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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0547051
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COMPLIANCE INFO
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Entry Properties
Last modified
9/13/2024 11:57:55 AM
Creation date
7/31/2024 1:47:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0547051
PE
4120
FACILITY_ID
FA0026674
FACILITY_NAME
PERMANENT COSMETICS BY GAYLE & KRISTEN
STREET_NUMBER
401
Direction
W
STREET_NAME
PINE
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
401 W PINE ST
P_LOCATION
02
QC Status
Approved
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EHD - Public
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Body Art Inspeco Report Date: / r' <br /> a <br /> N San Joaquin County Environmental Health Department Program 912- 0 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 1 12 0 <br /> (209)468-3420 Program �'��(('' <br /> www.siogv.orq/ehd Element: PR Us2 q�I Il.( <br /> Facility Name Address City Zip Code <br /> Ciao Bella Salon 1 w pine street Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Kristen Patterson-Cranford Final Inspection <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 /> ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, El <br /> ::Letc. <br /> Items washed,disinfected,packaged, labeled,and <br /> El 2" sterilized E] PREVENTING 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 /> Ej Decontamination/sanitation area separated and supplied El <br /> 5' a ro riatel 11Chemical used: Caviwipes <br /> Invoices and log kept for disposable,pre-sterilized <br /> 6" ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled,used,and disposed of <br /> 7" a ro riatel El Wet contact time provided: <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and 8' ❑ [_1 26. Barriers used <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27' asepticallyEl <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, Cross-contamination avoided during all phases of <br /> El warm water ❑ ❑ 30' procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Biologix ❑ 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 ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> E3 15. procedure area El ❑ 35. 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 /> Client records approved and available-Consent form <br /> El 18. uestionnai ❑ ❑ 37. Permits obtained and available <br /> and re ❑ <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 ❑ rElr41.T ❑ <br /> Received b (Print): Kristen Patterson-Cranford Received by(Signature): Phone: 209 329-7846 <br /> Specialist(Print): Mai Vue Specialist(Signature): Phone: (209)468-3284 <br /> Reinspecion oniabout: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />
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