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� - -- <br /> e�LLL <br /> Body Art Inspection Report Date: June 2, 2021 <br /> ySan Joaquin County Environmental Health Department Program <br /> 1 868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0546901 <br /> (209) 468-3420 <br /> P • vn4 Aoay.om/ehd Program <br /> a<r Fop? 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 6/30/22 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 /> El El ElPa <br /> 1 . Autoclave: approved and effective - passed integrator lest 22. etrts replaced between clients - grommets, elastic bands,c. ❑ <br /> El Items washed,. disinfected , packaged, labeled, and <br /> 2' sterilized El CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spare test/log maintained ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ ❑ <br /> ❑ 5' 1 aourocriateiv ❑ Chemical used: <br /> ® <br /> Invoices and log kept for disposable, pre-sterilized 6. ❑ El25. Disinfectant used appropriately/sufficient contact time Elequipment <br /> Sharps containers labeled, used, and disposed of <br /> El 7' ❑ Wet contact time provided: <br /> appropriately <br /> El 8. Jewelry, tattoo and piercing equipment - clean and El L126, Barriers used Elsterilized <br /> PRACTITIONER HEALTH AND HYGIENE El 27. Products applied to skin are single use/dispensed aseptically El <br /> ❑ 9. No eating, drinking or smoking - clean clothes F.] El 28. Storage of inks, pigments, needles, lubes, etc. El <br /> El Hands washed effectively and timely F1 El 29. Jewelry, Inks, Needles etc approved and used correctly ❑ <br /> Handwasning facilities properly supplied and accessible, <br /> ❑ 11 . El El 30. Cross-contamination avoided during all phases of procedure El <br /> warm water <br /> [112. Hepatitis B vaccination ElBESTBUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training ❑ El 31 . Areas separated/no living or sleeping quarters <br /> Source: [132. Floors and walls clean and in good repair, adequate light El <br /> Appropriate personal protective equipment available and Workstation, surfaces, including chairs, armrests, etc. in <br /> El 14. 33.used ❑ ❑ good repair <br /> El <br /> CUSTOMERSICLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. El El 36. Operation and employee training records present <br /> procedure area <br /> ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plants) submitted for review ❑ <br /> ® 18 Client records approved and available - Consent form and ❑ ❑ 37. Permits obtained and available ❑ <br /> questionnaire <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: 209-46&3526 <br /> Refnspectton onlabout: A reinspection fee of $152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />