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u1N Body Art InspectieReport9/27 / 11 Date: San Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 • Record: 1 i (209) 468-3420 www.siogv.org/ehd Program -tiro r''p/ Element: I Facility Name Address City Zip Code Salon De Bellezza 5940 pacific ave Stockton 95207 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Lorlie Ty Final Insection The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safety Code (HSC). V = Violation C = Corrected On Site V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION (cont.) C ❑ 1 Autoclave: approved and effective - passed integrator El ❑ 22' Parts replaced between clients - grommets, elastic bands, ❑ test etc. ❑ 2 Items washed, disinfected, packaged, labeled, and ❑ sterilized PREVENTING CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated El ❑ 4. Integrators used/monthly spore testllog maintained ❑ El 24. Appropriate chemical disinfectant used ❑ ❑ 5 Decontamination/sanitation area separated and supplied ❑ Chemical used: Sani-cloth a ro riatel ® 6 Invoices and log kept for disposable, pre -sterilized El 25. Disinfectant used appropriately/sufficient contact time equipment 13❑ 7 Sharps containers labeled, used, and disposed of E]a Wet contact time provided: 30 secs, 10 mins for HIV ro riatel ❑ 8 Jewelry, tattoo and piercing equipment - clean and El [126. Barriers used El sterilized ❑ 27' Products applied to skin are single use/dispensed PRACTITIONER HEALTH AND HYGIENE aseptically❑ ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ❑ 11. Handwashing facilities properly supplied and accessible, F1 ❑ 30' Cross -contamination avoided during all phases of ❑ warm water rocedure ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ❑ 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ ❑ Source: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 14. Appropriate personal protective equipment available and ❑ ❑ 33 Workstation, surfaces, including chairs, armrests, etc. in ❑ used ood repair CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ ❑ 15 Branding is completed with no other customers in El El 35. Operation and employee training records present E] rocedure area ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s) submitted for review ❑ ❑ 18 Client records approved and available - Consent form ❑ El 37. Permits obtained and available uestionnaire ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received by (Print): Lorlie Ty Received by (Signature): Phone: (209) 644-8111 Specialist (Print): Mai Vue Specialist (Si nature): Phone: (209) 468-3284 Reinspecion on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH -11/17