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"' Body Art InspectieReport • Date: <br /> •o <br /> a San Joaquin County Environmental Health Department Program n <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: �l W SLI 2—5L,2- <br /> (209)468-3420 Program <br /> a< FORa .. www.sio-qv.org/ehd Element: � ' <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> r. 3 Shawn Edwards <br /> QLGSWIO LLA47c& 3 RRA <br /> Pru. S 43 911 S4 wi* F6 wxi <br /> Observations and Corrective Actions: <br /> 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use <br /> paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) The <br /> studio currently emloys three artists. One sink is required for every two practitioners. Add a sink to procedure area or <br /> schedule no more than two artist to work at a time. <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 Assure that all client questionnaires are filled-out completely. <br /> 33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good <br /> repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, <br /> durable, and nonabsorbent finish. HSC 119314 Maintain all client contact surfaces in good repair. Fix tear in chair in <br /> procedure area. <br /> ALL 1�dxlf LI-ILL's 'r6 85 Av_�� 6Y 11Z)11191i� <br /> Reinspecion onlabout: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />