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�QUry`� Body Art Inspection Report �2' • _ ' .y,, y {, San Joaquin County Environmental Health Department Date: July 14, 2023Program 1868 E. Hazelton Ave., Stockton, CA 95205 Record: SR0086933 (209)468-3420 �`••. -11 www.siogv.orq/end Program q�rF0 Element: 4103 Facility Name Address City Zip Code Luxe Beauty Loft LLC 1110 W Kettleman Lane Lodi 95240 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Leticia Harris Consultation 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 ❑ 1. Autoclave: approved and effective -passed integrator test El ❑ -22.7Parts replaced between clients - grommets, elastic bands, ❑ ❑ 2 Items washed, disinfected, packaged, labeled, and ❑ sterilized PREVENTING CROSS -CONTAMINATION ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ [1 23. Workstation/procedure area decontaminated ❑ ❑ 4. Integrators used/monthly spore test/log maintained ❑ 24. Appropriate chemical disinfectant used ❑ Elappropriately [__1 5 Decontamination/sanitation area separated and supplied El Chemical used: ® 6 Invoices and log kept for disposable, pre -sterilized E]25. Disinfectant used appropriately/sufficient contact time equipment E] ❑ ❑ 7 Sharps containers labeled, used, and disposed of ❑ Wet contact time provided: appropriately ® 8 Jewelry, tattoo and piercing equipment - clean and El 26. Barriers used ❑ sterilized 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, El El30. Cross contamination avoided during all phases of procedure ❑ warm water ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES 13. Bloodborne Pathogen training ❑ 31. Areas separated/no living or sleeping quarters ❑ ❑ ❑ Source: ❑ 32. Floors and walls clean and in good repair, adequate light ❑ ❑ 14. Appropriate personal protective equipment available and El El 33' Workstation, surfaces, including chairs, armrests, etc. in ❑ used good repair CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ ❑ 15 Branding is completed with no other customers in [I El 35. Operation and employee training records present ❑ 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® 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): Leticia Harris Received by (Signature): EMAILED Phone: 916-842-6220 Specialist (Print): Sandip Singh Specialist (Signature): Phone: 209-468-3526 Reinspection on/about: A reinspection fee of $162 per hour may be charged. Page 1 of 3 EH -11/17