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BodyArt Ins ecti*e ort d �6 <br /> P P Date: <br /> San Joaquin County Environmenta' ReAFDl Department Program <br /> Jim, <br /> _ 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 fi® ��f Pro ram �J 1 <br /> •.�'s.r,ctiµi�`v www.siogv.org/ehd �6/6,4���6' �d��OE Cj/� ��. B°O g 7 /�V <br /> Element: <br /> Facility Name Address City Zip Code <br /> Stockton Tattoo 742 e.weber ave. Stockton 95202 <br /> Name of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Angel Ugarte Final to Open <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, Eltest etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> F1 2. sterilized E] PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated El <br /> ❑ 4. Integrators used/monthly spore test/log maintained [I ❑ 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• ❑ E] 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled,used,and disposed of <br /> ❑ 7� ❑ Wet contact time provided: <br /> appropriately <br /> F-1 8. <br /> ro riatel <br /> Jewelry,tattoo and piercing equipment-clean and <br /> F-1 8' El [1 26. Barriers used <br /> sterilized <br /> 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 /> Handwashing facilities properly supplied and accessible, 30' Cross-contamination avoided during all phases of El❑ 11. warm water ❑ ❑ procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> rEl <br /> 13. Bloodborne Pathogen training El ❑ 31. Areas separated/no living or sleeping quarters ElSource: El32. Floors and walls clean and in good repair,adequate light ElAppropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in 14. used ro <br /> El 33. ood re air El <br /> El34. Perm it/registration posted E]Branding is completed with no other customers in <br /> El 15. procedure area El35. Operation and employee training records present E] <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. El ® 37. Permits obtained and available El <br /> and <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 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): Angel U arte Received by(Signature): Phone:209-933-1156 <br /> Specialist(Print): J.Easter Specialist(Signature)7 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 />