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Body Art Inspects Report <br /> Date: 'J1I 9 <br /> ?!. San Joaquin County Environmental Health Department <br /> Program M�p <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 <br /> \•,•• ....•••;c-' Program <br /> < FORc� www.siogv.org/ehd L41 0,3 <br /> - Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Observations and Corrective Actions: <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)-Provide EHD with the written agreement <br /> for mail-back with Darob Inc. <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) <br /> 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br /> section 119307. <br /> 16. Client shall be at least 18 years of age to receive a tattoo, permanent cosmetics, or branding. Body piercing, unless <br /> performed in the presence of parent or guardian, the client, must be 18 years of age. HSC 119302-Include copy of driver's <br /> license/identification with client records to verify age. <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-Include in consent form: notice that inks are not FDA approved and health <br /> consequences are unknown, also include lot number in client records. Include in medical questionnaire: requirements <br /> for antibiotics prior to surgery or dental procedures, and other risk factors for bloodborne pathogens. <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)-Include in postprocedure instructions: signs and symptoms of infection. <br /> 31. A body art facility shall be separated from any residential areas used for sleeping, bathing, or meal preparation and shall not <br /> share a common entrance or toilet facility with residence. The toilet facility must have a sink with hot and cold water, <br /> containerized liquid soap, and single-use paper towels that are dispensed from a wall-mounted, touchless dispenser. HSC <br /> 119314 <br /> Notes: <br /> 1) Provide EHD with a copy of bloodborne pathogen training certification. <br /> 2) Update IPCP and provide EHD with the signed copy. <br /> 3) Submit written agreement with Darob Inc. for sharps disposal. <br /> Unless otherwise noted, correct all violations prior to final inspection. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />