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U'" Body Art Inspect Report Date: `i /s JIG <br /> °c <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420�. Program <br /> wwwElement: <br /> PR Number PRACTITIONERIARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0537535 William Jessie Huggins inactive <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) <br /> 7. The sharps waste container shall be within arm's reach and labeled with the word "sharps waste"or with the biohazard symbol <br /> and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. <br /> Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) <br /> 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br /> section 119307. <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 <br /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. HSC 119308(b) <br /> 24. Disinfectant shall have ability to reduce or eliminate the presence of disease-causing microorganisms, including HIV and <br /> hepatitis B virus. HSC 119301(k) <br /> 25. Disinfectant shall be used according to the manufacturer's instructions. HSC 119309(b) <br /> 28. Sterilized instrument packs, equipment and jewelry shall be stored in a labeled container or cabinet that is protected from <br /> dust or moisture. Sterile instrument packs shall be evaluated before use; instrument packs shall be discarded or reprocessed if <br /> condition is compromised. HSG 119315 <br /> 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br /> The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to <br /> floor, from nail and hair activities and be separated from all business not related to body art. Approval of co-located body art <br /> facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each <br /> procedure area shall have lined waste containers. HSC 119314& 119317 <br /> 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written <br /> Infection Prevention and Control Plan (IPCP)shall be maintained, followed and updated. HSC 119313 <br /> 36. Design plans shall be submitted to EHD for approval prior to constructing or remodeling body art facility. HSC 119312 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 2 of 3 <br /> EH-03/2015 <br />