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t' RCVISED Body Art Inspection Report Date: 18 LZ I /Q San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: SZOU B 3 5 93 P (209)468-3420 Program www.siopv.org/ehd 9 W V Element: Facil ty Naroe Address City Zip Code Beatty By Liana 5759 pacific ave.#b105 Stockton 95207 Nam-3 of Perm iURegistration 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 SANITATION cont. C F1 1 Autoclave: approved and effective-passed integrator El 22 Parts replaced betweei clients-grommets, elastic bands, Eltest etc. Items washed,disinfected, packaged, labeled, and F1 2' sterilized E] PREVENTING CROSS-CON-AMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical aisinfectant used Decontamination/sanitation area separated and supplied El El 5' appropriately El Chemical used: ® Invoices and log kept for disposable, pre-sterilized 6. L1 ❑ 25. Disinfectant used appropriately/sufficient contact time equipment ElSharps containers labeled, used, and disposed of F-1 7' a ro riatel ❑ Wet contact time provided: Jewelry,tattoo and piercing equipment-clean and 8. sterilized El El 26. Barriers used El 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 Ltc approved and used correctly ❑ Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of ® 11 warm water El ❑ 30. procedure El ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ® 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ Source: ® 32. Floors and walls clean and in good repair, adequate light ❑ Appropriate personal protective equipment available and El E-1 surfaces, ncluding chairs, armrests,etc. in El❑ 14. used ❑ 33. ood repair CUSTOMERS/CLIENTS ❑ 34. Permit/registration post--d El Branding is completed with no other customers in F-1 15. rocedure area El ❑ 35. Operation and employee training records present El ❑ 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. iEl El 37. Permits obtained and available and questionnaire ❑ ® 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACFINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received b.r(Print): Liana Hoang-EMAILED Received by(Signature): Phone:209-373-5889 Spec alist(Tint): Sandip Singh Specialist(Signature): &J,11112 J, Phone: 209-468-3526 F einspecior on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 EH-11117