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Body Art Inspecs Report 0 Date: D ZGII 9 <br /> San Joaquin County Environmental Health Department Program p <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: / w S Lib S�S <br /> (209)468-3420 <br /> Program a I <br /> www.sioay.ora/ehd Element: <br /> Facility Name Address City Zip Code <br /> Uptown Ink 3228 pacific ave. Stockton 95204 <br /> Name of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Cesar Flores 6/30/2020 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 /> r �Raw� <br /> mom _. <br /> ❑ 1. Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test I etc. <br /> Items washed,disinfected, packaged, labeled,and <br /> ❑ 2. sterilized ❑ P <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 F1El 5. appropriately <br /> ❑ Chemical used: <br /> ® <br /> Invoices and log kept for disposable, pre-sterilized 6• [_1 El25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled, used,and disposed of <br /> ® 7' <br /> appropriately <br /> ❑ [Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. El El 26. Barriers used <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> El- _ 27. asepticallyEl <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 /> Handwashing facilities properly supplied and accessible, ❑ Cross-contamination avoided during all phases of El® 11. warm water El 30' procedure <br /> 77777 <br /> El12. Hepatitis B vaccination ❑ � lwl <br /> ;' <br /> MrN <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 /> E] 14. used El ❑ 33' good repair <br /> ❑ <br /> 'r ; a <br /> El34. Permit/registration posted El <br /> IN <br /> Branding is completed with no other customers in <br /> El 15. ❑ ® 35. Operation and employee training records present Elrocedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ <br /> 0 <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ <br /> Client records approved and available-Consent form <br /> ® 18. and uestionnaire El ® 37. Permits obtained and available ❑ <br /> ❑ 19. Appropriate aftercare instructions given to client El 38. Impoundment ❑ <br /> ❑ 39. Hearing scheduled ❑ <br /> r�w_z MAN <br /> ❑ 20. Safe machine design ❑ [1 40. Closure ❑ <br /> ❑ 21. Machines cleaned and`disinfected between clients El ❑ 41. E]Received b Print): CMALu� Received b (Signature): Phone: <br /> Specialist(Print): J.Easter Specialist(Signature): Phone: (209)953-7310 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br />