. El repair <br /> CUSTOMERS/CLIENTS El 34. Permit/registralion posted ❑ <br /> El 15. Branding is completed with no other customers in - <br /> rocedure area El El35. Operation and employee training records present El <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 and ❑ ❑ 37. Permits obtained and available Eluestionnaire <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 . ❑ <br /> Received by (Print): Esau Mendoza Received by (Signature): EMAILED Phone: 650-228-3308 <br /> Specialist (Print): Sandip Singh Specialist (Signature): Phone: 209-468-3526 <br /> Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />