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Body P P Art Ins eA Report Date: s jt <br /> ahs <br /> k San Joaquin County Environmental Health Department Program <br /> u { 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: ��SL31SZ <br /> c u P (209)468-3420 <br /> Program <br /> q<iFiarh' www.siogv.or4/ehd g �lL, <br /> Element: <br /> Facility Name Address City Zip Code <br /> Canvas Tattoo 304 w.harding way#b Stockton 95204 <br /> Name of Perm it/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Melissa Santos 6/30/15 Re-inspection <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, Eltest etc. <br /> Items washed,disinfected,packaged,labeled,and <br /> El 2' sterilized El 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 /> Decontamination/sanitation area separated and supplied El <br /> El 5' <br /> appropriately <br /> E] Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6' equipment ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> ® 7 Sharps containers labeled, used,and disposed of <br /> appropriately <br /> ❑ Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> ❑ E] 26. Barriers used <br /> sterilized ❑ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE F-1 27. 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, ElElavoided during all phases of Elwarm water ❑ 30' procedure <br /> ❑ 12. Hepatitis B vaccination ❑ 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 [E][E] 33 Workstation,surfaces, including chairs,armrests,etc. in Elused ood re air <br /> CUSTOMERSICLIENTS ❑ 34. Permit/registration posted E] <br /> El Branding is completed with no other customers in <br /> rocedure area ❑ ® 35. Operation and employee training records present E] <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 37. Permits obtained and available <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 ❑ ❑ 41. ❑ <br /> Received b (Print): Melissa Santos Received b Si natu ne: 209 941-0875 <br /> Specialist(Print): Benjamin Esotto,Sr REHS S ecialist(Signature): Phone: 209 468-3178 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />