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SAN J OAQU I N Environmental Health Department <br /> C= CaU `J I Y <br /> Body Art Inspection Report <br /> Facility Name : Facility Address : Date : <br /> AUTHENTIC IMAGES TATTOO & PIERCING 2139 JACKSON AVE , ESCALON June 25 , 2021 <br /> Preventing Cross Contamination <br /> 25 HSC 119309(b) Disinfectant used appropriately/sufficient contact time ❑ V ❑ COS <br /> 26 HSC 119311 (h ) Barriers used ❑ V ❑ COS <br /> 27 HSC 119311 (a) Products applied to skin are single use/dispensed aseptically ❑ V ❑ COS <br /> 28 HSC 119315 Storage of inks, pigments, needles , tubes , etc. ❑ V ❑ COS <br /> 29 HSC 119310 , 119311 Jewelry, Inks , Needles etc approved and used correctly ❑ V ❑ COS <br /> 30 HSC 119309 Cross-contamination avoided during all phases of procedure ❑ V ❑ COS <br /> Best Business Practices <br /> 31 HSC 119314 Areas separated/no living or sleeping quarters ❑ V ❑ COS <br /> 32 HSC 119314 , 119317 Floors and walls clean and in good repair, adequate light ❑ V ❑ COS <br /> 33 HSC 119314 Workstation , surfaces, including chairs , armrests , etc, in good repair ❑ V ❑ COS <br /> 34 HSC 119306 , 119312 Permit/registration posted ❑ V ❑ COS <br /> 35 HSC 119313 Operation and employee training records present ❑ V ❑ COS <br /> Compliance and Enforcement <br /> 36 HSC 119312 Plan (s) submitted for review ❑ V ❑ COS <br /> 37 HSC 119312 , 119306 Permits obtained and available ❑ V ❑ COS <br /> 38 HSC 119319 Impoundment ❑ V ❑ COS <br /> 39 HSC 119320 Hearing scheduled ❑ V ❑ COS <br /> 40 HSC 119320 Closure ❑ V ❑ COS <br /> Other Violations <br /> 41 See below Other violations ❑ V ❑ COS <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Item # Remarks <br /> 6 HSC 119315 (f) Invoices and log kept for disposable , pre-sterilized equipment. <br /> A facility that uses single use instruments shall maintain record of purchase , log of procedures , names of <br /> practitioner and client , date of procedure , instruments used , and written evidence from the manufacture that the <br /> instruments have undergone sterilization . The record of purchase , evidence of sterilization , type and number of <br /> instruments used shall be maintained for a minimum of 90 days after use . HSC 119315 (D - <br /> A sterilization certificate was not available for the Goliath Needles with the lot #18 - 10 . Provide EHD with a certificate <br /> for the Goliath Needles . <br /> FA0026071 PR0546103 SC001 06/25/2021 <br /> EHD Rev. 6/15/2021 Page 2 of 3 Body Art 01 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468 -3420 1 F 209 464 -0138 1 www . sjgov . org/ EHD <br />