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Body Art Inspen Report Date: S16111— <br /> San <br /> ltj( I11San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: P2y S3'7n l <br /> (209)468-3420 Program <br /> yaage►�' www.siogv.org/ehd 1 <br /> Element: 4 <br /> Facility Name Address City Zip Code <br /> Ink City Tattoo 3008 a hammer In Stockton 95212 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Phillip Mendoza 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 ElI PREVENTING CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry Eli ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> ElDecontamination/sanitation area separated and supplied <br /> ❑ 5' ElChemical used: <br /> appropriately <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6• ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> equipment <br /> ElSharps containers labeled,used,and disposed of <br /> ❑ 7" ❑ Wet contact time provided: <br /> Appropriately <br /> F18 Jewelry,tattoo and piercing equipment-clean and ❑ El 26. Barriers used El <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE [_1 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 r0l <br /> [129. Jewelry,Inks,Needles etc approved and used correctly ❑ <br /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> ® 11' warm water F1 30" procedure <br /> El <br /> 12. Hepatitis B vaccination BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingEl ® 31. Areas separated/no living or sleeping quarters El <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in <br /> F1 14. Elused ❑ 33" good repair ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> F1 15. ❑ ® 35. Operation and employee training records present Elrocedure 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 /> ® 18 Client records approved and available-Consent form El El37. Permits obtained and available E]and questionnaire <br /> ® 19. Appropriate aftercare instructions given to client ❑ El38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleanedandand disinfected between clients Ell 01 41. ❑ <br /> 1A <br /> Received b Print: %% ') C eceived b Si nature: Phone:�Oci )— 4-)32Specialist(Print): C(1 rvt, Specialist Si nature: Ew�da_m .__ Phone: <br /> Zoo - l7 <br /> Reinspecion on/about: A reinspection fee of$125 per hour may charged. Page 1 of 2 <br /> EH-04/2014 <br />