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�U�- <br /> !�• \ Body Art Inspection Report Date: 8-30-2023 <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: SR0087097 <br /> j (209)468-3420 <br /> ® ,O• �q! www.sioay.org/ehd Program <br /> 4C,F Aga/ Element: 4103 <br /> Facility Name Address City Zip Code <br /> DNA Beauty Suites 4502 N Pershing Ave. Stockton 95207 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Courtney Conley Consultation <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 /> Parts replaced between clients-grommets,elastic bands, <br /> El 1. Autoclave: approved and effective-passed integrator test El E] 22. etc. El <br /> ❑ <br /> Items washed,disinfected,packaged, labeled,and 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 E] ❑ <br /> ❑ 5. appropriately <br /> El E] <br /> used: <br /> Invoices and log kept for disposable, pre-sterilized <br /> F-1 6. ❑ El25. Disinfectant used appropriately/sufficient contact time ❑ <br /> equipment <br /> ❑ <br /> Sharps containers labeled, used,and disposed of <br /> 7. appropriately El Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> E] 8. sterilized El El 26. Barriers used E] <br /> PRACTITIONER HEALTH AND HYGIENE ❑ 27. Products applied to skin are single use/dispensed aseptically [:1 <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 /> Handwashing facilities properly supplied and accessible, <br /> El 11. warm water E] El30. Cross-contamination avoided during all phases of procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen training ❑ ❑ 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ❑ 32. Floors and walls clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available and Workstation,surfaces, including chairs,armrests,etc. in <br /> E] 14. used El ❑ 33' good repair <br /> E] <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. rocedure area E] [:135. Operation and employee training records present E] <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 E]uestionnaire <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 ❑ ❑ 41. ❑ <br /> Received by(Print): Courtney Conley Received by(Signature): emailed Phone: 541-905-8266 <br /> Specialist(Print): Stephanie Ramirez Specialist(Signature): Phone:209-616-3069 <br /> Reinspection on/about: A inspection fee of$162 per hour may be charged. Page 1 of 2 <br /> EH-11/17 �j <br />