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Body Art Inspection Report Date: <br />San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Record: <br />(209) 468-3420 <br />August 16, 2022 <br />PR0547890 <br />\0www.s6oay.ora/ehd Program <br />�rFo� Element: 4120 <br />Facility Name Address City Zip Code <br />Revive Me Aesthetics 445 W Beverly Place Tracy 95376 <br />Name of Permit/Registration Holder Permit Exp, Date Time In Time Out Inspection Type <br />Dr. Luis Melendez 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, elastic bands, <br />El 1. Autoclave: approved and effective -passed integrator test El El 22. etc. El <br />Items washed, disinfected, packaged, labeled, and <br />El 2' sterilized El CROSS -CONTAMINATION <br />❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated El <br />El Integrators used/monthly spore test/log maintained El 24, Appropriate chemical disinfectant used <br />Decontamination/sanitation area separated and supplied ❑ ElEl5' appropriately ❑ Chemical used: <br />Invoices and log kept for disposable, pre -sterilized <br />❑ 6. equipment ElEl25. Disinfectant used appropriately/sufficient contact time ❑ <br />Sharps containers labeled, used, and disposed of <br />El 7appropriately❑ Wet contact time provided: <br />❑ <br />Jewelry, tattoo and piercing equipment - clean and 8' sterilized El El 26, Barriers used El <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. warm water El El30. Cross -contamination avoided during all phases of procedure El <br />❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br />❑ 13. Bloodborne Pathogen training ❑ El 31, Areas separated/no living or sleeping quarters El <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 ❑ ❑ 33' ood repair El <br />CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br />❑ <br />Branding is completed with no other customers in 15. procedure area El 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 />® <br />Client records approved and available - Consent form and 18. El [: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. 1 ❑ <br />Received by (Print): Alaa Abdallah <br />Received <br />Emailed <br />Phone: 661-436-9178 <br />Reinspection on/about: A reinspection fee of $156 per hour may be charged. Page 1 of 2 <br />EH -11/17 <br />