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U1, ' Body Art InspectifoReport 40 Date: ` S �a. is San Joaquin County Environmental Health Department Program Q G 1868 E. Hazelton Ave., Stockton, CA 95205 Record: (209) 468-3420 www.siogv.org/ehd Program Element: L(� Facility Name Address City Zip Code Pretty Obsessed Boutique 2341 pacific ave. #b Stockton 95204 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Raynelle Preciado Initial Consult. 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 V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont.) C ❑ 1 Autoclave: approved and effective - passed integrator ❑ ❑ 22 Parts replaced between clients - grommets, elastic bands, ❑ PRACTITIONER HEALTH AND HYGIENE ❑ 9. No eating, drinking or smoking - clean clothes ❑ 10. Hands washed effectively and timely ® 11 Handwashing facilities properly supplied and accessible, warm water ® 12. Hepatitis B vaccination ® 1 13. 1 Bloodborne Pathogen training test ❑ 2 Items washed, disinfected, packaged, labeled, and ❑ CUSTOMERS/CLIENTS sterilized ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ 4. Integrators used/monthly spore test/log maintained ❑ 5 Decontamination/sanitation area separated and supplied 18 Client records approved and available - Consent form and questionnaire appropriately ® 6 Invoices and log kept for disposable, pre -sterilized ❑ ❑ equipment ® 7 Sharps containers labeled, used, and disposed of ❑ appropriately El 8. Jewelry, tattoo and piercing equipment - clean and ❑ ❑ sterilized PRACTITIONER HEALTH AND HYGIENE ❑ 9. No eating, drinking or smoking - clean clothes ❑ 10. Hands washed effectively and timely ® 11 Handwashing facilities properly supplied and accessible, warm water ® 12. Hepatitis B vaccination ® 1 13. 1 Bloodborne Pathogen training MACHINE SAFETY AND SANITATION ❑ 20. Safe machine design ❑ 21. Machines cleaned and disinfected between clients Received Preciado Received ❑ Source: ❑ 14. Appropriate personal protective equipment available and used ❑ CUSTOMERS/CLIENTS ❑ 15. Branding is completed with no other customers in procedure area ❑ 16. Customers eighteen (18) years of age or older ❑ 17. Skin adequately prepared for procedure ® 18 Client records approved and available - Consent form and questionnaire ® 19. Appropriate aftercare instructions given to client MACHINE SAFETY AND SANITATION ❑ 20. Safe machine design ❑ 21. Machines cleaned and disinfected between clients Received Preciado Received ❑ ❑ 23. 1 Workstation/procedure area decontaminated ❑ ❑ ❑ ® 24. Appropriate chemical disinfectant used ❑ ❑ ❑ Chemical used: ❑ ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time 38. ❑ ❑ Wet contact time provided: ❑ ❑ ❑ 26. Barriers used ❑ ❑ El 27. Products applied to skin are single use/dispensed asepticall ❑ ❑ ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ [1 29. Jewelry, Inks, Needles etc approved and used correctly ❑ El El 30. Cross -contamination avoided during all phases of procedure ❑ ❑ BEST BUSINESS PRACTICES ❑ 31. Areas separated/no living or sleeping quarters ❑ 11 ® 32. Floors and walls clean and in good repair, adequate light ❑ El ® 33. Workstation, surfaces, including chairs, armrests, etc. in good repair E] ® 34. Permit/registration posted ❑ ❑ ® 35. Operation and employee training records present ❑ v Specialist (Print): Beniamin Escotto, Sr REHS Specialist (Signature): .A' An n Y4W Phone: (209) 468-3178 Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 1 of 3 EH -03/2015 COMPLIANCE AND ENFORCEMENT ❑ ❑ 36. Plan(s) submitted for review ❑ ❑ ❑ 37. Permits obtained and available ❑ ❑ ❑ 38. Impoundment ❑ ❑ 39. Hearing scheduled ❑ ❑ ❑ 40. Closure ❑ ❑ ❑ 41. ❑ v Specialist (Print): Beniamin Escotto, Sr REHS Specialist (Signature): .A' An n Y4W Phone: (209) 468-3178 Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 1 of 3 EH -03/2015