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,{"QUIN <br /> ,.y............n, <br /> . ..E-F'_oZ� Body Art Inspection Report Date: 8-15-2023 <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: SR0087036 <br /> r (209)468-3420 <br /> C' P•' www.siogv.orq/end Program <br /> gciFaa?j Element: 4103 <br /> Facility Name Address City Zip Code <br /> Tantra Ink House of Permanent Makeup 445 W Weber Avenue Suite#232 Stockton 95203 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Lynda Diaz Consultation <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 /> ❑ 1. Autoclave:approved and effective-passed integrator test ❑ El22• 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 ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used <br /> ❑ 5 Decontamination/sanitation area separated and supplied ❑ ❑ <br /> appropriately <br /> El Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6. ❑ El25. Disinfectant used appropriately/sufficient contact time ❑ <br /> equipment <br /> Sharps containers labeled,used,and disposed of <br /> El 7' ❑ Wet contact time provided: <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> 8' El El26. Barriers used Elsterilized <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 ❑ 30. Cross-contamination avoided during all phases of procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ 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 good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. procedure area El El35. Operation and employee training records present El <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. ❑ ❑ 37. Permits obtained and available <br /> questionnaire ❑ <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled Q <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. j ❑ <br /> Received by(Print): Lynda Diaz Received by(Signature): emailed Phone: <br /> Specialist(Print): Stephanie Ramirez Specialist(Signature): phone:209-616-3069 <br /> Reinspection on/about: A reinspection fee of$162 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />