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Body Art Inspection Report Date: January 7, 2022 h{ San Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0547391 (209) 468-3420 `P sioay.ara/ehd Program Z1 0 Element: 4120 Facility Name Address City Zip Code Ink N Out 159 N Hunter Sl Stockton 95202 Name of Permit/Registration Holder Permit Exp. Date Time. In Time Out Inspection Type Robert Askew and Ericson Nadlang 6/30/22 Routine The above facility is inspected for compliance with Division 104, Pad 15, Chapter 7 of California Health and Safety Code (HSC) Pads replaced between clients - grommets, elastic bands, ❑ EH -11/17 V = Vinlatlnn C. = rnrrerraA On Rite etc. El 2' V CLEANING AND STERILIZATION C 5S* V MACHINE SAFETY AND SANITATION cont. C E:11. Autoclave: approved and effective - passed integrator test El El 22 Pads replaced between clients - grommets, elastic bands, ❑ EH -11/17 &/ etc. El 2' Items washed, disinfected, packaged, labeled, and 1:1PREVENTING sterilized CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used El El 5' Decontamination/sanitation area separated and supplied ElChemical used: appropriately El 6. Invoices and log kept for disposable, pre -sterilized ElEl25. Disinfectant used appropriately/sufficient contact time equipment 1-1Sharps. ❑ 7, containers labeled, used, and disposed of ❑ Wet contact time provided: appropriately ❑ 8 Jewelry, tattoo and piercing equipment - clean and ❑ ❑ 26. Barriers used ❑ sterilized PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ❑ 11. Handwashing facilities properly supplied and accessible, El [130. Cross -contamination avoided during all phases of procedure El warm water ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ ❑ ❑ Source: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ El 14. Appropriate personal protective equipment available and ❑ ❑ 33'good Workstation, surfaces, including chairs, armrests, etc. in ❑ used repair CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ ❑ 15. Branding is completed with no other customers in ❑ El35. Operation and employee training records present Elrocedure area ❑ 16. Customers eighteen (1 S) years of age or older ❑ I COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plants) submitted for review ❑ ❑ 18. Client records approved and available - Consent form and El El 37. Permits obtained and available ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Ericson Received by (Sionature): 4� Phone: 209.981-1589 Specialist (Print): Sandip Singh Specialist (Signature): !:ya�r,yr 5S* Phone: 209-466-3526 Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH -11/17 &/