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Body Art Inspean Report Date: thG �1�J <br /> ?{ San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: S Q loo <br /> (209)468-3420 <br /> c - �`P.• www.slogv.orq/ehd Program 4J (y <br /> Element: <br /> Facility Name Address City Zip Code <br /> Lotus Piercing and Tattooing 3200 naglee rd.#116 Tracy 95304 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Yogesh Patel Consultation <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 /> ® <br /> Items washed,disinfected,packaged,labeled,and 2 sterilized ❑ PREVENTING CROSS-CONTAMINATION <br /> ® 3. Autoclave loaded correctly/packages allowed to dry ❑ ® 23. Workstation/procedure area decontaminated E]® 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ® 5. appropriately ❑ Chemical used: <br /> ❑ <br /> Invoices and log kept for disposable,pre-sterilized 6' equipment El El25. Disinfectant used appropriately/sufficient contact time <br /> ElSharps containers labeled, used,and disposed of <br /> ® 7' E] Wet contact time provided: <br /> appropriately <br /> ® 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized ❑ ❑ 26. Barriers used E]Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ® 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 /> ® <br /> Handwashing facilities properly supplied and accessible, 30Cross-contamination avoided during all phases of 11. warm water ❑ ❑ . procedure <br /> El <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 Elusedgood repair <br /> CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. El ® 35. Operation and employee training records present <br /> procedure area <br /> ❑ <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 /> Client records approved and available-Consent form <br /> ® 18. Client <br /> questionnaire El El 37. Permits obtained and available El <br /> ® 19. Appropriate aftercare instructions given to client ❑ ❑ 1 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): Yo esh Patel Received b Si nature: Phone: 'Lam d-4{- 1;V 1- <br /> S ecialist(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 3 <br /> EH-04/2014 <br />