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' r <br /> pLI <br /> o� Body Art Inspection Report <br /> San Joaquin County Environmental Health Department Date: 3/8/22Program <br /> ' 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: PR0542033 <br /> (209)468-3420 <br /> �p �P www.sioay.org/ehd Program <br /> q��r`•�w?>Ji Element: 4120 <br /> Facility Ne me Address City Zip Code <br /> Lumiere Spa 15 W.Oak St Lodi 95240 <br /> Name of Fermit/Regis ration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Georgina Carranza 6/30/22 <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 ❑ ❑ 22 Parts replaced between clients-grommets.elastic bands. ❑ <br /> etc. <br /> Items wasted,disinfected,packaged,labeled,and <br /> El 2. sterilized El CROS-CONTAMINATION <br /> ❑ 3. Autoclave baded 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 /> Decontamiiation/sanitation area separated and supplied ❑ ❑ <br /> ❑ 5' appropriately ❑ Chemical used: <br /> Invoices and log kept for disposable, pre-sterilized <br /> ® 6. ❑ El25. Disinfectant used appropriately/sufficient contact time Elequipment <br /> Sharps cortainers lateled,used,and disposed of <br /> ® 7' ElWet contact time provided: <br /> appropriately <br /> Jewelry,tatoo and piercing equipment-clean and <br /> E] 8. El ❑ 26. 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 wass-ied effe--tively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ <br /> Handwashi ig facilities properly supplied and accessible, <br /> El 11. hot water El [_130. Cross-contamination avoided during all phases of procedure ❑ <br /> ❑ 12. Hepatitis B vaccina-ion ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingEl ❑ 31. Areas separated/no living or sleeping quarters E] <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 ❑ 33. ood repair <br /> ❑ <br /> CUSTOMERS/CL ENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> [:115. rocedure area El ® 35. Operation and employee training records present ❑ <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. ❑ [137. Permits obtained and available E)uestionnaire <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machi-ie desicn ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines ceaned and disinfected between clients ❑ ❑ 41. ❑ <br /> Received ty(Print): Georgina Carranza Received by(Signature): EMAILED Phone:209-625-7772 <br /> Specialist¢Print): Pinre Chao Specialist(Signature): Phone:209-468-3854 <br /> Reinspection on/abOLt: A reinspection fee of$152 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br />