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*' _. ' <br /> Body Art Inspectl�Report SDate:San Joaquin County Environmental Health Department Program /�G53�3�'y'1868 E.Hazelton Ave.,Stockton,CA 95205 Record:(209)468-3420 Program• www.siogv.orq/ehds V A do. CoAement: <br /> Anel�osr5-a�a�/ o� <br /> Facility Name Address City Zip Code <br /> Anchors Away <br /> 209 a kettleman lane Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Shane Winans 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 /> Autoclave:approved and effective-passed integrator E] [1 22. Parts replaced between clients-grommets,elastic bands, ❑ <br /> ❑ 1. test 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 testllog maintained ❑ ❑ 24. Appropriate chemical disinfectant used ❑ <br /> Decontamination/sanitation area separated and supplied ❑ Chemical used: <br /> ❑ 5. appropriately <br /> Invoices and log kept for disposable,pre-sterilized® 6' ui <br /> equipment <br /> ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ <br /> Sharps containers labeled,used,and disposed of ❑ Wet contact time provided: <br /> ® <br /> 7. <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and ❑ ❑ 26. Barriers used ❑ <br /> ❑ 8. sterilized <br /> P❑ 27 Products applied to skin are single use/dispensed El HEALTH AND HYGIENE asepticall <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely rED] <br /> ❑ 29. Jewelry,Inks, Needles etc approved and used correctly ❑ <br /> El 11. Handwashing facilities properly supplied and accessible, ❑ 30 Cross-contamination avoided during all phases of El <br /> warm water procedure <br /> El 12. Hepatitis B vaccination BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodbome Pathogen trainingElEl31. 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 ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS E] 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in ❑ ❑ 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 rEE11 <br /> El 36. Plan(s)submitted for review ❑ <br /> ® 18 Client records approved and available-Consent form El37. Permits obtained and available F1and questionnaire <br /> El19. Appropriate aftercare instructions given to client ❑ 38. Impoundment El <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)327-8868 <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 />