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QEF" Body Inspects Re <br /> Y Art P Port <br /> Date: 1.111 G I�4 <br /> N z San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 1'P Ro$y j G 7 <br /> (209)468-3420 Program <br /> www.siogv.org/ehd Element: Ie20 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Joan Sneed(BBP exp.2/5/20)BBP and permit <br /> PRO542672 posted <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)—The record of purchase was not available. Maintain record of purchase for <br /> a minimum of 90 days.- ca tvrcTQ D ON aim JS <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—The client consent form does not include all of the information listed in Form B. <br /> Include the following on the client consent form: <br /> A. Client status regarding pregnancy. <br /> B. Other risk factors for Bloodborne pathogens. <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—The Infection <br /> Prevention Control Plan was not updated. Provide a copy of the IPCP to the EHD.—Corrected on site. <br /> All corrections are to be submitted to the EHD by December 30, 2019. <br /> NOTES: <br /> 1. GRP is used for sharps waste disposal.A written agreement is on file. <br /> 2.The Infection Prevention Control Plan was updated on site. Review and update IPCP,annually. <br /> 3. Keep a copy of all invoices/purchase records on site. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />