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Body Art Inspection Report Date: May 18, 2022 San Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: SR0085254 (209)468-3420 w .sioov.ora/eho Program Element: 4103 Facility Name Master Your E Name of Permlt/Registration Holder Address 3031 W March Lane #104 Permit Exp. Date Time In City ZipCode Stockton 95219 Time Out Inspection Type Mariana Castillo Consultation The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safely 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 test El El 22. Parts replaced between clients -grommets, elastic bands, Eletc. El 2' Items washed, disinfected, packaged, labeled, and El sterilized CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 4. Integratorsused/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used ❑ ElE] 5'I Decontamination/sanitation area separated and supplied ❑ Chemical used: appropriately El 6. Invoices and log kept for disposable, pre -sterilized El1125. Disinfectant used appropriately/sufficient contact time equipment El ❑ 7. containers labeled, used, and disposed of ❑ Wet contact time provided: appropriately E] 8' Jewelry, tattoo and piercing equipment - clean and El El 26, Barriers used Elsterilized PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed 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 ❑ El 11. Handwashing facilities properly supplied and accessible, [I El30. Cross -contamination avoided during all phases of procedure El warm water ❑ 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 andin good repair, adequate light ❑ ❑ 14. Appropriate personal protective equipment available and El ® 33' Workstation, surfaces, including chairs, armrests, etc. in El used good repair CUSTOM ERS/CLIENTSEl34. Permitiregistration posted ❑ ❑ 15. Branding is completed with no other customers in ❑ ❑ 35. Operation and employee training records present Elrocedure 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 ❑ El 18. Client records approved and available - Consent form and ❑ ❑ 37. Permits obtained and available Eluestionnaire ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑ j 20. 1 Safe machine design ❑ ❑ 40. Closure ❑ El21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received by (Print): Mariana Castillo Received by (Signature): EMAILED Phone: 209-915-7553 Specialist (Print): Sandip Singh Specialist (Signature): �'��'b f Phone: 209-468-3526 Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH -11/17