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a <br /> Body Art InspectioReport is Date: <br /> 1 San Joaquin County Environmental Health Department Program SR( ;�I I yt� <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: R <br /> (209)468-3420 Program Ll I ,may <br /> C7FpR� <br /> www siogy org/ehd Element: l V <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO541951 Taylor Mulroone <br /> PR0542998 Brittany Wait <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 evidence of sterilization for purchased blades for lot number: <br /> LU18111235, LU18111233, L1060810, and EVER040. <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 documentation of proper <br /> disposal when the sharp container is mail back. <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 the following statements on the medical questionnaire: "current <br /> medications" and "other risks factors for blood borne pathogens." <br /> 32. A body art facility shall have floors,walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br /> The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to <br /> floor, from nail and hair activities and be separated from all business not related to body art. Approval of co-located body art <br /> facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each <br /> procedure area shall have lined waste containers. HSC 119314 8119317—Gaps between the floor should be sealed and <br /> floor should be smooth and easy cleanable.Seal the baseboards to the floor. <br /> 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312—Post the <br /> health permits in a conspicuous place. <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—Review the IPCP <br /> annually.When there is a new practitioner, review the IPCP with them and have them sign and date the IPCP. <br /> 37. A body art facility shall not conduct business without a valid health permit. A person shall not perform body art without a valid <br /> registration and a permitted facility. A body art facility shall notify the LEA in writing within 30 days of resignation, <br /> termination of a practitioner.A new hire or apprentice must be registered the EHD prior to performing body art at the facility. <br /> HSC 119312 8 119306—A body art facility moving to a new unpermitted facility must be permitted with the EHD before <br /> practicing any body art procedures at the new facility. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 3 <br /> EH-11/17 <br />