COMPLIANCE INFO_TERI EISERT - Laserfiche WebLink

Home Browse Search

Body Art Inspection Report Date(MM/DD/YY) a`U'7 y y County of San Joaquin County,Environmental Health Department C < 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number J h�11 Z 7 (209)468-3420 www.sigov.oro/ehd Permit Type �a Facility Name Address City Zip Code CT Pennk/Registration Holder Name Permit Exp.Date Total Time Inspection Type `n" >':I 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 � � ; " TATTOO AND,PERMANENT COSMETICS MACHINE CLEANING AND STERILIZATION our cos SAFETYANI)SAN"ITATION our Cos In N/0 1. Autoclave is approved and effective-passed In N/O 18. Safe machine design NIA int rator test NIA In N/0 2. Process of cleaning,labeling,packaging and 0 In NIO 19. Machines cleaned and disinfected between 0 0 NIA sterli7iing items correct) N/A clients In N/0 3. Autoclave loaded correctly/packages allowed to 0 In NIO 20. Parts replaced between clients-grommets, 0 0 NIA dry NIA elastic bands,etc. In N/O 4. Integrators used/monthly spore test/log 0 0 PREVENTING CROSS-CONTAMINATION N/A maintained In N/0 5. Decontaminatiordsanitation area separate and 0 In N/0 21. Workstation/procedure area decontaminated 0 0 N/A supplied* NIA In NIO 6. Invoices and log kept for disposable,pre- in N/0 22. Chemical disinfectant used 0 0 NIA sterilized equipment,backu supplies available* N/A Chemical used: In NIO 7. Sharps containers supplied,labeled,used and In WO 23. Disinfectant used sufficient contact time Wet 0 0 NIA disposed of corrects * N/A contact time provided: In N/0 8. Jewelry,tattoo and piercing equipment-storage 0 n 10 24. Barriers available and used as part of 0 NIA and use NIA procedure +� "�' yIn NIO 25. Products applied to skin are single 0 13 PRACTITIONER HEALTH AMID FIXGIE ,' N/A use/dispensed aseptically In N10 9. No eating,drinking or smoking-clean clothes 0 0 In N/0 26. Storage of inks,pigments,needles,tubes,etc., 0 0 N/A NIA In N/O 10. Hands washed effectively and timely 0 0 In N/0 27. Jewelry,Inks,Needles etc approved and used 0 0 NIA NIA In N10 11. Handwashing facilities properly supplied and 0 In N10 28. Cross-contamination avoided during all phases 0 0 IA accessible,warm potable water* N/A of procedure In N/O 12. Personal protective equipment available and 0 AT BEST BUSINESS PRACTICES NIA used,eyewash station available a CuSD�ERSICI:IENT5 � In NIO 29. Areas separated/no living or sleeping ❑ ❑ "* ;, FRI N/Aquarters/no animals In N/0 13. Branding is completed with no other customers in 0 0 In NIO 30. Floors and walls clean and in good repair, 0 N/A procedure area N/A adequate light In N10 14. Customers eighteen(18)years of age or older 0 0 In N/0 31. Workstation,surfaces,including chairs,,etc.in 0 N/A N/A good repair;trash removed frequently* In N/0 15. Skin prepared for procedure. In N/0 32. Permit/registration and required signs posted NIA 0 0 N/A ❑ ❑ In NIO 16. Client records available-Consent form& % 0 In N/0 33. IPCP and employee training records and 0 0 NIA questionnaire N/A Hepatitis B vaccination status present In NIO 17. Aftercare instructions given to client 0 In N/0 34 Restrooms available,stocked* 0 0 NIA 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 L of