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S Body Art Inspect&Report <br /> Date: 114,L20 <br /> .4San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: JZQ 6,17 q.7!j <br /> r P.. (209)468-3420 Program <br /> www.siogv.org/ehd Element: q/a <br /> Facility Name Address City Zip Code <br /> Fawn Yees Permanent Cosmetics 6231 pacific ave#3 Stockton 95207 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Fawn Liang 6/30/20 FAW N Y L E 9'9 8 ® G MAt L. to m 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 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test ❑ ❑ 22. 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 /> DecontaminatioNsanitation area separated and supplied El 5' appropriately ❑ Chemical used: CaviWipes <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6. El ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> equipment ❑ <br /> Sharps containers labeled,used,and disposed of <br /> ❑ 7' <br /> appropriately <br /> ❑ [Wet contact time provided: 3 mins <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8' sterilized E] ❑ 26. Barriers used ❑ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE F1 27' ase tical[ ❑ <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,❑ 30. Cross-contamination avoided during all phases of 11. warm water ❑ ❑ rocedure E3 <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 /> Appropriate personal protective equipment available and ❑ Workstation,surfaces, including chairs,armrests,etc.in <br /> ❑ 14. used El 33. good repair ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Perm it/registration posted ❑ <br /> Branding is completed with no other customers in <br /> F1 15. E] F] 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 ❑ <br /> Client records approved and available-Consent form <br /> El 18. questionnaire E] 1:137. Permits obtained and available Eland <br /> ❑ 19. Appropriate aftercare instructions given to client El El 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): Fawn Liang Received by(Signature): Phone:209-478-1266 <br /> Specialist(Print): Sandip Singh Specialist(Signature)7 Phone: 209-468-3526 <br /> 14 41 <br /> s� <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of-3- <br /> EH-1 1/17 <br /> f-3-EH-11/17 <br /> �a <br />