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Body Art Inspp <br /> ee Report Date: <br /> ,.�o......,.• .c° 5 (� <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: P(LnS l l boo <br /> P (209)468-3420 Program <br /> www.siogvorg/ehd Element: 141z-c) <br /> Facility Name Address City Zip Code <br /> Gypsy Soul Tattoo 118 w.Yosemite ave. Manteca 95336 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> John Holguin 6/30/16 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 /> El 2' sterilized 11PREVENTING 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 ❑ <br /> ❑ 5. appropriately ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable,pre-sterilized <br /> equipment E] El25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled, used,and disposed of ❑ <br /> ® 7. appropriately ❑ Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> F-1 8' ❑ El26. Barriers used <br /> sterilized ❑ <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 /> ❑ <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of ❑11. warm water El ❑ 30. procedure <br /> ® 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodbome 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 Elused ood re air <br /> CUSTOMERS/CLIENTS ® 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. rocedure area ❑ ® 35. Operation and employee training records present ❑ <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 ❑ El 37. Permits obtained and available E] <br /> and <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): Chris McPherson Received by(Signature-. Phone: 209 351-5124 <br /> Specialist(Print): Benjamin Escotto,Sr REHS S ecialist(Signature): Phone: 209 468-3178 <br /> Reinspecion onlabout: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />