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Body Art Inspection Report Date: September 6,2024 N �'`' San Joaquin County Environmental Health Department Program Mi 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: AR2400988 " •• ` (209)468-3420 c'•. �P www.siogv.orq/ehd Program bR`' Element: 4103 Facility Na ne Address City Zip Coda Colorful Acdictions 1005 E Pescadero Ave#215 Tracy 95376 Name of Parmit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type William Huggins Consultaticn The facility is inspected for compliance with Division 104, Part 15,Cha ter 7 of California Health and Safety Code(HSC). V=Violation C=Corrected On Site V CLEANING AND STERILIZATION C V I MACHINE SAFETY AND SANITATION cont. C HSC 119315-Autoclave:approved and effective-passed HSC 119311 -Parts replaced between clients-grommets, ❑ 1 integrator test El ❑ 22 elastic bands,etc. El HSC 1193D9-Items washed,disinfected,packaged, El 2' labeled,and sterilized E] PREVENTING CROSS-CONTAMINATION HSC 119315-Autoclave loaded correctly/packages El 3' allowed to dri ❑ ❑ 23. HSC 119309-Workstation/procedure area decontaminat;d El ® HSC 119315-Integrators used/monthly spore test/log 4. maintained ❑ 24. HSC 119301 -Appropriate chemical disinfectant used El ❑ ® HSC 119314-Decontamination/sanitation area separated 5. and supplied appropriately E] Chemical used: ❑ 6 HSC 119315-Invoices and log kept for disposable,pre- ❑ 25 HSC 119309-Disinfectant used appropriately/sufficient sterilzed a ui ment ❑ contact time ❑ ® HSC 119314-Sharps containers labeled,used,and 7' ro riatel El Wet contact time provided: dis osed of a ❑ 8 HSC 119310 119315-Jewely,tattoo and piercing [I ❑ 26. HSC 119314-Barriers used ❑ equipment-clean and sterilized HSC 119311 -Products applied to skin are single PRACTITIONER HEALTH AND HYGIENE El 27 use/dispensed aseptically ❑ ® 9 HSC 119309-No eating,drinking or smoking-clean ❑ ❑ 28 HSC 119309, 119311 -Storage of inks,pigments,needles, ❑ clothes tubes,etc. HSC 119310, 119311 -Jewelry, Inks,Needles etc approved El10. HSC 119308-Hands washed effectively and timely El El29. and used correctlyEl ❑ HSC 119314-Handwashing facilities properly supplied HSC 119308-Cross-contamination avoided during all 11. and accessible,warm water ❑ ❑ 30. phases of procedure El ❑ 12. HSC 119306-Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES 13. HSC 119307-Bloodborne Pathogen training ® 31. HSC 119314-Areas separated/no living or sleeping quare•s ❑ ❑ Source: ❑ ® 32 HSC 119314-Floors and walls clean and in good repair, ❑ adequate light HSC 119308-Appropriate personal protective equipment HSC 119314-Workstation,surfaces,including chairs, E] 14. available and used ❑ ® 33. armrests,etc.in good repair ❑ CUSTOMERS/CLIENTS ❑ 34. HSC 119312-Permit/registration posted ❑ HSC 119309-Branding is completed with no other HSC 119313-Operation and employee training records El 15. ❑customers in procedure area El 35' present ❑ ❑ 16. HSC 119302-Customers eighteen(18)years of age or ❑ older COMPLIANCE AND ENFORCEMENT ❑ 17. HSC 119308-Skin adequately prepared for procedure ❑ ❑ 36. HSC 119312-Plan(s)submitted for review ❑ ® HSC 119303-Client records approved and available- 18. Consent forrr and questionnaire ❑ El37. HSC 119312-Permits obtained and available El HSC 119303. 119308-Appropriate aftercare instructions El 19' iver to client El El38. HSC 119319-Impoundment ❑ MACE INE SAFETY AND SANITATION ❑ 39. HSC 119320-Hearing scheduled ❑ ❑ 20. HSC 119311 -Safe machine design ❑ ❑ 40. HSC 119312, 119317, 119320-Closure ❑ ❑ 21 HSC 119311 -Machines cleaned and disinfected between ❑ ❑ 41. ❑ clients Received by(Print): William Huggins Received by(Signature): EMAILED Phone:925-518-6573 Specialist(Tint): Sandip Singh Specialist(Signature): affwlG __ ___ __ Phone:209468-3526 61 Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 1 of 4 EH-11/17