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l Body Art Inspect*Report Date: y1-71 115 <br /> ° c°c <br /> %a San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: Sqx on)C,14 p <br /> (209)468-3420 <br /> N`P'• www.siogv.orq/ehd Program (�W'l <br /> L/FOR. Element: -1 15 <br /> Facility Name Address City Zip Code <br /> East Main Tattoo 2165 e.main st. Stockton 95205 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Angel Ugarte Final Consult. <br /> The above facility is inspected for compliance with Division 104,Part 15,Chapter 7 of California Health and Safety Code(HSG). <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 /> ® <br /> Items washed,disinfected,packaged,labeled,and 2 sterilized ❑ PREVENTING 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 /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5. ❑ Chemical used: <br /> appropriately <br /> 6. <br /> ro riatel <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6. equipment El El25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled,used,and disposed of ❑ <br /> ® 7' a ro riatel El et contact time provided: <br /> -1 F <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. El 26. Barriers used E]sterilized <br /> ❑ 27 Products applied to skin are single use/dispensed ElPRACTITIONER HEALTH AND HYGIENE 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 El 30' El procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingfn [EE11 31. Areas separated/no living or sleeping quarters E]Source: 32. Floors and walls clean and in good repair,adequate light El14 Appropriate personal protective equipment available and 33 Workstation,surfaces,including chairs,armrests,etc.in ❑ <br /> used ood re air <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area [I El 35. 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 <br /> and uestionnaire ❑ ❑ 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 ❑ ❑ 41. ❑ <br /> Received b (Print): Angel U arte Received by(Signature): Phone: 209 688-2161 <br /> Specialist(Print): Benjamin Escotto,Sr REHS Specialist(Signature)7 Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />