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'.�ti oG` Body Art Inspece Report ` 5 2, I f S <br /> Date: <br /> It <br /> ) San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> i (209)468-3420 <br /> • �� �x`' www.siogv.oro/ehd Program 1170 <br /> _E o 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 6/30/15 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 /> ❑ 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 /> El 2' sterilized E] PREVENTING 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 E] ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied ❑ <br /> ❑ 5' El Chemical used: Sani-Cloth <br /> appropriately <br /> Invoices and log kept for disposable,pre-sterilized <br /> ® 6. equipment El ❑ 25. Disinfectant used appropriately/sufficient contact time <br /> Sharps containers labeled,used,and disposed of E]F1 7' ❑ Wet contact time provided: 10 mins <br /> appropriately <br /> Jewelry,tattoo and piercing equipment-clean and <br /> El 8. El El26. Barriers used <br /> sterilized ❑ <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE ® 27. ase tical) El <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 /> ® 11. warm water El ❑ 30' procedure El <br /> ❑ 12. 1 Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ® 13. Bloodbome 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 /> El 14. used E] ❑ 33. go repair <br /> El <br /> CUSTOMERS/CLIENTS ® 34. Perm it/registration posted ❑ <br /> ❑ <br /> Branding is completed with no other customers in 15. El ® 35. Operation and employee training records present <br /> procedure area ❑ <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 /> ® <br /> Client records approved and available-Consent form 18. ❑ ❑ 37. Permits obtained and available Elandquestionnaire <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 ❑ El 41 ❑ <br /> Received b (Print): ShirleyLuna Received b Si nature: Phone:(209)642-1170 <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 />