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I "I 2 Items washed, disinfected, packaged, labeled, and sterilized E]PREVENTING >0_P°"' " �o Body Art Inspeco Report etc. �; 1Z "; z} San Joaquin County Environmental Health Department ❑ 3. 1868 E. Hazelton Ave., Stockton, CA 95205 Program 1 u 6,;3 23. Workstation/procedure area decontaminated Record: c4tiF0Rd`P (209) 468-3420 www.siogv.org/ehd Program _ 24. Appropriate chemical disinfectant used Element: f Facility Name Address City Zip Code Pretty Obsessed Boutique 2353 pacific avenue suite a Stockton 95204 Name of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Raynelle Preciado Final Inspection The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of Califomia Health and Safety Code (HSC). V = Violation C = Corrected On Site V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont. C ❑ 1 Autoclave: approved and effective - passed integrator E] E] 22 Parts replaced between clients - grommets, elastic bands, Eltest ❑ 2 Items washed, disinfected, packaged, labeled, and sterilized E]PREVENTING etc. CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ [j 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used ❑ ❑ 5 Decontamination/sanitation area separated and supplied appropriately El Chemical used: Caviwipes1 ❑ 6 Invoices and log kept for disposable, pre -sterilized equipment El El25. Disinfectant used appropriately/sufficient contact time E] ❑ 7 Sharps containers labeled, used, and disposed of appropriately ❑ Wet contact time provided: 1 min ❑ 8. Jewelry, tattoo and piercing equipment - clean and El 26. Barriers used Elsterilized PRACTITIONER HEALTH AND HYGIENE El 27. Products applied to skin are single use/dispensed aseptically ❑ ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ❑ 11 Handwashing facilities properly supplied and accessible, water ❑ ❑30 Cross -contamination avoided during all phases of rocedure Elwarm ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES El13. Bloodbome Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ Source: AboveTraining.com ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 14. Appropriate personal protective equipment available and ❑El33 Workstation, surfaces, including chairs, armrests, etc. in good repair El CUSTOMERSICLIENTS ❑ 34. Permit/registration posted ❑ ❑ 15. Branding is completed with no other customers in rocedure area ❑ ❑ 35. Operation and employee training records present El ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s) submitted for review ❑ ❑ 18 Client records approved and available - Consent form and uestionnaire El El 37. Permits obtained and available El ❑ 19. 1 Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received b (Print): Ra nelle Preciado Received by (Signature): Phone: 510 828-3244 Specialist (Print): Mai Vue Specialist (Signature): Phone: (209) 468-3284 Reinspecion oniabout: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH -11/17