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Body Art Inspection Report Date: <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> s P;% (209)468-3420 Program <br /> gL,FpR� www.siogv.org/ehd Element: <br /> Facility Name Address City Zip Code <br /> Beida's Beauty Salon 222 w river rd.ste.a Ripon 95366 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Maria Caballero Consulation <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, Eltest etc. <br /> ❑ <br /> Items washed,disinfected, packaged, labeled, and 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 ❑ [:1 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5' ❑ Chemical used: Barbicide <br /> appropriately <br /> Z 6. <br /> ro riatel <br /> Invoices and log kept for disposable,pre-sterilized <br /> ® 6' El El 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> E]Sharps containers labeled, used,and disposed of <br /> ® 7' Elaro appropriately Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. El El 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 11. warm water El ❑ 30. procedure El <br /> ® 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen trainingEl ❑ 31. Areas separated/no living or sleeping quarters El <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 /> El 14. used El ❑ 33. good repair <br /> E] <br /> A ❑ <br /> � d ❑ 34. PermiUregistration posted <br /> CUSTOMERS/CLIEITS, <br /> ❑ <br /> Branding is completed with no other customers in 15. ❑ ® 35. Operation and employee training records present Elrocedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. 1 Plan(s)submitted for review ❑ <br /> ® <br /> Client records approved and available-Consent form 18. El El 37. Permits obtained and available <br /> and questionnaire <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 /> rD 21. Machines cleaned and disinfected between clients ❑ [:141. El <br /> Received by(Print): Maria Caballero Received by(Signature): Phone:209-595-6888 <br /> Specialist(Print): Sandip Singh Specialist(Signature): Phone: 209-468-3526 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br />