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!U1 <br /> Body Art Inspeco Report 4L Date: SI$� <br /> �a :., ......co <br /> r <br /> San Joaquin County Environmental Health Department Program u b <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: eR0 1 b O <br /> (209)468-3420 Program <br /> www.SI09 "' <br /> y.Or9/ehd <br /> Element: 2� <br /> Facility Name Address City Zip Code <br /> Mudville Tat2 Studio 127 w. harding way#a Stockton 95204 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Gustavo Hurtado 6/30/18 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 ❑ ❑ 22j Parts replaced between clients-grommets,elastic bands, ❑ <br /> test 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 ❑ <br /> ❑ 5. E] Chemical used: Madacide <br /> appropriatelyInvoices and log kept for disposable,pre-sterilized <br /> ® 6• ❑ El25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled, used,and disposed of <br /> ® 7 a ropriatel El [Wet contact time provided: 6 mins <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 /> PRACTITIONER HEALTH AND HYGIENE [j 27. aseptically ❑ <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 <br /> ❑ 11. warm water El El 30' procedure El <br /> ® 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Cathie Montie ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14 Appropriate personal protective equipment available and ❑ � 33 Workstation,surfaces,including chairs,armrests,etc.in ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Perm ittregistration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. procedure area NJ 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 /> ❑ <br /> Client records approved and available-Consent form 18. El El37. Permits obtained and available <br /> and questionnaire ❑ <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 ❑ ❑ 41. ❑ <br /> Received b (Print): Gustavo Hurtado Received b Si nature: "`� Phone:(209 546-2739 <br /> F It <br /> Specialist(Print): Ha rit Mattu,Sr REHS Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />