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Body Art Inspection Report Date: 12/27/21 nSan Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PRO546374 (209) 468-3420 <aeo�P • w .sioay.ore/ehd Program d Element: 4120 Facility Name Address City Zip Code Brow Divas 4 N School St. Lodi 95240 Name of Permil/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Marian Chavez 6/30/22 Routine The above facility is inspected for compliance with Division 104, Part 15, Chapter 7 of California Health and Safety Code (HSC). V = Violation C = Corrected On Site V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont. C Parts replaced between clients - grommets, elastic bands, El ❑ 1. Autoclave: approved and effective -pass ed integrator test ❑ ❑ 22. etc. Items washed, disinfected, packaged, labeled, and El 2' sterilized ❑ PREVENTING CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated El ❑ 4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used Decoarea separated and supplied El Elo El 5' appropriately o❑ Chemical used: Invoices and log kept for disposable, pre -sterilized ❑ 6. ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time F1equipment Sharps containers labeled,. used, and disposed of El 7' appropriately ❑ Wet contact time provided: Jewelry, tattoo and piercing equipment - clean and El 8. sterilized E] El 26. Borders used El PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ Handwashing facilities properly supplied and accessible, El 11. El❑ ❑ 30. Cross -contamination avoided during all phases of procedure warm water ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ Source: ® 32. Floors and walls clean and in good repair, adequate light ❑ Appropriate personal prolective equipment available and Workstation, surfaces, including chairs, armrests, etc. In ❑ 14. used ❑ ❑ 33' good repair El CUSTOMERSICLIENTS ❑ 34. Permit/registration posted ❑ Branding is completed with no other customers in El 15. rocedure area ❑ ❑ 35. Operation and employee training records present El ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure J El 36. Plants) submitted for review ❑ Client records approved and available - Consent form and ® 18. questionnaire El37. Permits obtained and available19. Appropriate aftercare instructions given to client El38. Impoundment ElMACHINE SAFETY AND SANITATION 39. Hearing scheduled Safe machine design ❑ 20. 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received by (Print)' Marian Chavez Received by (Signature): Emailed Phone: 805-260-2329 Specialist (Print): Sandip Singh Specialist (Signature): ad # Phone' 209-468-3526 Reinspection onlabout: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH -11/17 J,