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coG Body Art Inspection Report Date: 3/8/22 <br /> mSan Joaquin County Environmental Health Department Program <br /> 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0541656 <br /> (209) 468-3420 <br /> � �a�/P • v ww.sioay.ora/ehd Program <br /> kr,a Element: 4120 <br /> Facility Name Address City Zip Code <br /> Flawlous 806 W. Lodi Ave Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Kell Degenstem 6/30/22 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: I❑ 1 . Autoclave: approved and effective - passed integrator lest ❑ ❑ 22 Parts replaced between clients - grommets, elastic bands ,etc.Items washed, disinfected, packaged, labeled, and <br /> 2' sterilized ❑ PREVENTING 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 /> ❑ 5 Decontamination/sanitation area separated and supplied ❑ Elappropriately <br /> El Chemical used: <br /> ® 6 Invoices and log kept for disposable, pre-sterilized <br /> equipment ❑ El25. Disinfectant used appropriately/sufficient contact time El® 7 Sharps containers labeled, used, and disposed of El ppcontact time provided: <br /> a ro riatel <br /> ❑ 8 Jewelry, tattoo and piercing equipment - clean and <br /> sterilized El El 26. Barriers used El <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed 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 /> ❑ 11 . Handwashing facilities properly supplied and accessible, <br /> hot water E1 El30. Cross-contamination avoided during all phases of 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: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ <br /> ❑ 14 Appropriate personal protective equipment available and Workstation, surfaces, including chairs, armrests , etc. in <br /> used El El 33' El <br /> goo repair <br /> CUSTOMERS/CLIENTS ❑ 34. Perm it/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> procedure area ❑ ® 35. Operation and employee training records present ❑ <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 /> ® 18 Client records approved and available - Consent form and ❑ ❑ 37. Permits obtained and available ❑ <br /> questionnaire <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ]EI MACHINE SAFETY AND SANITATION El39. Hearing scheduled El20. Safe machine design El El40. Closure El21 . Machines cleaned and disinfected between clients <br /> Received by (Print): Kell Degenslein Received by (Signature): EMAILED Phone: 209-556-3281 <br /> Specialist (Print): Pinne Chao Specialist (Signature): Phone: 209-468-3854 <br /> Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br />