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" Body Art Inspecti�eport Date: / y /� <br /> I <br /> San Joaquin County Environmental Health Department Program <br /> ,a , <br /> + 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: Q2(5 5 7 <br /> a d <br /> (209)468-3420 Program <br /> www.siogv org/ehd Element: LA 1z' 1 <br /> Facility Name Address City Zip Code <br /> True Classic Tattoo 423 e.miner ave. Stockton 95202 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Victor Lara 6/30/15 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, ❑ <br /> test etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> [1 2' sterilized 11PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dryrEl ❑ 23. Workstation/procedure area decontaminated El <br /> r_1 Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5' appropriately Chemical used: Madacide <br /> Invoices and log kept for disposable,pre-sterilized <br /> ® 6. equipment ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled,used,and disposed of ❑ <br /> ❑ 7' a ro riatel El Wet contact time provided: 20 minutes <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8' ❑ El 26. Barriers used <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27. ase ticall El <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ [1 29. Jewelry, Inks,Needles etc approved and used correctly ❑ <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> ® 11. warm water El ❑ 30. procedure ❑ <br /> ❑ 12. 1 Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingEl ❑ 31. Areas separated/no living or sleeping quarters El <br /> Source: Above Training ❑ 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 /> ❑ 14. used E] ❑ 33' good repair ❑ <br /> CUSTOMERS/CLIENTS ❑ 34, Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. 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. Plan(s)submitted for review ❑ <br /> Client records approved and available-Consent form <br /> ® 18. El Eluestionnaire 37. Permits obtained and available <br /> and ❑ <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 I ❑ I ❑ 1 41. 1 ❑ <br /> Received b (Print): Victor Lara Received by(Signature): Phone:(209)937-0937 <br /> Specialist(Print): Harprit Mattu,Sr REHS Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion onlabout: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />