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Body Art Inspect* Report Date: 3/2-/18 <br /> San Joaquin County Environmental Health Department Program <br /> j 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: P"!A Lfl CdZ <br /> (209)468-3420 Program <br /> www.sioay.org/ehd Element: t jl 2 v <br /> Shannon Meder-BBP+permit available not posted, <br /> PR0541081 corrected on site <br /> Observations and Corrective Actions: <br /> 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br /> client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br /> sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br /> minimum of 90 days after use. HSC 119315(f)-Proof of presterilization must include lot number of instruments. <br /> 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br /> section 119307.-Corrected on site. <br /> 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are <br /> available for inspection. HSC 119303-Include in consent form: notice that all inks are not FDA approved and health <br /> consequences are unknown. Include in medical questionnaire: other risk factors for blood borne pathogens. <br /> Corrected on site: history of herpes infection at the procedure site. <br /> 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312-Corrected on <br /> site. <br /> Notes: <br /> 1) Contact manufacturer, SofTap for proof of presterilization including lot number for needles. <br /> Unless otherwise noted, correct all violations by March 16, 2018. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />