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Body Art Inspeco Report Date: 5 1315 =. San Joaquin County Environmental Health Department Program N; ap� a 1868 E. Hazelton Ave., Stockton, CA 95205 Record: o(209) 468-3420 Program ) q<%FORa` www siogv.or /g ehd Element: `l ZO Facility Name Address City Zip Code Wrong Side of the Tracks 512 n. union rd. Manteca 95337 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Aaron Brockman 6/30/15 Re -inspection 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, ❑ test etc. El 2' Items washed, disinfected, packaged, labeled, and El sterilized CROSS -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 ❑ ❑ 5' Decontamination/sanitation area separated and supplied F] Chemical used: appropriately ® 6• Invoices and log kept for disposable, pre -sterilized ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time equipment ElSharps ® 7' containers labeled, used, and disposed of ❑ Wet contact time provided: a ro riatel ❑ 8' Jewelry, tattoo and piercing equipment - clean and El El26. Barriers used ❑ sterilized El 27' Products applied to skin are single use/dispensed PRACTITIONER HEALTH AND HYGIENE asepticallyEl ❑ 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, E] ❑ 30. Cross -contamination avoided during all phases of El warm water ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ® 13. Bloodborne Pathogen trainingEl[EE11 31. Areas separated/no living or sleeping quarters El Source: 32. Floors and walls clean and in good repair, adequate light ElEl 14 Appropriate personal protective equipment available and ❑ 33 Workstation, surfaces, including chairs, armrests, etc. in 11used good repair CUSTOMERS/CLIENTS ❑ 34• Perm ittregistration posted ❑ ❑ 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 ❑ ❑ 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 ❑ ro 41. ❑ Brockman Received Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 1 of 2 EH -03/2015