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#0 '00e, Body Art Inspection Report Date: December 1,2023 2San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Recofd: PR0515394 (209)468-3420 w .sioov"omlehd Program eoElement: 4120 Facility Name Address City Zip Code 12 Monkeys Tattoo 911 Central Ave Tracy 95376 Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type Jon Highland 6/30/24 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 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, 11 El ❑ integrator test 22' elastic bands,etc. HSC 119309-Items washed,disinfected,packaged, El 2' labeled,and sterilized ❑ .PREVENTING CROSS-CONTAMINATION ❑ 3 HSC 119315-Autoclave loaded correctly/packages ❑ ❑ 23. HSC 119309-Workstation/procedure area decontaminated ❑ allowed to dry ❑ 4 HSC 119315-Integrators used/monthly spore tesVlog ❑ 24. HSC 119301 - maintained ❑ Appropriate chemical disinfectant used El 5 HSC 119314-Decontaminationtsanilation area separated and supplied appropriately ❑ Chemical used: ❑ 6 HSC 119315-Invoices and log kept for disposable,pre- ❑ 25 HSC 119309-Disinfectant used appropriately/sufficient sterilized equipment El time ❑ ❑ 7 HSC 119314-Sharps containers labeled,used,and disposed of appro datel ❑ 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 ❑ HSC 119309-No eating,drinking or smoking-clean HSC 119309, 119311-Storage of inks,pigments,needles, ❑ 9' clothes ❑ ❑ 28' tubes,etc. ❑ ❑ 10. HSC 119308-Hands washed effectively and timely ❑ ❑ 49 HSC 119310, 119311 -Jewelry,Inks,Needles etc.approved E]and used correct) HSC 119314-Handwashing facilities properly supplied HSC 119308-Cross-contamination avoided during all ❑ 11. and accessible,warm water ❑ ❑ 30' hases of procedure El ❑ 12. HSC 119306-Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES 13. HSC 119307-Bloodbome Pathogen training El 31. HSC 119314-Areas separated/no living or sleeping quarters ❑ ® Source: El ® 32 HSC 119314-Floors and walls clean and in good repair, ❑ adequate fi ht ❑ 14 HSC 119308-Appropriate personal protective equipment HSC 119314-Workstation,surfaces,including chairs, ❑ available and used ❑ ® 33' armrests,etc.in good repair CUSTOMERS/CLIENTS ❑ 34. NSC 119312-Permi tregistration posted ❑ HSC 119309-Branding is completed with no other HSC 119313-Operation and employee training records El 15. 35 customers in procedure area ❑ ® ' resent E) HSC 119302-Customers eighteen(18)years of age or El i6. 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- ❑78' El Consent form and uestionnaire ® 37. HSC 119312-Permits obtained and available HSC 119303, 119308-Appropriate aftercare instructions 19" ❑ ❑ 38. HSC 119319-Impoundment given to client ❑ 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 r11 41 ❑ clients Received by(Print): Jon Highland Received by(Signature): EMAILED Phone:209-839-1265 Reinspection onlabout: A reinspection fee of$162 per hour may be charged. Page 1 of 4 EH-11/17