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�l <br />Body Art Inspeco Report <br />40 <br />LA laU �� 5 <br />i� <br />San Joaquin County Environmental Health Department <br />Date: <br />11sterilized <br />v <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />Program <br />Record: <br />SQ.OU'I��la$ <br />�,o P <br />Qt,FORe�` <br />(209) 468-3420 <br />www.sio.qv.org/ehd <br />Program <br />9 <br />Element: <br />l U 3 <br />❑ <br />13. <br />Bloodborne Pathogen training <br />❑ <br />Facility Name Address City Zip Code <br />Teleios Tattoo Studio 3414 delaware ave. Stockton 95204 <br />Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br />Daniel Hirschler Final Con./Rout. <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 />El 1 Autoclave: approved and effective - passed integrator E] E]22 Parts replaced between clients - grommets, elastic bands, ❑ <br />test etc. <br />❑ 2. <br />❑ 3. <br />❑ 4. <br />❑ 5. <br />❑ 6. <br />❑ 7. <br />❑ 8. <br />Items washed, disinfected, packaged, labeled, and <br />sterilized ❑ PREVENTING CROSS -CONTAMINATION <br />Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated <br />Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br />Decontamination/sanitation area separated and supplied <br />------- ❑ Chemical used: <br />Invoices and log kept for disposable, pre -sterilized <br />equipment <br />❑ <br />Sharps containers labeled, used, and disposed of <br />Elappropriately <br />10. <br />Jewelry, tattoo and piercing equipment - clean and <br />11sterilized <br />❑ <br />11 <br />PRACTITIONER HEALTH AND HYGIENE <br />❑ <br />9. <br />No eating, drinking or smoking - clean clothes <br />❑ <br />❑ <br />10. <br />Hands washed effectively and timely <br />❑ <br />❑ <br />11 <br />Handwashing facilities properly supplied and accessible, <br />warm water <br />❑ <br />❑ <br />12. <br />Hepatitis B vaccination <br />❑ <br />❑ <br />13. <br />Bloodborne Pathogen training <br />❑ <br />❑ <br />29. <br />Source: <br />❑ <br />❑ <br />14. <br />Appropriate personal protective equipment available and <br />rl <br />❑ <br />15. <br />Branding is completed with no other customers in <br />procedure area <br />❑ <br />❑ <br />16. <br />Customers eighteen (18) years of age or older <br />❑ <br />❑ <br />17. <br />Skin adequately prepared for procedure <br />❑ <br />❑ <br />18 <br />Client records approved and available - Consent form <br />questionnaire <br />Eland <br />❑ <br />19. <br />Appropriate aftercare instructions given to client <br />❑ <br />MACHINE SAFETY AND SANITATION <br />❑ 20. Safe machine design <br />❑ 21. Machines cleaned and disinfected between clients <br />Received <br />El <br />7 <br />❑ <br />25. <br />Disinfectant used appropriately/sufficient contact time <br />❑ <br />❑ <br />32. <br />Wet contact time provided: <br />❑ <br />❑ <br />26. <br />Barriers used <br />❑ <br />❑ <br />27 <br />Products applied to skin are single use/dispensed <br />aseptically <br />❑ <br />❑ <br />28. <br />Storage of inks, pigments, needles, tubes, etc. <br />❑ <br />❑ <br />29. <br />Jewelry, Inks, Needles etc approved and used correctly <br />❑ <br />❑ <br />30. <br />Cross -contamination avoided during all phases of <br />❑ <br />BEST BUSINESS PRACTICES <br />❑ <br />1 31. <br />Areas separated/no living or sleeping quarters <br />❑ <br />❑ <br />32. <br />Floors and walls clean and in good repair, adequate light <br />❑ <br />❑ <br />33. <br />Workstation, surfaces, including chairs, armrests, etc. in <br />good repair <br />❑ <br />❑ <br />34. <br />Perm it/registration posted <br />❑ <br />❑ <br />35. <br />Operation and employee training records present <br />❑ <br />COMPLIANCE AND ENFORCEMENT <br />❑ <br />36. <br />Plan(s) submitted for review <br />❑ <br />37. <br />Permits obtained and available <br />❑ <br />38. <br />Impoundment <br />❑ <br />39. <br />Hearing scheduled <br />❑ <br />40. <br />Closure <br />❑ <br />41. <br />623 - <br />Specialist (Print): Benjamin Escotto Sr REHS Specialist (Signature): � � , Phone: (209) 468-3178 <br />Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 1 of 2 <br />EH -03/2015 <br />