Establishment Inspection Survey Inspection Survey Please help the Board of Barbering and Cosmetology improve the quality of its services by completing the following anonymous survey. Your participation is entirely voluntary and the responses will have no bearing on the results of your inspection. OK Question Title * 1. What is your establishment's ZIP code? OK Question Title * 2. What was the date of your inspection? Date Date OK Question Title * 3. Did the inspector identify her/his self within one minute after entering your salon? Yes No OK Question Title * 4. Did the inspector present identification upon entering the establishment? Yes No OK Question Title * 5. Who was your inspector? Inspector Aldana Inspector Babadzhanyan Inspector Brown Inspector Camp Inspector Campbell Inspector Choplin Inspector DeSutter Inspector Garcia Inspector Herrera Inspector Kunze Inspector Lapastora Inspector Longmore Inspector Medina Inspector Mendoza Inspector Moisant Inspector Montoya Inspector Payton Inspector Perez Inspector Sanchez Inspector Stranahan Inspector Williams I don't remember OK Question Title * 6. How many stations are in your salon? 1-5 6-10 11-25 26-40 Over 40 OK Question Title * 7. How long did the inspection last? 0 - 15 minutes 16 - 30 minutes 30 minutes - 1 hour Over 1 hour OK Question Title * 8. Did your inspection result in a violation? Yes No OK Question Title * 9. Did the inspector clearly discuss why you received the violation(s) and how to avoid future violations? Yes No OK Question Title * 10. Additional Comments: OK Question Title * 11. Optional: Please provide Establishment name and license number OK DONE