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Body o Y Art Ins pec& Report Date: 3/l/16 San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: QHS y Oo 3 q (209)468-3420 www.s6ogv.oro/ehd Program !FoR-� Element: y i� Facility Name Address City Zip Code New Life Tattoo 3414 delaware ave. Stockton 95204 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Americo Salazar Jr. 6/30/18 Routine The above 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 ,wry ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, E]test etc. El 2 Items washed,disinfected, packaged,labeled, and ❑ a, sterilized ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ ❑ 4. integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used Decontamination/sanitation area separated and supplied El [j 5. a ro riatel E] Chemical used: Clorox wipes,Madacide Invoices and log kept for disposable, pre-sterilized ® 6• equipment El El25. Disinfectant used appropriately/sufficient contact time Sharps containers labeled, used,and disposed of E]❑ 7' a ro riately El Wet contact time provided: 4 min,30 sec Jewelry,tattoo and piercing equipment-clean and El 8' [I El 26. Barriers used E]sterilized ahr ( r' Products applied to skin are single use/dispensed RALT. R Y,G1 ; � El 27` asepticallyEl 1 -5 ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments, needles,tubes,etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of El 11. warm water El ❑ 30. procedure ❑ ,,. IR ❑ 12. Hepatitis B vaccination ❑ ' ,EA« ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ Source: Cathy Montie El32. Floors and walls clean and in good repair,adequate light E] Appropriate personal protective equipment available and Workstation,surfaces, including chairs, armrests,etc.in ❑ 14. used ❑ ❑ 33` good repair ❑ NO, G 1......TS <, 34. Permit/registration posted El Branding is completed with no other customers in ❑ 15. El El® 35. Operation and employee training records present procedure area ® 16. Customers eighteen(18)years of age or older ❑ ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ Client records approved and available-Consent form ® 18. 11 El 37. Permits obtained and available and questionnaire ® 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ 0WfiwaA,_D,$A ,T O $ .;,M. ❑ 39. Hearing scheduled El ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received by(Print): Americo Salazar Jr. Received by(Signature): rnt") Phone:(209)405-8951 Specialist(Print): Navjot Sahota Specialist(Signature): Phone:(209)468-3178 Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 EH-11/17 V