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p Body Art Inspection Report � oG Y p p Dale: April 25, 2022 mSan Joaquin County Environmental Health Department Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0539655 (209) 468-3420 •'fy .si00yof0/eh6 Program .Fd N� Element: 4120 Facility Name Address City Zip Code Death Ray Tattoo 181 S Union Rd #105 Manteca 95336 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Ian Goff and Wesley Fareas 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 Paris replaced between clients - grommets, elastic bands, El 1. Autoclave: approved and effective - passed integrator test El El 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 ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used Decontamination/sanitation area separated and supplied ❑ El 5. appropriately ❑ Chemical used: Invoices and log kept for disposable, pre -sterilized ® 6. ❑ ❑ 25. Disinfectant used appropriately/sufficient contact time Elequipment Sharps containers labeled, used, and disposed of El 7" appropriately ❑ Wet contact time provided: Jewelry, tattoo and piercing equipment - clean and El 8' sterilized ❑ ❑ 26. Barriers used ❑ PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ ❑ 9. No eating, drinking or smoking - clean clothes Ell ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needlesetc approved and used correctly ❑ Handwashing facilities properly supplied and accessible, El 11. warm water El El 30. Cross -contamination avoided during all phases of procedure ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES ❑ 13, Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters El Source: ® 32. Floors and walls clean and in good repair, adequate light ❑ Appropriate personal protective equipment available and Workstation., surfaces, including chairs, armrests, etc. in ❑ 14. used ❑ ❑ 33. goo d repair El CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ Branding is completed with no other customers in E] 15, ❑ ® 35. Operation and employee training records present Elrocedure area ❑ 16. Customers eighteen (18) years of age or older ❑ COMPLIANCE AND ENFORCEMENT ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s) submitted for review ❑ Client records approved and available - Consent form and ® 18, El El 37. Permits obtained and available questionnaire ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ Received by (Print): Ian Goff and Wesley Fareas Received by (Stgnature): Emailed Phone: 209- 647-4791 Specialist (Print): Sandip Singh Specialist (Signature): aii S'dwd Phone: 209-468-3526 Reinspection onlabout: A reinspection fee of $152 per hour may be charged. Page 1 of 2 EH-it/17