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f <br /> !]P, <br /> Body Art Inspec U /Report Date: "/! 17/1 8 <br /> j San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 1 Q <br /> TzO Slti Z 9 <br /> (209)468-3420 <br /> Program i€ �`www.sio_qv.org/ehd <br /> Element: �7-C) <br /> Facility Name Address City Zip Code <br /> Beauty Luxe&Co. 9210 thornton rd. Stockton 95209 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Fong Vang 6/30/18 Final/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.) C <br /> ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, Eltest etc. <br /> ❑ <br /> Items washed,disinfected,packaged,labeled,and 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 /> El 5. ❑ Chemical used: Cavi-wipes <br /> appropriately <br /> El 6. <br /> p ropriatel <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6. equipment ❑ El25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled,used,and disposed of ❑ <br /> ® 7• ElWet contact time provided: 3 mins <br /> appropriately <br /> E] 8. <br /> ppro riatel <br /> Jewelry,tattoo and piercing equipment-clean and <br /> E] 8' 1:1 El 26. Barriers used <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 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 ❑ [j 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. warm water E] El 30' procedure E] <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingEl ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Bioiogix ❑ 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 Elused good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Perm ittregistration posted ❑ <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 ❑ 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. iEl El 3T Permits obtained and available Eland 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): Fong Vang Received b (Signature): Phone: 916 715-8401 <br /> Specialist(Print): Har rit Mattu,Sr REHS Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion onlabout: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />