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°U <br /> `" c Body Art Inspect Report <br /> N oz< San Joaquin County Environmental Health Department <br /> Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: ��(j � <br /> (209)468-3420 <br /> `.c•, <br /> Y. <br /> Program <br /> d ••••• i�` www.siogv.org/ehd <br /> l�,Foa Element: ��j <br /> Facility Name Address City Zip Code <br /> Uptown Ink 3228 pacific ave Stockton 95204 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Cesar Flores Initial consult. <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, Eltest etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> El 2. sterilized El CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry [:3 ❑ 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 /> ❑ <br /> 5. appropriately <br /> El Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized <br /> ® 6• ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled,used,and disposed of <br /> ® 7' Elappropriately <br /> [Wet contact time provided: <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and 8 E] ® 26. Barriers used Elsterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27. ase ticall E] <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ ❑ 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] 30 procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingF1 [:1El31. Areas separated/no living or sleeping quarters <br /> Source: Cathy Montie ® 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ® <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in <br /> 14. used ❑ ❑ 33 good repair <br /> El <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El ® 35. Operation and employee training records present 11rocedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ I COMPLIANCE AND ENFORCEMENT <br /> ® 17. Skin adequately prepared for procedure ❑ ri <br /> 36. Plan(s)submitted for review 10Client records approved and available-Consent form <br /> ® 18. and uestionnaire El 37. Permits obtained and available E]® 19. Appropriate aftercare instructions given to client ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled El <br /> El Safe machine design ❑ ❑ 40. Closure El <br /> F-1 Machines cleaned and disinfected between clients E] ❑ 41. ❑ <br /> Received b Print): Cesar Flores Received b (Signature): one:209-406-1007 <br /> Specialist(Print): Harprit Mattu,Sr REHS Specialist(Signature): '46Phone: 209 468-3284 <br /> Reinspeclon on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 3 <br /> EH-03/2015 <br />