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` Body Art Inspection Report Date: October 5,2021 <br /> San Joaquin County Environmental Health Department Program <br /> . 1868 E.Hazelton Ave.,Stockton,CA 95205 {{�� <br /> milt_ A: azeve., on, <br /> - / (209)468-3420 Record: <br /> c �P www.sioay.ora/ehd Program <br /> `gCiFa'N Element: 4103 <br /> Facility Name Address City Zip Code <br /> The Hidden Gem 4545 Georgetown Place F-42 Stockton 95207 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Liana Hoang 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 /> Tle <br /> El1. Autoclave:approved and effective-passed integrator test El El 22. c.rts replaced between clients grommets,elastic bands, ❑ <br /> Items washed,disinfected,packaged,labeled,and <br /> ❑ 2. sterilized El 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 El El 5' a ro riatel ElChemical used: <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6. ❑ El25. Disinfectant used appropriately/sufficient contact time El <br /> ui ment <br /> Sharps containers labeled,used,and disposed of <br /> El 7' a ro riatel El Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> F-1 8. ❑ El 26. Barriers used <br /> sterilized <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed 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 ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ <br /> ❑ <br /> Handwashing facilities properly supplied and accessible,11. warm water El ❑ 30. Cross contamination avoided during all phases of procedure El <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> El El <br /> Bloodborne Pathogen training El ❑ 31. Areas separated/no living or sleeping quarters El <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> Appropriate ersonal protective equipment available and Workstation surfaces including chairs,armrests,etc. in <br /> p P9 <br /> ❑ 14. used ❑ ❑ 33. good repair <br /> ❑ <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El El 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. Plan(s)submitted for review ❑ <br /> Client records approved and available-Consent form and <br /> ❑ 18. El El 37. Permits obtained and available <br /> questionnaire <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 ❑ El 41. El <br /> Received by(Print): Liana Hoang Received by(Signature): Phone:209-373-5889 <br /> Specialist(Print): Pinne Chao Specialist(Signature): Phone:209-468-3854 <br /> Reinspection on/about: A reinspection fee of$152 per hour may be charged. Page 1 of 2 <br /> EH-11/17 <br />