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'U , <br /> ° Body Art Inspection Report Date: July 12, 2021 <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E. Hazelton Ave., Stockton, CA 95205 Record: New PR# <br /> (209) 468-3420 <br /> 'CC,Q 5Q' • w sioov.org/ehd Program <br /> r # p. ,i Element: 4120 <br /> Facility Name Address City Zip Code <br /> Permanent Cosmetics by Gayle and Kristen 401 W. Pine St. Lodi 95240 <br /> Name of PermiVRegistration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Kristen Patterson-Cranford 6/30/22 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 /> El1 . Autoclave: approved and effective - passed integrator test [I E) 22. tc.22. Parts replaced between clients - grommets, elastic bands, ❑ <br /> Items washed, disinfected, packaged, labeled, and <br /> El 2' sterilized ❑ 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 /> Decontamination/sanitation area separated and supplied ❑ ❑ <br /> ❑ 5' ❑ Chemical used: <br /> aro riatel <br /> ❑ <br /> Invoices and log kept for disposable, pre-sterilized 6. ❑ El25. Disinfectant used appropriately/sufficient contact time Elequipment <br /> Sharps containers labeled, used, and disposed of <br /> El T <br /> appropriately ❑ Wet contact time provided: <br /> ❑ <br /> Jewelry, tattoo and piercing equipment - clean and 8' El 2s. 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 /> ❑ <br /> Handwashing facilities properly supplied and accessible,11 . ❑ ❑ 30. Cross-contamination avoided during all phases of procedure Elwarm water <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingElElEl31 . Areas separatedlno living or sleeping quarters <br /> Source: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ <br /> ❑ <br /> Appropriate personal protective equipment available and Workstation, surfaces, including chairs, armrests, etc. in 14. used ❑ ❑ 33' good repair ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. ❑ ❑ 35. Operation and employee training records present <br /> procedure area ❑ <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 and <br /> E] 18. El El 37. Permits obtained and available Eluestionnaire <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION _ ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design NEI <br /> ❑ 40. Closure 11 <br /> 0.. <br /> Machines cleaned and disinfected between clients ❑ 41 . ❑ <br /> Received by (Print): Kristen Patterson-Cranford Received by (Signature): Phone: 209-329-7846 <br /> Specialist (Print): Sandip Singh Specialist (Signature): Phone:209-468-3526 <br /> Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />