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Body Art Inspec& Report <br /> oz L <br /> cSan Joaquin County Environmental Health Department Date:Pro9 ram i <br /> { 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> P. (209)468-3420 Program ^ <br /> .CiFb ��. www.siogv.org/ehd Element: Ll t k <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 6/30/14 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 ❑ ❑ 7Parts replaced between clients-grommets,elastic bands, Eltest etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> ® 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. appropriately ❑ Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized <br /> ® 6• El El 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled, used,and disposed of <br /> ® 7' ElWet contact time provided: <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. sterilized El F126. Barriers used El <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE E] 27. aseptically ❑ <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. E]❑ 10. Hands washed effectively and timely El ❑ 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 /> ® 11. warm water El El 30' procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodbome 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 /> F1 14. used ❑ 33. good repair <br /> El <br /> CUSTOMERS/CLIENTS ❑ 34. Perm it/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 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 /> ® <br /> Client records approved and available-Consent form 18. i ❑ El 37. Permits obtained and available El <br /> and <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 ❑ El41. ❑ <br /> ee 1� G� <br /> Received b (Print): Wayne Delan hder Received b Si nature): 1. P(onge: <br /> Specialist(Print): Afonso Arambula Specialist(Signature): Phone: 209 468-9673 <br /> Reinspecion on/about: A reinspection fee of$125 per hour y c Page 1 of 3 <br /> EH-04/2014 <br />