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>,ro Body Art Inspec Report40 <br />N� �{ San Joaquin County Environmental Health Department <br />Date <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />(209)468-3420 <br />77 <br />Procr9am <br />• <br />R' <br />www.sioqv.org/ehd <br />Element: <br />Facility Name Address City Zip Code <br />Wicked Wayz 920 s cherokee lane Lodi 95240 <br />Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br />Abdullah, Mohamed 6/30/14 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 Parts replaced between clients - grommets, elastic bands, Eltest ❑ ❑ 22' etc. <br />❑ 2 Items washed, disinfected, packaged, labeled, and <br />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 />® 5 Decontamination/sanitation area separated and supplied ❑ <br />❑ Chemical used: <br />appropriately <br />[:1 6 Invoices and log kept for disposable, pre-sterilized <br />equipment El 25. Disinfectant used appropriately/sufficient contact time <br />® <br />El <br />7 Sharps containers labeled, used, and disposed of <br />ro ❑ Wet contact time provided: <br />ariatel <br />❑ 8 Jewelry, tattoo and piercing equipment - clean and <br />sterilized El F-126. Barriers used El <br />Products applied to skin are single use/dispensed <br />PRACTITIONER HEALTH AND HYGIENE El 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 ❑ ❑ 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 warn water E] ❑ 30" procedure <br />❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br />® 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br />Source: ❑ 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 E]used good repair <br />CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br />❑ 15. Branding is completed with no other customers in <br />rocedure area El El 35. Operation and employee training records present ❑ <br />❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br />❑ <br />17. <br />Skin adequately prepared for procedure <br />❑ <br />❑ <br />36. <br />Plan(s) submitted for review <br />❑ <br />® <br />18. <br />Client records approved and available - Consent form <br />and uestionnaire <br />El <br />El <br />37. <br />Permits obtained and available <br />El <br />❑ <br />19. <br />Appropriate aftercare instructions given to client <br />❑ <br />❑ <br />38. <br />Impoundment <br />❑ <br />MACHINE SAFETY AND SANITATION <br />❑ <br />39. <br />Hearing scheduled <br />❑ <br />❑ <br />20. <br />Safe machine design <br />❑ <br />❑ <br />40. <br />Closure <br />❑ <br />❑ <br />21. <br />Machines cleaned and disinfected between clients <br />❑ <br />® <br />41. <br />119314 (5) Adequate Toilet Facilities <br />❑ <br />�p <br />Received b (Print): Terry R Minatre Received by (Signature): Phone62Q ( ;7( <br />Specialist (Print): Alfonso Arambula Specialist (Signature): Phone: (209) 468-9673 <br />Reinspecion on/about: A reinspection fee of $125 per hour may charged. Page 1 of 2 <br />EH -04/2014 <br />