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Body Art Inspect Report 9 Date: 6-7/1� <br /> o <br /> G <br /> I r San Joaquin County Environmental Health Department Program R L�9, <br /> ` 1868 E.Hazelton Ave.,Stockton,CA 95205 Recons: P' `(�VS 1u ` S�c <br /> (209)468-3420 Program � <br /> www.siogv.org l <br /> /ehd 1 (20 <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO541951 Taylor Mulroone -BBP Current and Posted <br /> PR0542998 Brittany Wait-BBP Current and 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(0—Provide evidence of sterilization for the purchased blades with the lot <br /> number: 018091233. Maintain a copy of the sterilization certificate for the lot number 19S-201 for review by the EHD. <br /> Notes: <br /> 1. Facility is ok to open. <br /> 2. Provide a copy of the Infection Prevention and Control Plan with the signatures and dates of both practitioners <br /> to the EHD. <br /> 3. When there is a new practitioner working at the facility, review the Infection Prevention and Control Plan with <br /> them. Have them sign and date the IPCP. <br /> 4. Maintain a copy of the clients' Driver's License with their client consent form. <br /> 5. Once practitioners receive their permits, post the permits in a conspicuous place. <br /> CORRECT ALL VIOLATIONS PRIOR TO OCTOBER 4, 2019. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />