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E <br /> PQu`" Body Art InspeA Report 46 Date: t / <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> Record: <br /> � p, (209)468-3420 Program �� T— <br /> d<rFoaa` www.siogv.orp/ehd <br /> Element: <br /> Facility Name Address City Zip Code <br /> Secret Sidewalk Tattoo 8 w. 11 u'st. Tracy 95376 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Eddy Reyes 6/30/17 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 Parts replaced between clients-grommets,elastic bands, <br /> test El ❑ 22" etc. El <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized E] PREVENTING 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 ❑ <br /> appropriately ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment El El25. 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 /> sterilized ❑ El 26. Barriers used ❑ <br /> ❑ 27 Products applied to skin are single use/dispensed ElPRACTITIONER HEALTH AND HYGIENE 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 ❑ ❑ 29. Jewelry,Inks,Needles etc approved and used correctly ❑ <br /> ❑ 11 Handwashing facilities properly supplied and accessible, ❑ Cross-contamination avoided during all phases of ❑ <br /> warm water El30" procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and ❑ [133 Workstation,surfaces,including chairs,armrests,etc.in ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area [I El 35. Operation and employee training records present ❑ <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 /> ® 18 Client records approved and available-Consent form <br /> and questionnaire E] El 37. Permits obtained and available El <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ <br /> Received by(Print): Eddy Reyes Received by(Signature): Phone:(209)879-9411 <br /> Specialist(Print): Benjamin Escotto,Sr REHS Specialist(Signature): 1 ivw ry Phone:(209)468-3178 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />