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')O PQ•t'ry".O Body Art Insped on ReportDate: _311411f San Joaquin County Environmental Health Department Program y, { 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: c P (209)468-3420 Program 9<jFea�� www.siogv.org/ehd Element: yt Facility Name Address City Zip Code The Studio 2441 s.stockton st.,suite#5 Lodi 95240 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Rosemarie Haas 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 V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont C ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, [ test etc. Items washed,disinfected,packaged,labeled,and El 2. sterilized El CROSS-CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated [ ❑ 4. Integrators used/monthly spore test/log maintained ❑ Q 24. Appropriate chemical disinfectant used Decontamination/sanitation area separated and supplied [ El 5. El Chemical used: Cavicide appropriately Invoices and log kept for disposable,pre-sterilized ® 6• equipment ❑ 25. Disinfectant used appropriately/sufficient contact time Sharps containers labeled,used,and disposed of C El 7 a ro riatel El Sharps contact time provided: 3 min Jewelry,tattoo and piercing equipment-clean and El8. sterilized El El 26. Barriers used [ Products applied to skin are single use/dispensed PRACTITIONER HEALTH AND HYGIENE ® 27. aseptically [ ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. [ El10. Hands washed effectively and timely E:1 ❑ El ❑ 30.29. Jewelry, Inks,Needles etc approved and used correctly [ Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of ❑ 11. warm water procedure 1: ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ® 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters [ Source: Bloodbome+Airborne Pathogen(BAP) ❑ 32. Floors and walls clean and in good repair,adequate light [ Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in E] 14. used El ❑ 33' good repair [ CUSTOMERS/CLIENTS ❑ 34. Perm it/registration posted [ Branding is completed with no other customers in F1 15. ❑ ® 35. Operation and employee training records present [ procedure area ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review [ Client records approved and available-Consent form ® 18. ❑ El37. Permits obtained and available [ and questionnaire ® 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment [ MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled [ ❑ 20. Safe machine design ❑ ❑ 40. Closure [ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. [ Received b (Print): Rosemarie Haas Received b (Si nat�:;L Q. " hone:(209)986 4639 S ecialist Print): Nav'ot Sahota Specialist(Signature): Phone: 209 468-3178 Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of EH-11/17 �.