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n n �q, Body Alt Inspection Report Date: 11/22/2024 e San Joaquin County Environmental Health Department Program N: ..� 1668 E.Hazelton Ave.,Stockton,CA 95205 Record: AP2401305 (209)468-3420 • c° �' wwwsiocv.orolehd Program ''ciFo�iN Element: Facility Name Address city Zip Code Skin&Shades 37 W.Yokuts Ave.STE B Studio 21 Stockton 95207 Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type Jennie Rodriguez consultation 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 MACHINE SAFETY AND SANITATION. cont O HSC 119315-Autoclave: approved and effective-passed HSC 119311 -Parts replaced between clients-grommets, Eli integrator test ❑ ❑ 22' elastic bands,etc. El ❑ HSC 119309-Items washed,disinfected, packaged,2. labeled,and sterilized ❑ PREVENTING CROSS-CONTAMINATION ❑ HSC 119315-Autoclave loaded correctly/packages 3' allowed to d ❑ ❑ 23. HSC 119309-Workstation/procedure area decontaminated El ❑ HSC 119315-Integrators used/monthly spore test/log 4' maintained Eli 24. HSC 119301 -Appropriate chemical disinfectant used HSC 119314-Decontamination/sanitation area separated ❑ ❑ El 5' and supplied appropriately ❑ Chemical used: ❑ 6 HSC 119315-Invoices and log kept for disposable,pre- ❑ 25 HSC 119309-Disinfectant used appropriately/sufficient sterilized a ui menit ❑ contact time ❑ HSC 119314-Sharps containers labeled, used, and ❑ 7' disposed of appro riatel ❑ Wet contact time provided: 8 HSC 119310, 119315-Jewelry,tattoo and piercing ❑ ❑ 26. HSC 119314-Barriers used ❑ equipment-clean and sterilized HSC 119311 -Products applied to skin are single PRACTITIONER HEALTH AND HYGIENE ❑ 27' use/dispensed aseptically ❑ ® 9 HSC 119309-No eating,drinking or smoking-clean ® ❑ 28 HSC 119309, 119311 -Storage of inks,pigments,needles, El 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 I HSC 119308-Cross-contamination avoided during all 11. and accessible warm water ❑ ❑ 30' phases of rocedure ❑ ❑ 12. HSC 119306-Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES 13. HSC 119307-Bloodborne Pathogen training ❑ 31. HSC 119314-Areas separated/no living or sleeping quarters ❑ ❑ Source: El HSC 32 HSC 119314-Floors and walls clean and in good repair, adequate light El 14. HSC 119308-Appropriate personal protective equipment HSC 119314-Workstation,surfaces, including chairs, available and used El ❑ 33. armrests etc.in good repair ❑ CUSTOMERS/CLIENTS ❑ 34. HSC 119312-Permittregistration posted ❑ HSC 119309-Branding is completed with no other HSC 119313-Operation and employee training records El 15. customers in procedure area El ❑ 35' resent ❑ El 16. HSC 119302-Customers eighteen(16)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 form and uestionnaire El ❑ 37. HSC 119312-Permits obtained and available ❑ 19 HSC 119303, 119308-Appropriate aftercare instructions ❑ ❑ 38. HSC 119319-Impoundment ❑ given to client MACHINE SAFETY AND SANITATION ❑ 39. HSC 119320-Hearing scheduled ❑ ❑ 2 HSC 9311 -Safe machine design ❑ ❑ 40. HSC 119312, 119317, 119320-Closure ❑ ❑ 21 HSC 119311 -Machines cleaned and disinfected between 41' HSC 119309 The practitioner shall maintain a clean clients ® and sanitary environment. Received b (Print):Jennie Rodriguez Received b Si nature : E ILED Phone:209 403-4216 Specialist(Print): Stephanie Ramirez Specialist(Signature): .L.JnM ' Phone.209-616-3069 T� e r Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 1 of 2 EH-11/17