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�Aa"'" Body Art InspecA Report t Date: 10130111 ¢'k San Joaquin County Environmental Health Department Program ❑ 10. 1868 E. Hazelton Ave., Stockton, CA 95205 Record: 1X 05-1.2 /8'l, cq<JFo'a�'�P (209) 468-3420 Program ❑ 12. www.siogv.orglehd Element: A41021 Facility Name Address City Zip Code Union Tattoo 512 n union rd. Manteca 95337 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Joshua Hushes 6/30/20 Impoundment Routine 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 41NG AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont C Parts replaced between clients -grommets, elastic bands, El test etc. Autoclave: approved and effective - passed integrator El El 22. Items washed, disinfected, packaged, labeled, and sterilized ElI PREVENTING CROSS -CONTAMINATION Autoclave loaded correctly/packages allowed to dry ❑ 1 ❑ 23. Workstation/procedure area decontaminated Integrators used/monthly spore test/log maintained Decontamination/sanitation area separated and supplied appropriately Invoices and log kept for disposable, pre -sterilized equipment Sharps containers labeled, used, and disposed of appropriately Jewelry, tattoo and piercing equipment - clean and sterilized El PRACTITIONER HEALTH AND HYGIENE Branding is completed with no other customers in area ❑ 9. No eating, drinking or smoking - clean clothes ❑ ❑ 10. Hands washed effectively and timely ❑ ❑ 11 Handwashing facilities properly supplied and accessible, warm water ❑ ❑ 12. Hepatitis B vaccination ❑ ® 13. Bloodbome Pathogen training Jewelry, Inks, Needles etc approved and used correctly ❑ 20. Source: 10used ❑ 14 Appropriate personal protective equipment available and ❑ El 15. Branding is completed with no other customers in area Elrocedure ❑ 16. Customers eighteen (18) years of age or older ❑ ❑ 17. Skin adequately prepared for procedure ❑ ® 18' Client records approved and available - Consent form and questionnaire ❑ ® 19. Appropriate aftercare instructions given to client ❑ ❑ MACHINE SAFETY AND SANITATION Jewelry, Inks, Needles etc approved and used correctly ❑ 20. Safe machine design ❑ ❑ 21. Machines cleaned and disinfected between clients ❑ Received by (Print): Joshua Hughes Received by ❑ 24. Appropriate chemical disinfectant used Chemical used: ❑ 25. Disinfectant used appropriately/sufficient contact time ❑ ® 32. [Wet contact time provided: ❑ ❑ 26. Barriers used ❑ E] 27. Products applied to skin are single use/dispensed El ❑ 28. Storage of inks, pigments, needles, tubes, etc. ❑ ❑ 29. Jewelry, Inks, Needles etc approved and used correctly ❑ ❑ 30. Cross -contamination avoided during all phases of ----�..__ ❑ BEST BUSINESS PRACTICES ❑ 31. Areas separated/no living or sleeping quarters ❑ ® 32. Floors and walls clean and in good repair, adequate light ❑ El 33. Workstation, surfaces, including chairs, armrests, etc. in good repair ❑ ❑ 34. Permit/registration posted ❑ ® 35. Operation and employee training records present ❑ COMPLIANCE AND ENFORCEMENT ❑ 36. Plan(s) submitted for review ❑ ❑ 37. Permits obtained and available ❑ ❑ 38. Impoundment ❑ ❑ 39. Hearing scheduled ❑ ❑ 40. Closure ❑ ❑ 41. ❑ iature : Phone: 209-825-5000 ure): ,"le,lr 446 Phone: 209-468-3526 Reinspecion on/about: A reinspection fee of $152 per hour may be charged. EH -11/17 Page 1 of 3