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Body Art Inspect*Report Date: 10/2 41 <br /> San Joaquin County Environmental Health Department Program /'� <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: p KC)S 1me-r1 q0 2 O <br /> (209)466-3420 <br /> , .. Program �' <br /> 2- <br /> www.siogy.orq/ehd <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO542967 Fong Van -Permit and BBP Posted and Current <br /> PRO543781 Lia Van -Permit and BBP Posted and Current <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)—Provide sterilization certificate for all blades use by practitioners.Send <br /> copy of the certificates to the EHD for review. <br /> Notes: <br /> 1. Practitioners use Solutions to service their sharps containers. <br /> 2. Review Infection Prevention and Control Plan at least once a year.Sign and date the IPCP after reviewing it. <br /> 3. Maintain a copy of the manifest after sending the sharps containers back to Solutions. <br /> 4. Practitioners use Caviwipes for disinfection. <br /> 5. Fong Vang—Biologix;expired on March 1,2020. <br /> 6. Lia Vang—Biologix; expired on September 18, 2020. <br /> CORRECT VIOLATION PRIOR TO NOVEMBER 6,2019. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />