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Body Art Ins en Report <br /> X, P Date: a'/-2/1&1 <br /> "; San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: VUW <br /> 1 r <br /> -3420 <br /> (209)468 <br /> o P.. Program <br /> WVVW.siogv.orq/ehd <br /> Element: (� <br /> Facility Name Address City Zip Code <br /> JC Salon Studio 941 willora rd. Stockton 95207 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Otilia Aguila Final 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, [ <br /> test etc. <br /> ❑ <br /> Items washed,disinfected,packaged, labeled,and 2' sterilized F1PREVENTING 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 /> El 5. ❑ Chemical used: Bleach Solution <br /> appropriately <br /> 6. <br /> ro riatel <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6. El El 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> Sharps containers labeled,used,and disposed of [ <br /> El 7' a ro riatel El Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and ❑ ❑ 26. Barriers used [ <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE 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 /> El 11. 30.warm water ❑ ❑ procedure E: <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters [ <br /> Source: ProTrainings ❑ 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 /> EI 14. used ❑ El 33. good repair [ <br /> CUSTOMERS/CLIENTS ❑ 34. Perm it/registration posted [ <br /> ❑ <br /> Branding is completed with no other customers in 15. El El35. Operation and employee training records present [ <br /> procedure area <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 /> Client records approved and available-Consent form <br /> ® 18. questionnaire <br /> El El 37. Permits obtained and available [ <br /> and <br /> [54 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): Otilia Aguila Received b (Signature):&"4AQPhone:(209)688-5678 <br /> Specialist Print): Nav of Sahota Specialist(Signature): Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of <br /> EH-11/17 <br />