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ZraVI5FD <br /> ` , Body Art Inspection Report Date: <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PIZO 5'i$ 3 A C <br /> (209)468-3420 <br /> P: Program <br /> i`- www.siogv.org/ehd ■_/'�O <br /> Element: '7 <br /> Facility Name Address City Zip Code <br /> Brows By Michelle Grace 37 w yokuts ave.#b Stockton 95207 <br /> Name of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Michelle Tabancura 6/30/21 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 /> ❑ 1 Autoclave: approved and effective-passed integrator El ❑ 22 Parts replaced between clients-grommets, elastic bands, Eltest etc. <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 /> El5. appropriately ❑ Chemical used: <br /> Invoices and log kept for disposable, pre-sterilized <br /> El 6' El El25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled, used,and disposed of <br /> ❑ 7' ❑ Wet contact time provided: <br /> appropriately <br /> F� 8. <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ ❑ 26. Barriers used Elsterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27' ase ticall FED <br /> ❑ 9. No eating,drinking or smoking-clean clothes El ❑ 28. Storage of inks,pigments, needles,tubes,etc. <br /> El10. Hands washed effectively and timely El ❑ 29. Jewelry, Inks, Needles etc approved and used correctly <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of El <br /> El 11. 30 <br /> warm water ❑ ❑ . procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training El ❑ 31. Areas separated/no living or sleeping quarters El <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and ❑ ® 33 Workstation,surfaces, including chairs,armrests,etc. in ❑ <br /> used good repair <br /> (� OW,,; ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> IEl <br /> 15. ❑ El35. Operation and employee training records present <br /> procedure area <br /> ❑ <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 /> ❑ <br /> Client records approved and available-Consent form ❑ <br /> and uestionnare 18. i El El 37. Permits obtained and available <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): Michelle Tabancura Received by(Signature): Eye A.1 Phone:209-762-2669 <br /> Specialist(Print): Sandip Singh Specialist(Signature): (JAIA- „ Phone: 209-468-3526 <br /> Reinspecion on/about: A reinspection fee of$152 er hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />