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Body Art Inspec* Report . Date: J /2 I A <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: O s3 7 O 7 <br /> (209)468-3420 <br /> a`P• www.sioov.org/ehd Program I 2-C> <br /> Element: <br /> Facility Name Address City Zip Code <br /> Bella Luna Salon 702 porter ave#a Stockton 95207 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Shirley B.Luna 6/30/16 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 /> ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22 Parts replaced between clients-grommets,elastic bands, ❑ <br /> test etc. <br /> Items washed,disinfected, packaged,labeled,and <br /> ❑ 2' sterilized ❑ <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore test/log maintained ro <br /> El 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5' a ro riatel Chemical used: <br /> Invoices and log kept for disposable,pre-sterilized <br /> El 6' equipment EJ25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled, used,and disposed of El <br /> F] 7. a ro riatel E] Wet contact time provided: <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. El El 26. Barriers used <br /> sterilized <br /> ❑ 27 Products applied to skin are single use/dispensed Elf1 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 /> Handwashing facilities properly supplied and accessible, Cross-contamination avoided during all phases of <br /> El 11. Elwarm water ❑ 30' rocedure ❑ <br /> El12. Hepatitis B vaccination E] <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 /> ❑ 14. used El ❑ 33' good repair <br /> El <br /> EMMM11 ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> ❑ 15. El El 35. Operation and employee training records present <br /> procedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ <br /> Client records approved and available-Consent form <br /> El 18. El Eluestionnaire 37. Permits obtained and available <br /> and ❑ <br /> ❑ 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> iftialfiAl BMW <br /> ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ r[It 41. ❑ <br /> Received b (Print): Received b (Si nature : Phone: <br /> Specialist(Print): Har rit Mattu,Sr REHS Specialist(Signature): Phone: 209 468-3284 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />