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a `" Body Art Ins ectO Report Y P P Date: SN N„ <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: n u S3b5 g 4 <br /> X (209)46 <br /> 8 3420 '1 <br /> / www.siogv.orq/ehd Program lJ Q-0 <br /> %FOR Element: �J <br /> Facility Name Address City Zip Code <br /> The Studio 2441 s.stockton st.,suite#5 Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Rosemarie Haas 6/30/16 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 ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test etc. <br /> ❑ <br /> Items washed,disinfected,packaged,labeled,and 2" sterilized El 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 /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5" appropriately ❑ Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized El 6" ui <br /> equipment ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> ElSharps containers labeled,used,and disposed of <br /> ❑ 7' <br /> appropriately <br /> ElWet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8" El El26. Barriers used ❑ <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE [j 27. ase tical) El <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. ❑ <br /> [1 10. Hands washed effectively and timely ro <br /> ❑ 29. Jewelry, Inks,Needles etc approved and used correctly El <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> F] 11. warm water ❑ 30. procedure ❑ <br /> ❑ 12. Hepatitis B vaccination BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ El31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc. in <br /> El 14. used El El 33' good repair El <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El El 35. Operation and employee training records present <br /> procedure area ❑ <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 /> Client records approved and available-Consent form <br /> El 18. [:1 El 37. Permits obtained and available <br /> and questionnaire <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 ❑ 01 41. r ❑ <br /> Received b (Print): Rosemarie Haas Received by(Signature): t Q A Phone: 209 986-4639 <br /> Specialist(Print): Benjamin Escotto,Sr REHS Specialist(Signature): Phone: 209 468-3178 <br /> Reinspecion onlabout: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />