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C'o Body Art Inspesn Report Date: <br /> San Joaquin County Environmental Health Department Program n n ^� <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: W S3 u <br /> (209)468-3420 Program <br /> °q</Fob.. www.siogv.org/ehd Element: <br /> Facility Name Address City Zip Code <br /> Twisted Addictions Tattoos 2141 yosemite ave. Manteca 95337 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Wayne Delanghder 6/30/15 Re-inspection <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 El <br /> ❑ 5' <br /> appropriately <br /> ❑ Chemical used: <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6' El F125. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled,used,and disposed of <br /> ® 7 ❑ Wet contact time provided: <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8' r_126. Barriers used Elsterilized <br /> ❑ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27' asepticallyE] <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 /> ® <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of 11' warm water E] El 30' rocedure E] <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 /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in <br /> F-1 14. used 11 El 33' good repair <br /> El <br /> CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. rocedure area El 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 /> ® 18 Client records approved and available-Consent form <br /> iEl El 37. Permits obtained and available E]anduestionnare <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. ❑ <br /> Received b (Print): Wayne Delan hder Received by(Signature): ne: 209 665-7564 <br /> Specialist(Print): Benjamin Escotto,Sr REHS Specialist(Signature): Phone: 209 468-3178 <br /> GI <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />