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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0544975
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COMPLIANCE INFO
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Entry Properties
Last modified
4/4/2023 1:49:30 PM
Creation date
7/3/2020 10:14:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0544975
PE
4120
FACILITY_ID
FA0025579
FACILITY_NAME
MIND, BODY AND SKIN (KROGH, SHARON)
STREET_NUMBER
20
Direction
W
STREET_NAME
TENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
20 W TENTH ST
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0544975_20 W TENTH_.tif
Tags
EHD - Public
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Body Art Inspects Report Date: <br /> y` San Joaquin County Environmental Health Department Program <br /> Q a, <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: O W 33 <br /> (209)468-3420 <br /> �•.,, c' ProgramWMWA <br /> � <br /> Element: '410. <br /> Facility Name Address City Zip Code <br /> The Salon Spa Studios 20 w 10th street Tracy 95376 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Sharon Krogh Consultation <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 /> El 1 Autoclave:approved and effective-passed integrator E] E] 22 Parts replaced between clients-grommets,elastic bands, <br /> test etc. <br /> 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 [-I ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5. appropriately ❑ Chemical used: <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6• ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled, used,and disposed of <br /> F1 7' E]appropriately <br /> [Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. El El 26. Barriers used Elsterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE F1 27' ase ticall ❑ <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. warm water E] 1:1 30. procedure ❑ <br /> ® 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodbome Pathogen training [E] 31. Areas separated/no living or sleeping quartersEJ <br /> Source: 32. Floors and walls clean and in good repair,adequate lightEl 14. Appropriate personal protective equipment available and E] 33 Workstation,surfaces,including chairs,armrests,etc. in Elused ood re air <br /> CUSTOMERS/CLIENTS ❑ 34. Perm ittreg istration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. El El 35. 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. iEl El 37. Permits obtained and available E]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): Sharon Kroh Received b (Signature. Phone:209-612-0430 <br /> Specialist(Print): Sandip Singh Specialist(Signature): Phone: 209468-3526 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />
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