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Body Art Inspection Report <br /> Date: September 1,2022 <br /> t San Joaquin County Environmental Health Department Program <br /> l 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0547312 <br /> (209)468-3420 <br /> www.siogv.org/ehd Program <br /> t�Fag�/ Element: 4121 <br /> Fac lity Name Address City Zip Code <br /> It's Just a Poke 239 N Pilgrim St. Stockton 95204 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Sint a Mejia 6/30/23 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 /> Parts replaced between clients-grommets,ela3tic bands, <br /> El 1. Autoclave:approved and effective-passed integrator test El El 22. etc. ❑ <br /> ❑ <br /> Items washed,disinfected,packaged,labeled,and <br /> 2. sterilized 1:1PREVENTING 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 /> Decontamination/sanitation area separated and supplied El El 5. appropriately <br /> ElChemical used: <br /> Invoices and log kept for disposable, pre-sterilized <br /> E] 6. <br /> equipment ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> El ❑ <br /> Sharps containers labeled, used,and disposed of <br /> El 7' ElWet contact time provided: <br /> appropriately <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and 8. El El 26. Barriers used Elsterilized <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed 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 /> Handwashing facilities properly supplied and accessible, <br /> ® 11. El El 30. Cross-contamination avoided during all phases of procedure <br /> warm water <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 clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in <br /> El 14. used El ❑ 33' good repair El <br /> CUSTOMERS/CLIENTS ❑ 34. Perm itfregistration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. El El 35. Operation and employee training records present <br /> rocedure area <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 /> ® <br /> Client records approved and available-Consent form and 18. E:1 [:137. 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 ty(Print): Sintia Mejia Received by(Signature): Phone:510-598-6059 <br /> SpEcialist(Print): Sandip Singh Specialist(Signature): �'Qyp �isL�fG Phone:209-438-3526 <br /> Reinspection on/about: A reinspection fee of$156 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br />