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r <br /> �° coG Body Art Inspection Report Date: February 24 2022 <br /> yi San Joaquin County Environmental Health Department Program <br /> 1868 E. Hazelton Ave., Stockton, CA 95205 g <br /> (209) 468-3420 <br /> Record: PR0546103 <br /> P' w .sioay.om/ehd Program <br /> ✓`cF o.. Element: 4120 <br /> Facility Name Address City Zip Code <br /> Authentic Images Tattoo & Piercing LLC 2139 Jackson Ave Escalon 95320 <br /> Name of Permil/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Alcira Vega 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 /> ❑ 1 . Autoclave: approved and effective - passed integrator test ❑ ❑ 2P_ Parts replaced between clients - grommets, elastic bands , ❑ <br /> Pe <br /> ❑ 2 Items washed, disinfected, packaged, labeled, and ❑ <br /> 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 /> ❑ 5 Decontamination/sanitation area separated and supplied ❑ ❑ <br /> appropriately ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable, pre-sterilized <br /> equipment ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> ® 7 Sharps containers labeled, used, and disposed of El El <br /> appropriately ❑ Wet contact time provided: <br /> ❑ 8 Jewelry, tattoo and piercing equipment - clean and <br /> sterilized ❑I ❑ 26. Barriers used ❑ <br /> PRACTITIONER HEALTH AND HYGIENE El 27. Products applied to skin are single use/dispensed aseptically E] <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, <br /> warm water ❑ ❑ 30. Cross-contamination avoided during all phases of procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ <br /> 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 /> ❑ 14 Appropriate personal protective equipment available and ❑ ❑ 33 Workstation, surfaces, including chairs, armrests, etc. in Elused ood repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area ❑ ® 35. Operation and employee training records present ❑ <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 and <br /> questionnaire ❑ ❑ 37. Permits obtained and available ❑ <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): Alcira Vega Received by (Signature) : EMAILED Phone: 209988 1536 <br /> Specialist (Print): Pinne Chao Specialist (Signature): Phone: 209-468-3864 <br /> Reinspection onlabout:_March 10, 2022. A reinspection fee of $152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />