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.cam <br /> >; Body Art Inspection Report <br /> Date: March 3,2023 <br /> Q•. s a1 San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> .:<. Record: PR0547051 <br /> (209)468-3420 <br /> www.siopv.ora/ehd Program <br /> Element: 4120 <br /> Facility Name Address City Zip Code <br /> Permanent Cosmetics by Gayle&Kristen 401 W Pine St. Lodi 95240 <br /> Name of Permit/Registration Holder Permit Exp.Date Time In Time Out Inspection Type <br /> Kristen Patterson-Cranford 6/30/23 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 /> Parts replaced between clients-grommets,elastic bands, <br /> El 1. Autoclave:approved and effective-passed integrator test ❑ ❑ 22.7tElc. <br /> ❑ 2 Items washed,disinfected,packaged,labeled,and <br /> sterilized 01PREVENTING 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 /> ❑ 5 Decontamination/sanitation area separated and supplied ❑ Elappropriately <br /> ❑ Chemical used: <br /> ® 6 Invoices and log kept for disposable, pre-sterilized <br /> equipment ❑ ® 25. Disinfectant used appropriately/sufficient contact time❑ Elappropriately 7 Sharps containers labeled, used,and disposed of <br /> ❑ Wet contact time provided: <br /> ❑ 8 Jewelry,tattoo and piercing equipment-clean and <br /> sterilized ElEl26. Barriers used El <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 /> ❑ 11. Handwashing facilities properly supplied and accessible, <br /> warm water E] El30. Cross-contamination avoided during all phases of procedure ❑ <br /> ❑ 12. Hepatitis B vaccination ❑ <br /> BEST BUSINESS PRACTICES <br /> ® 13. Bloodborne Pathogen training El <br /> 31. Areas separated/no living or sleeping quarters E] <br /> Source: ® 32. Floors and walls clean and in good repair,adequate light ❑ <br /> ❑ 14. Appropriate personal protective equipment available and Workstation,surfaces,including chairs,armrests,etc.in <br /> used El F-1 33' E]good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> ❑ 15. Branding is completed with no other customers in <br /> rocedure area ❑ ® 35. Operation and employee training records present 1:1 <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 /> ❑ 18 Client records approved and available-Consent form and ❑ ❑ <br /> ® 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 ❑ ❑ 41. ❑ <br /> Received by(Print): Kristen Patterson-Cranford Received by(Signature): EMAILED Phone:209-329-7846 <br /> Specialist(Print): Sandip Singh Specialist(Signature): Phone:209-468-3526 <br /> Reinspection on/about: A reinspection fee of$156 per hour may be charged. Page 1 of 3 <br /> EH-11/17 <br />