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Body Art Inspect* Report Date: S�a7I15 <br /> .Z San Joaquin County Environmental Health Department <br /> Program pe,� q <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PLO S31 3 Oy <br /> p (209)468-3420 Program <br /> `t_t�FORa�' www.siogv.org/ehd <br /> Element: LA <br /> Facility Name Address City Zip Code <br /> Anchors Away Tattoo 209 e.kettleman In. Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Shane Winans 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, Eltest etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> 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® 5' <br /> appropriately <br /> ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment ❑ El 25. Disinfectant used appropriately/sufficient contact time <br /> El <br /> 17 Sharps containers labeled, used,and disposed of <br /> ElWet contact time provided: <br /> appropriately <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized TO] <br /> El 26. Barriers used ❑ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE E:1 27. aseptically E] <br /> PRACTITIONER <br /> 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 /> ❑ 11. Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> warm water El ❑ 30 E]. procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training [Ell ❑ 31. Areas separated/no living or sleeping quarters El <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 ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> 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 /> ❑ 18 Client records approved and available-Consent form <br /> questionnaire <br /> El F] 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): Shane Winans Received b (Signature- Phone: 209 327-8863 <br /> Specialist(Print): Benjamin Escotto,Sr REHS Specialist Si natu Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />