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Body Artlnspean Report Date: S ,� San Joaquin County Environmental Health Department Program • 1868 E. Hazelton Ave., Stockton, CA 95205Record: P�6 C , ., 5's-1- l (209) 468-3420 Program `P www.siogv.org/ehd Element: U l Z 1 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 6/30/14 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 V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont. C ® 1 Autoclave: approved and effective - passed integrator El ❑ 22 Parts replaced between clients - grommets, elastic bands, ❑ test etc. ® 2. Items washed, disinfected, packaged, labeled, and ElI sterilized PREVENTING CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ [1 23. Workstation/procedure area decontaminated ❑ ® 4. Integrators used/monthly spore testflog maintained ❑ ❑ 24. Appropriate chemical disinfectant used El® 5' Decontamination/sanitation area separated and supplied ❑ Chemical used: appropriately ® 6- Invoices and log kept for disposable, pre -sterilized El El 25. Disinfectant used appropriately/sufficient contact time equipment E]Sharps ® 7' containers labeled, used, and disposed of Wet contact time provided: appropriately❑ ❑ 8 Jewelry, tattoo and piercing equipment - clean and ❑ ❑ 26. Barriers used ❑ sterilized El 27' Products applied to skin are single use/dispensed El PRACTITIONER HEALTH AND HYGIENE ase tical) ❑ 9. No eating, drinking or smoking - clean clothes ❑ ® 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. 29. Jewelry, Inks, Needles etc approved and used correctly E] ® 11. Handwashing facilities properly supplied and accessible, 30' Cross -contamination avoided during all phases of ❑ warm water procedure ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ® 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ ❑ Source: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ El 14. Appropriate personal protective equipment available and Elused ❑ 33' Workstation, surfaces, including chairs, armrests, etc. in El go repair CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ ❑ 15. Branding is completed with no other customers in E] 35. Operation and employee training records present El® 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 ❑ ❑ 1 41. ❑ Received b (Print): Max Ackermann Received b Si nature Phone:g'I Specialist (Print): Benjamin Escotto Specialist (Signature): Phone: 209 468-3178 Reinspecion on/about: A reinspection fee of $125 per hour may charged. Page 1 of 3 EH -04/2014