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} Body Art InspectittReport Date: I <br /> �� << <br /> r San Joaquin County Environmental Health Department Program i g <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 <br /> www.siogv.org/ehd Program <br /> ` FCIR Element: y�Z� <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 R.Lara 6/30/19 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 ❑ [1 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test I 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 /> ❑ 5. appropriately ❑ Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized F] 6' ui <br /> equipment El El 25. Disinfectant used appropriately/sufficient contact time <br /> ElSharps containers labeled,used,and disposed of <br /> ❑ 7' ❑ Wet contact time provided: <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8' sterilized ❑ El26. Barriers used El <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27' ase ticali ❑ <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 El ❑ 30. procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑E] 31. Areas separated/no living or sleeping quarters ElSource: ❑ 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 El ❑ 33' good repair <br /> ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> ❑ 15. procedure area [:1 [:1 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 /> El and questionnaire <br /> ❑ ❑ 37. Permits obtained and available ❑ <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 N] El 41. ❑ <br /> Received b (Print): u`(Y-L'f L--c-, Received b Si nature): Phon :°L.d`f T37"Gc13.7 <br /> Specialist(Print): J.Easter Specialist(Signature): Phone: 209-953-7310 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />