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Body Art Inspejkn Report Date: a I'iq <br /> z <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: P1w Sag W7 <br /> (209)468-3420 <br /> e.`P• www.smogv.orq/ehd Program !1 <br /> ��F. R Element: _` <br /> Facility Name Address City Zip Code <br /> Lotus Piercing and Tattooing 3200 n. naglee rd.,suite#116 Tracy 95304 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Yogesh Patel 6/30/15 Initial 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 /> ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test etc. <br /> ,71 <br /> 2Items washed,disinfected,packaged, labeled,and <br /> E] . sterilized ❑ <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 /> El 5' appropriately <br /> El Chemical used: <br /> ❑ <br /> Invoices and log kept for disposable,pre-sterilized 6' equipment ❑ El25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled, used,and disposed of ❑ <br /> El 7' Elappropriately <br /> [Wet contact time provided: <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and 8' El El 26. Barriers used <br /> sterilized <br /> n <br /> Products applied to skin are single use/dispensed <br /> D HYGIE El 27. 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 ❑ ❑ 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 E] ❑ 30' rocedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ <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 /> Appropriate personal protective equipment available and Workstation,surfaces, including chairs,armrests,etc.in <br /> E] 14. used El ❑ 33' good repair <br /> E] <br /> SUS <br /> ❑ 34. Perm it/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El El 35. Operation and employee training records present <br /> procedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ <br /> ❑ 17. Skin adequately prepared for procedure ❑ 7- 777 r review ❑ <br /> Client records approved and available-Consent form <br /> ❑ 18. and questionnaire ❑ d available ❑ <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ 38. Impoundment ❑ <br /> on - ii C ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> r[js21. Machines cleaned and disinfected between client ❑ ❑ 41. ❑ <br /> Received b (Print): John Haynes Received by(Signature): Phone: 925 876-6535 <br /> Specialist(Print): Benjamin Escotto Specialist(Signature): Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$125 per hour may charged. Page 1 of 2 <br /> EH-04/2014 <br />