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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0542019
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COMPLIANCE INFO
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Entry Properties
Last modified
8/29/2024 2:05:52 PM
Creation date
7/3/2020 10:14:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0542019
PE
4120
FACILITY_ID
FA0024119
FACILITY_NAME
EXHALE SALON & SPA (LEYVA, ROCIO)
STREET_NUMBER
103
Direction
W
STREET_NAME
PINE
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
103 W PINE ST
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0542019_103 W PINE_.tif
Tags
EHD - Public
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u <br />>° o� Body Art Inspection Report <br />Date: March 8, 2022 <br />in � San Joaquin County Environmental Health Department Program <br />18eB E. Hazelton Ave., Stockton, CA 95205 Record: PR0542019 <br />(209)466-3420 <br />wuwsioov.orc/ehd Program <br />q��F.,o� - Element: 4120 <br />Facility Name Address City Zip Code <br />Exhale Salon &Spa 103 W Pine St Lodi 95240 <br />Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br />Rodio Leyva 6/30/22 Routine <br />The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Heallh 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 test ❑ ❑ 2P Parts replaced between clients -grommets, elastic bands, ❑ <br />etc. <br />❑ 2 Items washed, disinfected, packaged, labeled, and <br />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 ❑ ❑ <br />a ro riatel ❑ Chemical used: Cavacide <br />❑ 6 Invoices and log kept for disposable, pre -sterilized <br />e ui ment ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ <br />❑ 7 Sharps containers labeled, used, and disposed of <br />a pro riatel ❑ Wet contact time provioed: 3 Mins. <br />❑ 8 Jewelry; tattoo and piercing equipment -clean and <br />sterilized ❑ ❑ 26. Barriers used ❑ <br />PRACTITIONER HEALTH AND HYGIENE ❑ 27. Protlucts 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 />warm water ' ❑ ❑ 30. Cross -contamination avoided during all phases of procedure ❑ <br />❑ 12. Hepatitis B vaccination ❑ <br />BE5T 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 ❑ ❑ 33 Workstation, surtaces, including chairs, armrests, etc. in ❑ <br />used ood re air <br />CUSTOMERS/CLIENTS ® 34. PermiUregistrationpostwi ❑ <br />❑ 15. Branding is completed with no other customers in <br />rocedure 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. Plans) submitted for review ❑ <br />® 18. Client recortls approved and available -Consent form and ❑ <br />uestionnaire ❑ ❑ 37. Permits obtained and available <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 by (Print): Rocio Leyva Received by (Signature) Emailed Phone 209-430-7018 <br />Specialist (Print): Sandip Sin, h Specialist (Si nature)' S' �,p. 5'z' � Phone' 209-468-3526 <br />Reinspection onlabout: A reinspection fee of $152 per hour may be charged. ^ Page 1 of 3 <br />EH -11/17 C/j([/' <br />
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