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°u'" o Body Art Inspects Report Date: lZl Ilp o r 4 San Joaquin County Environmental Health Department Program 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: * (209)468-3420 ;F6... .• www.sjogv.org/ehd Program Li 0 Element: PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME Tina Phon Observations and Corrective Actions: 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a minimum of 90 days after use. HSC 119315(f) 7. The sharps waste container shall be within arm's reach and labeled with the word"sharps waste"or with the biohazard symbol and the word"Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in Form B. HSC 119308(b) 28. Sterilized instrument packs, equipment and jewelry shall be stored in a labeled container or cabinet that is protected from dust or moisture. Sterile instrument packs shall be evaluated before use; instrument packs shall be discarded or reprocessed if condition is compromised. HSC 119315 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to floor, from nail and hair activities and be separated from all business not related to body art. Approval of co-located body art facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each procedure area shall have lined waste containers. HSC 119314& 119317 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 All of the above mentioned observations must be corrected, a final consultation must be conducted, and all applicable fees must be paid prior to opening. Reinspecion onlabout: A reinspection fee of$130 per hour may be charged. Page 2 of 2 EH-03/2015