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Body Art Inspects Report Date: I1q I1$ <br />�C San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Record: P 2l) S L3 y SZ <br />(209) 468-3420 <br />www.siogv.org/ehd Program <br />Element: 141 <br />Facility Name Address City Zip Code <br />Canvas Tattoo 304 w. harding way #b Stockton 95204 <br />Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br />Melissa Santos 6/30/15 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 ❑ ❑ 22 Parts replaced between clients - grommets, elastic bands, ❑ <br />test etc. <br />El <br />2' <br />Items washed, disinfected, packaged, labeled, and <br />El <br />10. <br />Hands washed effectively and timely <br />sterilized <br />11 <br />® <br />3. <br />Autoclave loaded correctly/packages allowed to dry <br />❑ <br />® <br />4. <br />Integrators used/monthly spore test/log maintained <br />❑ <br />® <br />5' <br />Decontamination/sanitation area separated and supplied <br />❑ <br />Appropriate personal protective equipment available and <br />used <br />26. <br />appropriately <br />❑ <br />® <br />6 <br />Invoices and log kept for disposable, pre -sterilized <br />❑ <br />Customers eighteen (18) years of age or older <br />❑ <br />equipment <br />Skin adequately prepared for procedure <br />® <br />7' <br />Sharps containers labeled, used, and disposed of <br />❑ <br />19. <br />Appropriate aftercare instructions given to client <br />appropriately <br />❑ <br />❑ <br />8 <br />Jewelry, tattoo and piercing equipment - clean and <br />❑ <br />sterilized <br />PRACTITIONER HEALTH AND HYGIENE <br />® <br />9. <br />No eating, drinking or smoking - clean clothes <br />❑ <br />10. <br />Hands washed effectively and timely <br />® <br />11 <br />Handwashing facilities properly supplied and accessible, <br />warm water <br />❑ <br />12. <br />Hepatitis B vaccination <br />® <br />13. <br />Bloodborne Pathogen training <br />El <br />❑ <br />Source: <br />❑ <br />14. <br />Appropriate personal protective equipment available and <br />used <br />26. <br />CUSTOMERS/CLIENTS <br />❑ <br />15. <br />Branding is completed with no other customers in <br />procedure area <br />❑ <br />16. <br />Customers eighteen (18) years of age or older <br />❑ <br />17. <br />Skin adequately prepared for procedure <br />® <br />18 <br />Client records approved and available - Consent form <br />and questionnaire <br />® <br />19. <br />Appropriate aftercare instructions given to client <br />MACHINE SAFETY AND SANITATION <br />❑ 20. Safe machine design <br />❑ 21. Machines cleaned and disinfected between clients <br />PREVENTING CROSS -CONTAMINATION <br />❑ <br />23. <br />1 Workstation/procedure area decontaminated <br />❑ <br />[j <br />24. <br />Appropriate chemical disinfectant used <br />❑ <br />31. <br />Areas separated/no living or sleeping quarters <br />Chemical used: <br />❑ <br />❑ <br />25. <br />Disinfectant used appropriately/sufficient contact time <br />El <br />❑ <br />❑ <br />[Wet contact time provided: <br />® <br />❑ <br />26. <br />Barriers used <br />❑ <br />El <br />27. <br />Products applied to skin are single use/dispensed <br />ase tical) <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 />'-'I <br />36. <br />1 Plan(s) submitted for review <br />BEST BUSINESS PRACTICES <br />❑ <br />E]® <br />Permits obtained and available <br />❑ <br />31. <br />Areas separated/no living or sleeping quarters <br />❑ <br />❑ <br />❑ <br />® <br />32. <br />Floors and walls clean and in good repair, adequate light <br />❑ <br />❑ <br />Closure <br />® <br />33. <br />Workstation, surfaces, including chairs, armrests, etc. in <br />good repair <br />❑ <br />❑ <br />❑ <br />34. <br />Permit/registration posted <br />❑ <br />El I ® 135. 1 Operation and employee training records present 1 ❑ <br />COMPLIANCE AND ENFORCEMENT <br />❑ <br />36. <br />1 Plan(s) submitted for review <br />❑ <br />❑ <br />37. <br />Permits obtained and available <br />❑ <br />❑ <br />38. <br />Impoundment <br />❑ <br />❑ <br />39. <br />Hearing scheduled <br />❑ <br />❑ <br />40. <br />Closure <br />❑ <br />❑ <br />41. <br />❑ <br />Received b (Print): Melissa Santos Received b (Signature 941-0875 <br />Specialist (Print): Beniamin Escotto, Sr REHS Specialist (Signature): Phone: (209) 468-3178 <br />Reinspecion on/about: 1 1A Its A reinspection fee of $130 per hour may be charged. <br />EH -03/2015 <br />Page 1 of 3 <br />