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COMPLIANCE INFO_TERI EISERT
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0538753
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COMPLIANCE INFO_TERI EISERT
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Last modified
7/5/2023 12:09:13 PM
Creation date
5/24/2023 4:27:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0538753
PE
4120
FACILITY_ID
FA0022239
FACILITY_NAME
PRETTY IN INK @ KHARMA SPA
STREET_NUMBER
2009
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
11336408
CURRENT_STATUS
02
SITE_LOCATION
2009 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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-pfh.. <br /> Body Art Inspe n Report • Date: <br /> San Joaquin County Environmental Health Department Program <br /> (: 9 PtivS38�S3 <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> \� P (209)468-3420 Program <br /> www.sioay.org/ehd Element: 412.0 <br /> ,C(FOiRN' <br /> Facility Name Address City Zip Code <br /> Pretty In Ink @ Kharma Spa 2009 pacific ave. Stockton 95204 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Teri L.Turrentine-Eisert 6/30/15 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, Eltest etc. <br /> ❑ <br /> Items washed,disinfected,packaged,labeled,and 2' sterilized ❑ 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 ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> F1 5' ❑ Chemical used: <br /> appropriately <br /> 6. <br /> ro riatel <br /> ® <br /> Invoices and log kept for disposable,pre-sterilized 6• equipment ❑ El25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled,used,and disposed of ❑ <br /> ❑ 7 El Wet contact time provided: <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8' El El 26. Barriers used E3sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27' ase tical) El <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ® 28. Storage of inks,pigments, needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely [I ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ <br /> ❑ <br /> Handwashing facilities properly supplied and accessible, El30Cross-contamination avoided during all phases of 11. warm water ' procedure E] <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training EJ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in 14. used ❑ ❑ 33' good repair <br /> El <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. ❑ ❑ 35. Operation and employee training records present <br /> procedure area ❑ <br /> ® 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. 1 Plan(s)submitted for review ❑ <br /> ® 18 Client records approved and available-Consent form <br /> and uestionnaire and El 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. , r ❑ <br /> Received b (Print): Teri L.Turrentine-Eisert Received b Si natur : Phone: 209 365-3973 <br /> Specialist(Print): Benjamin Escotto,Sr REHS Specialist(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 />
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