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amiiv <br /> Body Art Inspection Report Date: 4/20/22 <br /> • San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0537424 <br /> (209)468-3420 <br /> �C �e www.siogv.org/ehd Program <br /> Element: 4120 <br /> Faciity Flame Address City Zip Code <br /> Fawn Yeas Permanent Cosmetics 6231 Pacific Ave Suite 3 Stockton 95207 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Fawn Liang 6/30/22 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 test El El 22. Parts replaced between clients-grommets, elastic bands, Eletc <br /> ❑ <br /> Items washed, disinfected, packaged, labeled, and <br /> 2. sterilized E] 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 El 24. Appropriate chemical cisinfectant used <br /> Decontamination/sanitation area separated and supplied <br /> ElEll <br /> ❑ 5. appropriately ❑ Chemical used: <br /> ❑ <br /> Invoices and log kept for disposable, pre-sterilized 6. ❑ El El Disinfectant used appropriately/sufficient contact time Elequipment <br /> Sharps containers labeled, used, and disposed of <br /> El 7' ❑ Wet contact time provided: <br /> aro riatel <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and 8. El F-126. Barriers used Elsterilized <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed 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 /> Handwashing facilities properly supplied and accessible, <br /> F-1 11. hot water El El30. Cross-contamination avoided during all phases of procedure El <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ro <br /> 31. Areas separated/no living or sleeping quarters ElSource: 32. Floors and walls clean and in good repair, adequate light El14. Appropriate personal protective equipment available and <br /> 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. ElEl❑ 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 /> ❑ <br /> Client records approved and available-Consent form and 18. El El 37. Permits obtained and available E]uestionnaire <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MA:HILAE SAFETY AND SANITATION [1 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ El41. E] <br /> Received t:y(Print): Fawn Liang Received by(Signature): EMAILED Phone:209-478-1266 <br /> Specialist(Print): Pinne Chao Specialist(Signature): Phone:209-468-3854 <br /> Reinspection on/about: A reinspectio of$152 pe hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />