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perU{� <br /> o� Body Art Inspectii2eport Date: <br /> San Joaquin County Environmeatal Health Department Program n <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: ►C G S Z.3 q S 2- <br /> =� (209)468-3420 <br /> www.siogv.org/ehd Program <br /> 6/1WVA S._ T4'T e& Sec-EiU)gf_)L. Element: C <br /> Facility Name Address City Zip Code <br /> Canvas Tattoo 304 west harding way#b Stockton 95204 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Melissa Santos 6/30/20 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 /> F11 Autoclave:approved and effective-passed integrator Parts replaced between clients-grommets,elastic bands, ❑ <br /> test El ❑ 22' etc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized ❑ PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> ❑ 5 Decontamination/sanitation area separated and supplied E]appropriate) El Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> eui ment El El25. Disinfectant used appropriately/sufficient contact time <br /> ❑ 7 Sharps containers labeled,used,and disposed of Elaro <br /> appropriately E] Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized El El26. Barriers used El <br /> ❑ 27 Products applied to skin are single use/dispensed ElPRACTITIONER HEALTH AND HYGIENE aseptically <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments, needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks,Needles etc approved and used correctly ❑ <br /> ❑ it. Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of ❑ <br /> warm water F-1 ❑ 30. procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingEl ® 31. Areas separated/no living or sleeping quarters El <br /> Source: ® 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and ❑ [j 33 Workstation,surfaces,including chairs,armrests,etc.in E]used good repair <br /> CUSTOMERSICLIENTS ❑ 34• Permittregistration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area El ® 35. Operation and employee training records present El <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 El® 18 Client records approved and available-Consent form <br /> and questionnaire El El 37. Permits obtained and available El <br /> ❑ 19. Appropriate aftercare instructions given to client C1 ❑ 38. Impoundment E] <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. Ell <br /> fi <br /> Received b (Print): Melissa Santos Received b re:Si na Phone:Zoe,, ���J'ds/ <br /> Specialist(Print): J.Easter Specialist Si nature: Phone: 209 953-7310 <br /> Reinspecion onlabout: A reinspection fee of$152 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br /> �Y <br />