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f1 <br /> Body Art Inspects Report Date: <br /> San Joaquin County Environmental Health Department Program <br /> ' 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: �R M-0 52-319 2 <br /> (209)468-3420 Program Z 1 <br /> w. <br /> wwsiogv org/ehd Element: 1 <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 6/30/18 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 /> Items washed,disinfected,packaged,labeled,and <br /> 2' sterilized E]I 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 El [124. Appropriate chemical disinfectant used <br /> ❑ <br /> Decontamination/sanitation area separated and supplied E] Chemical used: Madacide <br /> ® 5. appropriately <br /> Invoices and log kept for disposable,pre-sterilized <br /> � 6. ❑ E] 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ® 7 Sharps containers labeled, used,and disposed of ❑ [Wet contact time provided: <br /> appropriately <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and ❑ ❑ 1 26. Barriers used ❑ <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27. 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 /> ❑ 11. Handwashing facilities properly supplied and accessible, ❑ ❑ 30 Cross-contamination avoided during all phases of ❑ <br /> warm water I procedure <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: Above Training,Cathy Montie ❑ 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 /> Branding is completed with no other customers in <br /> El 15. ❑ ® 35. Operation and employee training records present El <br /> rocedure area <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 /> Client records approved and available-Consent form <br /> ❑ 18. d El [_137. Permits obtained and available ❑ <br /> anuestionnaire <br /> ® 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ 140 <br /> ClosureEl21. Machines cleaned and disinfected between clients ❑ 41. ❑ <br /> Received b (Print): Melissa Santos Received b Si ure: Phone: 209 941 -0875 <br /> Specialist Print): Ha rit Mattu,Sr REHS Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br />