COMPLIANCE INFO_TERI EISERT - Laserfiche WebLink

Home Browse Search

3-141-141 Body Art Inspection Report Date(MM1DD/YY) y County of San Joaquin County,Environmental Health Department 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number (209)468-3420 www.si-gov.ora/ehd Permit Type q l a o •.��< Fv_O R.I��. Facility Name Address City Zip Code CT Penni egistration Holder Name Permit Exp.Date Total Time Inspection Type t IC',rn jy vr-,p.✓►.�-m� _ ��r�-f�� 1''� �c�i-trn� sn: .r�c �v. RISK FACTORS AND INTERVENTIONS Risk factors are improper practices or procedures identified as contributing factors of cross-contamination. Interventions are control measures to prevent cross-contamination and transfer of pathogens from one person to another. In=In Compliance Out=Not in Compliance N/O=Not Observed N/A=Not Applicable COS=Corrected On Site h ry' TATTOO AND PERMANENT COSMETICS MACHINE' `. CLEANING AND STERILIZATION OUT cos SAFMANOSANITATION, our Cos In 1, Autoclave is approved and effective-passed y1n /O 18. Safe machine design 11 13 int rator test IneOU 2. Process of cleaning,labeling,packaging and 0 0 In N/0 19. Machines cleaned and disinfected between 0 0 stedizjing items correctly A clients In 0 3. Autoclave loaded correctly/packages allowed to 0 0 I NIO 20. Parts replaced between clients-grommets, 0 0 1 dry NIA elastic bands,etc. In 4. Integrators used/monthly spore test/log 0 0 PREVENTIN6d'OSS-CONTAMINATION N A maintained In 5. Decontamination/sanitation area separate and 0 0 InA/0 21. Workstation/procedure area decontaminated ❑ 13IA supplied* n NIO 6. Invoices and log kept for disposable,pre- 0 0In N/0 22. Chemical disinfectant used 0 0 NIA sterilized equipment,backu supplies available* N/A Chemical used: +moi - nN/0 7. Sharps containers supplied,labeled,used and 0 0 In N/O 23. Disinfectant used sufficient contact time Wet 0 0 N/A disposed of correct) /A contact timeprovided: In NIO 8. Jewelry,tattoo and piercing equipment-storage 0 01n)N/0 24. Barriers available and used as part of 0 0 MA and use NIA procedure R,, In N/0 25. Products applied to skin are single 0 0 PRACTITIONER HEALTH AND HYGIENE /A use/dispensed aseptically n_ /O 9. No eating,drinking or smoking-clean clothes 0 0 n N/O 26. Storage of Inks,pigments,needles,tubes,etc., 0 0 !A /A n N/0 10. Hands washed effectively and timely 0 0 In N/O 27. Jewelry,Inks,Needles etc approved and used 0 0 /A N/A n /0 11. Handwashing facilities properly supplied and 0 0 n 10 28. Cross-contamination avoided during all phases O 11N/A accessible,warm potable water* NIA of procedure n N/O 12. Personal protective equipment available and 0 0 BEST BUSINESS PRACTICES /A used,a awash station available* CUSTOMERSICLIENTS In 29. Areas separated/no living or sleeping 0 0 1quarters/no animals In 10 13. Branding is completed with no other customers in 0 0 n N10 30. Floors and walls dean and in good repair, ❑ ❑ !A procedure area NIA adequate light In /0 14. Customers eighteen(18)years of age or older 0 0n N/0 31. Workstation,surfaces,including chairs,,etc.in 0 0 N/A N/A good repair,trash removed frequently* n N/0 15. Skin prepared for procedure. 0 0 In N/0 32. Permit/registration and required signs posted* ❑ ❑ IA In N/O 16. Client records available-Consent form& 0 0 In /O 33. IPCP and employee training records and 0 0 _ /A questlionnaire !A He atitiis B vaccination status present UIn N/O 17. Aftercare instructions given to client 0 0 N10 34 Restrooms available,stocked* 0 0 IA N/A Received by(Print): Received by(Signature): Phone: Specialist(Print): Specialist(Signature): Phone: ❑ This report is an Official Notice of Violation.Corrections must be completed in the time specified. A reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. Reinspection Date(on or about) Page I of Ll