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�qu I N•. � Body Art Inspection Report Date: May 1, 2026 San Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0548626 (209)468-3420 Program �t`q �P www.siogv.ora/ehd Element: 4120 Facility Name Address City Zip Code Adorn Me Tattoo 5759 Pacific Ave #B145 Stockton 95207 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Jennifer Bou 6/30/26 Routine The facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safety Code (HSC). V = Violation C = Corrected On Site V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont. C ❑ 1 HSC 119315 - Autoclave: approved and effective - passed HSC 119311 - Parts replaced between clients - grommets, ❑ integrator test ❑ ❑ 22' elastic bands, etc. ❑ 2 HSC 119309 - Items washed, disinfected, packaged, labeled, and sterilized ❑ PREVENTING CROSS-CONTAMINATION ❑ HSC 119315 - Autoclave loaded correctly/packages 3' allowed to d ElEl23. HSC 119309 - Workstation/procedure area decontaminated ❑ ❑ 4 HSC 119315 - Integrators used/monthly spore test/log El24. HSC 119301 - Appropriate chemical disinfectant used maintained El ❑ ❑ 5 HSC 119314 - Decontamination/sanitation area separated and supplied appropriatelyEl Chemical used: Cavicide and Caviwipes ❑ 6 HSC 119315 - Invoices and log kept for disposable, pre- ❑ 25 HSC 119309 - Disinfectant used appropriately/sufficient sterilized a ui ment ❑ contact time ❑ ® HSC 119314 - Sharps containers labeled, used, and 7' disposed of a ro riatel El Wet contact time provided: 3 mins (spray) and 1 min (wipes) ❑ $ HSC 119310, 119315 - Jewelry, tattoo and piercing equipment - clean and sterilized ❑ ❑ 26. HSC 119314 - Barriers used El El HSC 119311 - Products applied to skin are single PRACTITIONER HEALTH AND HYGIENE 27' use/dispensed asepticallyEl ❑ 9 HSC 119309 - No eating, drinking or smoking - clean ❑ ❑ 28 HSC 119309, 119311 - Storage of inks, pigments, needles, ❑ clothes tubes, etc. ❑ 10. HSC 119308 - Hands washed effectively and timely ❑ ❑ 29 HSC 119310, 119311 - Jewelry, Inks, Needles etc approved ❑ and used correct) ❑ HSC 119314 - Handwashing facilities properly supplied and HSC 119308 - Cross-contamination avoided during all ❑11. accessible, warm water ❑ ❑ 30. phases of procedure ❑ 12. HSC 119306 - Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES 13. HSC 119307 - Bloodborne Pathogen training ro 31. HSC 119314 - Areas separated/no living or sleeping quarters ElSource: HSC 119314 - Floors and walls clean and in good repair, 32. ade uate Ii ht El❑ 14 HSC 119308 -Appropriate personal protective equipment HSC 119314 -Workstation, surfaces, including chairs, Elavailable and used El 33' armrests, etc. in good repair CUSTOMERS/CLIENTS ❑ 34. HSC 119312 - Permit/registration posted ❑ ❑ 15. HSC 119309 - Branding is completed with no other HSC 119313 - Operation and employee training records customers in rocedure area El ❑ 35' El HSC 119302 - Customers eighteen (18) years of age or El 16. older El 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 form and uestionnaire El El37. HSC 119312 - Permits obtained and available El ❑ HSC 119303, 119308 - Appropriate aftercare instructions 19' iven to client ❑ El38. HSC 119319 - Impoundment El MACHINE 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): Jennifer Bou Received by (Signature): EMAILED Phone: 209-326-3940 Specialist (Print): Sandip Singh Specialist (Signature): Phone: 209-468-3526 Reinspection on/about: A reinspection fee of $179 per hour may be charged. Page 1 of 2 EH- 7-1-25