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I Body Art Inspect Report Date: <br /> 2< San Joaquin County Environmental Health Department Program p <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: T �7 S 3 7 d <br /> (209)468-3420 <br /> \c p`'• www,sjogv.org/ehd Program 12 l <br /> �4rFoa.-� Element: <br /> Facility Name Address City Zip Code <br /> True Classic Tattoo 423 e.miner Stockton 95202 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Victor Lara 6 A,,o/j(j 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 /> 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 ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied El <br /> 5' a pro riatel El Chemical used: Madacide <br /> Invoices and log kept for disposable,pre-sterilized <br /> ❑ 6" El El 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> 1-1Sharps containers labeled, used,and disposed of <br /> F1 7" ElWet contact time provided: 15 mins <br /> appropriately❑ 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 F-1 27' asepticallyE] <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 11. warm water El ❑ 30' 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: Above Training,Cathie Montie ❑ 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 /> El 14. used ❑ ❑ 33' good repair <br /> E] <br /> CUSTOMERS/CLIENTS ❑ 34. PermiWregistration posted ❑ <br /> Branding is completed with no other customers in <br /> F1 15. rocedure area E] ® 35. Operation and employee training records present El <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 /> ® <br /> Client records approved and available-Consent form 18. E] [_1uestionnaire 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 ❑ ❑ 41. ❑ <br /> Received b (Print): Victor Lara Received by(Signature): Phone: 209 937-0937 <br /> Specialist(Print): Harprit Mattu,Sr REHS Specialist Si nature): Phone:(209)468-3284 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />