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of "" ' C' . Body Art InspeAn Report Date: 2' San Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: �°ISy I3 O (209) 468-3420 `<.� ••••. •;a` www.siogv.org/ehd Program Element: L1/2-0 Facility Name Address City Zip Code Pretty Obsessed Boutique 2341 pacific ave. #b Stockton 95204 Name of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Raynelle Preciado 6/30/18 Routine The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safety Code (HSC). V = Violation C = Corrected On Site ATER!t IMION, C V I MACHINE SAFETY AND SANITATION con# t- 22 Parts replaced between clients - grommets, elastic bands, C ❑ 1 Autoclave: approved and effective - passed integrator ❑ ❑ [ test etc. ❑ 2 Items washed, disinfected, packaged, labeled, and ❑ sterilized PREVENTING GROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated [ ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used [ El 5' Decontamination/sanitation area separated and supplied ❑ Chemical used: Caviwipes a ro riatel ® 6' Invoices and log kept for disposable, pre -sterilized El El25. Disinfectant used appropriately/sufficient contact time a ui ment [ ® 7'Elaro Sharps containers labeled, used, and disposed of Wet contact time provided: 1 min appropriately El 8' Jewelry, tattoo and piercing equipment - clean and El El26. Barriers used [ sterilized ❑ 27' Products applied to skin are single use/dispensed [ PRACTITIONER HEALTH AND HYGIENE asepticall F-19. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. [ ❑ 10. Hands washed effectively and timely ❑ [:1 29. Jewelry, Inks, Needles etc approved and used correctly [ ❑ 11. Handwashing facilities properly supplied and accessible, E]warm ❑ 30' Cross -contamination avoided during all phases of [ water procedure ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ® 13. 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 El ® 33. Workstation, surfaces, including chairs, armrests, etc. in [ used good repair °OHSTOMER&CLIENTS = ® 34. Permitlregistration posted [ El 15. Branding is completed with no other customers in ❑ ❑ 35. Operation and employee training records present [ procedure area ® 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 El El 37. Permits obtained and available and questionnaire ❑ 19. 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 by (Print): Raynelle Preciado Received by (Signature)_ Phone_ (510) 828-3244 Specialist (Print): Nav of Sahota S edalist (Signature): Phone: 209 468-3178 Reinspecion on/about: A reinspection fee of $152 per hour may be charged. Page 1 of,' EH -11/17