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aur: <br />Body Art Inspection Report <br />ySan Joaquin County Environmental Health Department <br />1868 E. Hazellon Ave., Stockton, CA 95205 <br />(209)489-3420 <br />w .siogv.orglehd <br />Facility Name <br />Brows by Michelle Grace <br />Name of PermiURegisiration Holder <br />Address <br />37 W Yokuts Ave #B <br />Permit Exp. Date Time In <br />Date: <br />Program <br />Record: <br />Program <br />Element: <br />19.2022 <br />PR0545320 <br />City Zip Code <br />Stockton 95207 <br />Time Out Inspection Type <br />Michelle Tabancura 6/30/22 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 <br />Received by (Print): Michelle Tabancura Received by (Signature): EMAILED Phone: <br />CLEANING AND STERILIZATION <br />C <br />V <br />MACHINE SAFETY AND SANITATION cont. <br />C <br />El <br />1. <br />Autoclave: approved and effective - passed integrator test <br />El <br />El <br />22. <br />Parts replaced between clients -grommets, elastic bands, <br />Eletc. <br />❑ <br />2 <br />Items washed, disinfected, packaged, labeled, and <br />Elsterilized <br />PREVENTING CROSS -CONTAMINATION <br />Specialist <br />❑ <br />3. <br />Autoclave loaded correctly/packages allowed to dry <br />❑ <br />❑ <br />23. <br />Workstation/procedure area decontaminated <br />❑ <br />❑ <br />4. <br />Integrators used/monthly spore tesUlog maintained <br />❑ <br />❑ <br />24. <br />Appropriate chemical disinfectant used <br />❑ <br />❑ <br />5 <br />Decontamination/sanitation area separated and supplied <br />appropriately <br />❑ <br />Chemical used: <br />❑ <br />6. <br />Invoices and log kept for disposable, pre -sterilized <br />equipment <br />❑ <br />❑ <br />25. <br />Disinfectant used appropriately/sufficient contact time <br />❑ <br />❑ <br />7 <br />Sharps containers labeled, used, and disposed of <br />a ro riatel <br />❑ <br />Wet contact time provided: <br />❑ <br />8 <br />Jewelry, tattoo and piercing equipment - clean and <br />sterilized <br />❑ <br />❑ <br />25. <br />Barriers used <br />❑ <br />PRACTITIONER HEALTH AND HYGIENE <br />❑ <br />27. <br />Products applied to skin are single use/dispensed aseptically <br />❑ <br />❑ <br />9. <br />No eating, drinking or smoking - clean clothes <br />❑ <br />❑ <br />28. <br />Storage of inks, pigments, needles, tubes, etc. <br />❑ <br />❑ <br />10. <br />Hands washed effectively and timely <br />❑ <br />❑ <br />29. <br />Jewelry, Inks, Needles etc approved and used correctly <br />❑ <br />❑ <br />11. <br />Handwashing facilities properly supplied and accessible, <br />warm water <br />❑ <br />❑ <br />30. <br />Cross -contamination avoided during all phases of procedure <br />❑ <br />❑ <br />12. <br />Hepatitis B vaccination <br />DI <br />BEST BUSINESS PRACTICES <br />❑ <br />13. <br />Bloodborne Pathogen training <br />❑ <br />❑ <br />31. <br />Areas separated/no living or sleeping quarters <br />❑ <br />Source: <br />❑ <br />32. <br />Floors and walls clean and in good repair, adequate light <br />❑ <br />El <br />14. <br />Appropriate personal protective equipment available and <br />used <br />El❑ <br />33'good <br />Workstation, surfaces, including chairs, armrests, etc. in <br />repair <br />El <br />CUSTOMERS/CLIENTS <br />❑ <br />34. <br />Permit/registration posted <br />❑ <br />E] <br />15. <br />Branding is completed with no other customers in <br />rocedure area <br />❑ <br />® <br />35. <br />Operation and employee training records present <br />El <br />❑ <br />16. <br />Customers eighteen (18) years of age or older <br />❑ <br />COMPLIANCE AND ENFORCEMENT <br />❑ <br />17. <br />Skin adequately prepared for procedureJEEI <br />❑ <br />36. <br />Plan(s) submitted for review <br />El <br />❑ <br />18. <br />Client records approved and available - Consent form and <br />questionnaire <br />El <br />37. <br />Permits. obtained and available <br />ElEl19. <br />Appropriate aftercare instructions given to client <br />El <br />38. <br />Impoundment <br />El <br />MACHINE SAFETY AND SANITATION <br />❑ <br />39. <br />Hearing scheduled <br />❑ <br />❑ <br />20. <br />Safe machine design <br />El <br />40. <br />Closure <br />El <br />❑ <br />21. <br />Machines cleaned and disinfected between clients <br />❑ <br />41. <br />❑ <br />Reinspection <br />209-762-2669 <br />�� <br />Specialist <br />(Print): <br />Sandip Singh <br />Specialist (Signature): <br />��� 5'zyp./Z <br />Phone: <br />209-468-3526 <br />A reinspection fee of $152 per hour may be charged. <br />l`� <br />Page 1 of 2 <br />EH -11/17 <br />