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I <br /> Body Art Inspectift Report Date: /2 <br /> San Joaquin County t vironmental Health Department Program <br /> L07 <br /> r n g <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PpzuS3 ILI I ' <br /> (209)468-3420 <br /> cq<,Foac+`P Program <br /> www.siogv.org/ehd I <br /> H r L� <br /> Element: <br /> Facility Name Address City Zip Code <br /> Permanent Makeup by Sara 318 a yosemite avenue Manteca 95336 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Sara Price 6/30/19 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 /> ❑ 1 Autoclave:approved and effective-passed integrator Parts replaced between clients-grommets,elastic bands, Eltest El ❑ 22' 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 ❑ <br /> a ro riatel ❑ Chemical used: Opti-Gide Wipes and Citrus II <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment ❑ E] 25. Disinfectant used appropriately/sufficient contact time <br /> ® 7 <br /> appropriately <br /> Sharps containers labeled,used,and disposed of El Wet contact time provided: 2 mins,3 mins <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized El El26. Barriers used ❑ <br /> ® 27. Products applied to skin are single use/dispensed ElPRACTITIONER HEALTH AND HYGIENEaseptically <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 ❑ 30' El <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Cathie Montie ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and El ❑ 33 Workstation,surfaces,including chairs,armrests,etc.in El <br /> good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15 Branding is completed with no other customers in <br /> rocedure area El ® 35. Operation and employee training records present E] <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 ❑ El 37. Permits obtained and available F1 <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): Sara Price Received by(Signature): Phone: 209 824-7252 <br /> Specialist(Print): Mai Vue Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion onlabout: A reinspection fee of$152 per hour charged. Page 1 of 3 <br /> EH-11/17 <br /> �r <br />