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- -' Body Art Inspection Report Date: May 14,2021 <br /> San Joaquin County Environmental Health Department Program <br /> t him' 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: SR0083667 <br /> :u I <br /> (209)468-3420 <br /> C - P www.siopv.org/ehd grogram <br /> -lement: 4103 <br /> Facility Name Address City Zip Code <br /> Perfect Balance Salon 401 W Pine St. Lodi 95240 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Kristen Patterson-Cranford 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 /> ❑ 1. Autoclave:approved and effective-passed integrator test ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> etc. <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 /> Decontamination/sanitation area separated and supplied ® ❑ <br /> ❑ 5. appropriately ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> El ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> equipment E]Sharps containers labeled,used,and disposed of <br /> ❑ 7' <br /> appropriately <br /> E] Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8 ❑ ❑ 26. Barriers used E]sterilized <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,pigmerts,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 /> F1 11. warm water ❑ El30. Cross contamination avoided during all phases of procedure 171 <br /> ❑ 12. Hepatitis B vaccination ❑ <br /> BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training El ® E]31. Areas separated/no living or sleeping quarters <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces, including chairs,armrests,etc.in <br /> F-1 14. F-1used ❑ 33' good repair <br /> El <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> ❑ 15. procedure area ❑ ® 357 Operation and employee training records present ❑ <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ [1 36. Plan(s)submitted for review ❑ <br /> ® <br /> Client records approved and available-Consent form and 18. ❑ ❑ 37. Permits obtained and available E]uestionnaire <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 ❑ ❑ 41. ❑ <br /> Received by(Print): Kristen Patterson-Cranford Received by(Signature): EMAILED 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 3 <br /> EH-11/17 <br />