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/. Body Art Inspection Report Date: October 6, 2021 San Joaquin County Environmental Health Department Program l 1868 E. Hazelton Ave., Stockton, CA 95205 Record: SR0084278 •� (209) 468-3420 www.siogv.org/ehd Program 9'.FgRr'' Element: 4103 Facility Name Address City Zip Code Shauna HEro Beauty/Styles Salon 902 W Lodi Ave Lodi 95240 Name of P--rmit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Shauna Hall Consultation 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 test El El 22. 22. replaced between clients - grommets, elastic bands, El etc. ❑ 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. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used El E] 5. Decontamination/sanitation area separated and supplied ElChemical used: appropriately ® 6. Invoices and log kept for disposable, pre -sterilized ❑El25. Disinfectant used appropriately/sufficient contact time E]equipment ❑ 7' Sharps containers labeled, used, and disposed of ElWet contact time provided: ro riatel appropriately ❑ 8. 8. Jewelry, tattoo and piercing equipment - clean and El El 26. Barriers used sterilized 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 E]Handwash ® 11. ng facilities properly supplied and accessible, El El 30. Cross -contamination avoided during all phases of procedure El warm water ❑ 12. Hepatitis B vaccination ElBEST BUSINESS PRACTICES 13. Bloodborne Pathogen trainingEl❑ Areas separated/no living or sleeping quarters El31. ❑ 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 good repair CUSTOMERS/CLIENTS ❑ 34. Permit/registration 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 ❑ ® 18. Client records approved and available - Consent form and El El 37. Permits obtained and available questionnaire ❑ 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 Ly (Print): Shauna Hal Received by (Signature): Phone: 209-629-6353 Specialist Print): Pinne Chao Specialist (Signature): Phone: 209-468-3854 Reinspect on on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH -11/17