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Body Art Inspection Report Date: San Joaquin County Environmental Health Department Program •, '.'.`` 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: (209)468-3420 •SRP F:' www.siogv.org/ehd Program Element: =acility Name Address City Zip Code Beauty By Liana 5759 pacific ave.#b105 Stockton 95207 Vame of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type _iana Hoang Consultation The above facility is inspected for compliance with Division 104, Part 15,Chapter 7 of California Heath and Safety Code(HSC). V=Violation C=Corrected On Site V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SAVITATION(cont.) C ❑ 1 Autoclave: approved and effective-passed integrator ❑ ❑ 22 Parts replaced betwee-i clients-grommets,elastic bands. test etc. Items washed,disinfected, packaged, labeled,and El 2. sterilized E] PREVENTING CROSS-CON rAMINATION ❑ 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 Decontamination/sanitation area separated and supplied ❑ ❑ 5. a ro riately ❑ Chemical used: Invoices and log kept for disposable, pre-sterilized ® 6. El El 25. Disinfectant used appropriately/sufficient contact time equipment 1:1Sharps containers labeled, used,and disposed of El 7appropriately ❑ Wet contact time proviled: ❑ 8 Jewelry,tattoo and piercing equipment-clean and ❑ ❑ 26. Barriers used ❑ sterilized Products applied to skin are single use/dispensed PRACTITIONER HEALTH AND HYGIENE El 27 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, ❑ ❑ 30 Cross-contamination a ioided during all phases of ❑ warm water procedure ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ® 13. Bloodborne Pathogen trainingE] ❑ 31. Areas separated/no living or sleeping quarters E] Source: 32. Floors and walls clean and in good repair, adequate light ❑ Appropriate personal protective equipment available and Workstation,surfaces, including chairs, armrests,etc. in ❑ 14 El 33.used ❑ good repair ❑ CUSTOMERS/CLIENTS El 34. Permit/registration pos-ed ❑ Branding is completed with no other customers in El 15. rocedure area E] ❑ 35. Operation and employee training records present ❑ ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ ❑ Client records approved and available-Consent form 18. ❑ ❑ El37. Permits obtained and available and 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 by(Print): Liana Hoang-EMAILED Received by(Signature): Phone:209-373-5889 Specialist(Print): Sandip Singh Specialist(Signature): Phone: 209-468-3526 Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 3 EH-11/17