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U.1" Body Art Inspe&n Report • Date: <br /> , �►Lt/I'j <br /> N San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> Record: <br /> (209)468-3420 Program <br /> `P wwwslogv.org/ehd <br /> Element: Li ZG <br /> Facility Name Address City Zip Code <br /> True Tattoo 811 e.march In,suite#2 Stockton 95210 <br /> Name of Perm it/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Ryan Abellan Final/Routine <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, C <br /> test I etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> ❑ 2' sterilized El CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. 1 Workstation/procedure area decontaminated <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied Chemical used: Madacide C <br /> ❑ 5' <br /> appropriately <br /> El <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6. equipment El El 25. Disinfectant used appropriately/sufficient contact time <br /> C <br /> ❑ 7 Sharps containers labeled, used,and disposed of ❑ Wet contact time provided: 10 min <br /> appropriatel <br /> Jewelry,tattoo and piercing equipment-clean and <br /> ❑ 8. sterilized El El26. Barriers used C <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. aseptically C <br /> El 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments,needles,tubes,etc. <br /> ❑ 10. Hands washed effectively and timely <br /> El 29. Jewelry,Inks,Needles etc approved and used correctly <br /> ® 11. Handwashing facilities properly supplied and accessible, ❑ ❑ 30 Cross-contamination avoided during all phases of E: <br /> warm water I procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ® 31. 1 Areas separated/no living or sleeping quarters <br /> Source: Cathy Montie ® 32. Floors and walls clean and in good repair,adequate light <br /> ❑ 14. Appropriate personal protective equipment available and ❑ 33 Workstation,surfaces,including chairs,armrests,etc.in E <br /> used ood repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted E <br /> Branding is completed with no other customers in <br /> E] 15. rocedure area ❑ ❑ 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 C <br /> Client records approved and available-Consent form <br /> ® 18. E] E:137. Permits obtained and available C <br /> and questionnaire <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment C <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled C <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure C <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. C <br /> Received by(Print): Ryan Abellan Received b (Signature): Phone: 916 753-6898 <br /> Specialist Print): Nav of Sahota S ecialist Si nature: r Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />