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a�iih Body Art Inspection Report Date: July 19, 2023 +1 San Joaquin County Environmental Health Department Program < 1868 E. Hazelton Ave., Stockton, CA 95205 �4 Record: New Pr# �p (209) 468-3420 WWW.sIOpVAfp/ehd Program r- r>uV' Element: 4120 Facility Name Address City Zip Code Luxe Beauty Loft LLC 1110 W Kettleman Lane #30 Lodi 95240 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Leticia Harris 6/30/24 Final Inspection 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 El1. Autoclave: approved and effective - passed integrator test El❑ 22.7Parts replaced between clients grommets, elastic bands, Eltc. ❑ 2 Items washed, disinfected, packaged, labeled, and El sterilized 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 El ElElappropriately ❑ 5 Decontamination/sanitation area separated and supplied El used: ❑ 6 Invoices and log kept for disposable, pre-sterilized El 25. Disinfectant equipment El used appropriately/sufficient contact time ❑ ❑ 7 Sharps containers labeled, used, and disposed of ElWet contact time appropriately provided: ❑ 8 Jewelry, tattoo and piercing equipment - clean and El El 26. Barriers used Elsterilized PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically ❑ ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ❑ 11. Handwashing facilities properly supplied and accessible, ❑ El30. Cross contamination avoided during all phases of procedure El warm water ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ ❑ ❑ Source: [__1 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 14. Appropriate personal protective equipment available and ❑ ❑ 33. Workstation, surfaces, including chairs, armrests, etc. in E]used good repair CUSTOMERS/CLIENTS ❑ 34. Perm it/registration posted ❑ ❑ 15 Branding is completed with no other customers in El El 35. Operation and employee training records present El rocedure 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 ❑ ❑ 18 Client records approved and available - Consent form and El El 37. Permits obtained and available El uestionnaire ❑ 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 �E] ❑ 41. ❑ Received by (Print): Leticia Harris Received by (Signature): EMAILED Phone: 916-842-8220 Specialist (Print): Sandip Singh Specialist (Signature): aff*1 S Phone: 209-468-3526 Reinspection on/about: A reinspection fee of $162 per hour may be charged. Page 1 of 2 EH-11/17