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s , Body Art Inspection Report Date: January 31,2023 <br /> San Joaquin County Environmental Health Department <br /> Program <br /> i 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> �t,'•., Record: PR0526733 <br /> (209)468-3420 <br /> wWW.slOgy.Orq/ehd Program <br /> Jj�4�gar0 R��': <br /> Element: 4120 <br /> Facility Name Address City Zip Code <br /> The Pirates Lounge Tattoo Parlor 2714 Country Club Blvd#F Stockton 95204 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> John Holcomb 6/30/23 Routine <br /> The above facility is inspected for compliance with Division 104,Part 15,Chapter 7 of California Health and Safety Code(HSC). <br /> V=Violation C=Corrected On Site <br /> V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont.) C <br /> ❑ 1. Autoclave:approved and effective-passed integrator test [I ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> etc. <br /> ❑ 2 Items washed,disinfected,packaged, labeled,and <br /> sterilized 11PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used <br /> ❑ 5 Decontamination/sanitation area separated and supplied ❑ Elappropriately <br /> E] Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment E] ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ <br /> ® 7 Sharps containers labeled, used,and disposed of <br /> ElWet contact time provided: <br /> appropriately <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> ❑ ❑ 26. Barriers used Elsterilized <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ [:1 29. Jewelry,Inks, Needles etc approved and used correctly ❑ <br /> Handwashing facilities properly supplied and accessible, <br /> El 11. warm water El El30. Cross-contamination avoided during all phases of procedure E] <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> E] 13. Bloodborne Pathogen training El <br /> 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ® 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in 14. used El El 33. good repair ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. rocedure area ❑ ® 35. Operation and employee training records present El <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ <br /> ® <br /> Client records approved and available-Consent form and 18. uestionnaire El ® 37. Permits obtained and available ❑ <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. 1 Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑1 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ <br /> Received by(Print): John Holcomb Received by(Signature): EMAILED Phone:(209)200-3614 <br /> Specialist(Print): Sandip Singh Specialist(Signature): aadtc�i,A dirt Phone:(209)468-3526 <br /> Reinspection on/about: A reinspection fee of$156 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br /> I <br />