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o iN �� °�� Body Art Inspection Report Date: April 7, 2025 San Joaquin County Environmental Health Department Program 1` 'r 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0548537 (209) 468-3420 www.siogv.org/ehd Program qti F oRr Element: 4120 Facility Name Address City Zip Code Lucky You Tattoo 14051 CA 88 Lockeford 95240 Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type Esau Mendoza 6/30/25 Routine The 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 V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont. C HSC 119315 -Autoclave: approved and effective - passed HSC 119311 - Parts replaced between clients - grommets, El integrator inte rator test El ❑ 22' elastic bands, etc. HSC 119309 - Items washed, disinfected, packaged, El 2. labeled, and sterilized ❑ PREVENTING CROSS-CONTAMINATION HSC 119315 -Autoclave loaded correctly/packages El 3' allowed to d ❑ El23. HSC 119309 - Workstation/procedure area decontaminated El HSC 119315 - Integrators used/monthly spore test/log ❑ 4. maintained El24. HSC 119301 - Appropriate chemical disinfectant used ❑ ElHSC 119314 - Decontamination/sanitation area separated ❑ 5. El Chemical used: and supplied appropriately ® 6 HSC 119315 - Invoices and log kept for disposable, pre- ❑ 25 HSC 119309 - Disinfectant used appropriately/sufficient sterilized equipment ❑ contact time ❑ ❑ HSC 119314 - Sharps containers labeled, used, and 7' ro riatel El Wet contact time provided: disposed of a HSC 119310, 119315 - Jewelry, tattoo and piercing El 8' equipment - clean and sterilized ❑ El26. HSC 119314 - Barriers used El HSC 119311 - Products applied to skin are single PRACTITIONER HEALTH AND HYGIENE El 27' use/dispensed aseptically ❑ ® 9 HSC 119309 - No eating, drinking or smoking - clean ❑ ❑ 28 HSC 119309, 119311 - Storage of inks, pigments, needles, Elclothes tubes, etc. ❑ HSC 119310, 119311 - Jewelry, Inks, Needles etc approved 10. HSC 119308 - Hands washed effectively and timely El El29 and used correctlyEl ❑ HSC 119314 - Handwashing facilities properly supplied and HSC 119308 - Cross-contamination avoided during all 11. accessible, warm water El ❑ 30' phases of procedure ❑ ❑ 12. HSC 119306 - Hepatitis B vaccination ❑I I BEST BUSINESS PRACTICES 13. HSC 119307 - Bloodborne Pathogen training ❑ 31. HSC 119314 -Areas separated/no living or sleeping quarters ❑ ❑ Source: ® ® 32 HSC 119314 - Floors and walls clean and in good repair, ❑ adequate light ❑ HSC 119308 - Appropriate personal protective equipment HSC 119314 - Workstation, surfaces, including chairs, ❑14. available and used El ® 33' armrests, etc. in good repair CUSTOMERS/CLIENTS ❑ 34. HSC 119312 - Permit/registration posted ❑ ❑ HSC 119309 - Branding is completed with no other HSC 119313 - Operation and employee training records ❑15. customers in rocedure area El ❑ 35" resent HSC 119302 - Customers eighteen (18) years of age or El 16. older El AND ENFORCEMENT ❑ 17. HSC 119308 - Skin adequately prepared for procedure ❑ ❑ 36. HSC 119312 - Plan(s) submitted for review ❑ HSC 119303 - Client records approved and available - ❑ 18. Consent form and uestionnaire ❑ ® 37. HSC 119312 - Permits obtained and available El ® HSC 119303, 119308 - Appropriate aftercare instructions 19' iven to client El ❑ 38. HSC 119319 - Impoundment El MACHINE SAFETY AND SANITATION ❑ 39. HSC 119320 - Hearing scheduled ❑ ❑ 20. HSC 119311 - Safe machine design ❑ ❑ 40. HSC 119312, 119317, 119320 - Closure ❑ ❑ 21 HSC 119311 - Machines cleaned and disinfected between ❑ ❑ 41. ❑ clients Received by (Print): Esau Mendoza Received by (Signature): EMAILED Phone: 650-228-3308 Specialist (Print): Sandip Singh Specialist (Signature): .� / ,;, Phone: 209-468-3526 Reinspection on/about: A reinspection fee of$172 per hour may be charged. Page 1 of 4 EH-11/17