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�4P ' Body Art InspeA Report <br /> _ 02 Date: <br /> a. San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 <br /> ORa Program <br /> ••......••'�•P' <br /> c,Fwww.sjogv.orq/ehd <br /> Element: r{ <br /> Facility Name Address City Zip Code <br /> Canvas Tattoo 304 harding way Stockton 95204 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Melissa Santos 6/30/14 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 El ❑ 22 Parts replaced between clients-grommets,elastic bands, E]test etc. <br /> ® 2 Items washed,disinfected,packaged,labeled,and ❑ <br /> sterilized PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry [I ❑ 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 El <br /> appropriately ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment ❑ E] 25. Disinfectant used appropriately/sufficient contact time <br /> ❑ 7 Sharps containers labeled,used,and disposed of ❑ <br /> a ro riatel El Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized ❑ ® 26. Barriers used ❑ <br /> ❑ 27 Products applied to skin are single use/dispensed El <br /> HEALTH AND HYGIENE ase tical) <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 /> ❑ 11 Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> warm water El ❑ 30' El <br /> ❑ 12. Hepatitis B vaccination ❑ <br /> BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 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 ❑ <br /> used good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area El 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 ❑ <br /> ® 18 Client records approved and available-Consent form <br /> and uestionnaire El ❑ 37. Permits obtained and available El <br /> ® 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ 1 ❑ 41. 1 ❑ <br /> Received b (Print): Melissa Santos Received b (Signat Phone: � �G� / — <br /> Specialist <br /> S cialist Print: Afonso Arambula Specialist Si nature: Phone: 209 468-9673 <br /> Reinspecion on/about: A reinspection fee of$125 per hour may c a Page 1 of 2 <br /> EH-04/2014 <br />