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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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118
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4100 – Safe Body Art
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PR0540001
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COMPLIANCE INFO
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Entry Properties
Last modified
6/7/2023 4:32:59 PM
Creation date
7/3/2020 10:13:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0540001
PE
4120
FACILITY_ID
FA0021518
FACILITY_NAME
GYPSY SOUL TATTOO (MCPHERSON, CHRIS)
STREET_NUMBER
118
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
118 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0540001_118 W YOSEMITE_.tif
Tags
EHD - Public
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or <br /> Rauf 0 r-� ��� <br /> :2 \ ,^�- - r...._.,a,. e-..._ - a_e to..w.es.a.- n.m.=._.,.�e,..........tea <br /> 'w. <: S-ii i Joaquin CoUlAyCliYl119061'i1CliLQI f1Gd14lf SJGI.ailtalie t <br /> Program. <br /> 1868E Hazelton Ave.,Stockton,CA 95205 Record: R WSA4000 <br /> P, (209)468-3420 Program <br /> www.siogv.orglehd <br /> Element: <br /> Facility Name Address City Zip Code <br /> GVDsy Soul Tattoo 118 w.vosemite ave. Manteca 95336 <br /> Chris McPherson 6/30/17 Routine <br /> The above tacility is inspected for compliance with Division 104,Part 15,Chapter 7 of Calitomia 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 /> Items washed,disinfected,packaged,labeled,and <br /> El 2. sterilized El CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. 1 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. ❑ Chemical used: <br /> appropriately <br /> 6. <br /> ro riatel <br /> Invoices and nt log kept for disposable,pre-sterilized ❑ Elpp <br /> ® 6. 25. Disinfectant useappropriately/sufficient contact time <br /> a ui meI <br /> ElSharps containers labeled,used,and disposed of <br /> ® 7' ❑ Wet contact time provided: <br /> appropriately <br /> El 8. 1 <br /> ro riatel <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. ❑ I ❑ 26. Barriers used Elsterilized <br /> El 27 Products applied to skin are single use/dispensed <br /> El <br /> PRACTITIONER HEALTH AND HYGIENE asepticall <br /> ❑ 9. No eating,drinking or smoking-clean clothes I (_,) ® 28. i Storage of inks,pigments, needles,tubes,etc. ❑ <br /> El 10. Hands washed effectively and timely j-❑ ❑ 29. ` Jewelry, Inks,Needles etc approved and used correctly El <br /> ❑ <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of 11. warm water ❑, I ❑ 30. procedure ❑' <br /> ❑ 12. Hepatitis B vaccination ❑I BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑� El 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ® I 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 /> ❑ 14. used ❑ ❑ 33. good repair ❑ <br /> CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. 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 /> F1 3 <br /> F] 18. uestionnai ❑ 7. Permits obtained and available <br /> and re ❑ <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 d?~infected be.veer clients ❑ r[:1j 41- i I <br /> i i i i i i i i <br /> Specialist(Print): Ben amin Escotto,Sr REHS Specialist(Signature): Phone:(209)468-3178 <br />
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