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°"' Body Art Inspect*Report Date: -a o--14-( <br /> ••,cep <br /> San Joaquin County Environmental Health Department <br /> Program <br /> � s <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> c P (209)468-3420 Program <br /> q<7FoaN� www.siogv.orq/ehd Element: <br /> Facility Name Address City Zip Code <br /> Anchors Away Tattoo 209 a kettleman In Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Shane Winans 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 ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> El 2' sterilized E] PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ro <br /> 23. Workstation/procedure area decontaminated4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied El <br /> 5. appropriately ElChemical used: <br /> Invoices and log kept for disposable,pre-sterilized El 6' ui <br /> equipment El El 25. Disinfectant used appropriately/sufficient contact time <br /> ElSharps containers labeled,used,and disposed of <br /> ® 7' Elappropriately <br /> [Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and Elsterilized <br /> El 8' ❑ ❑ 26. Barriers used <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27 aseptically ❑ <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 /> El El 30. <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> ❑ 11. warm water procedure El <br /> 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodbome Pathogen training ❑ ® 31. Areas separated/no living or sleeping quarters El El❑ 32. Floors and walls clean and in good repair,adequate light ElEl14. Appropriate personal protective equipment available and El ❑ 33 Workstation,surfaces, including chairs,armrests,etc.in ❑ <br /> used qood repair <br /> CUSTOMERS/CLIENTS ❑ 34. Perm it/registration posted ❑ <br /> Branding is completed with no other customers in <br /> ❑ 15. ❑ 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 F1® 18 <br /> Client records approved and available-Consent form <br /> [_1 37. Permits obtained and available Eland uestionnaire <br /> El 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. :E]l <br /> Received b (Print): Shane Winans Received b (Signature Phone: -32 y U(? <br /> Specialist Print): Afonso Arambula Specialist Si natu Phone: 209 468-9673 <br /> Reinspecion on/about: A reinspection fee of$125 per hour may c a e . Page 1 of 2 <br /> EH-04/2014 <br />