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PR Number <br />Body Art Ins ece Report <br />PR0538063 <br />James Lan le -BBP <br />San Joaquin County Environmental Health Department <br />Date:Yhoffia <br />Miranda Chavez (apprentice) <br />Pram <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />Record: I39 Q SZA 3 9 <br />c <br />�trFc aN` <br />(209) 468-3420 <br />www.siogv.org/ehd <br />Pro gram <br />LAW <br />Element: <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PR0538063 <br />James Lan le -BBP <br />PR0537751 <br />Zachary Smith <br />Miranda Chavez (apprentice) <br />Observations and Corrective Actions: <br />I PR Number I PRACTITIONER/ARTIST NAME I <br />5. Decontamination and sterilization areas shall be separated from procedure areas by a space of at least 5 feet or by a <br />cleanable barrier and equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper <br />towels dispensed from a wall -mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(c) <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) <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 <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) <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 & 119317 <br />33. All surfaces and objects in the procedure area, including chairs, armrests, tables, countertops, and trays, shall be in good <br />repair and capable of being disinfected. All counter surfaces and service trays in the procedure area shall have a smooth, <br />durable, and nonabsorbent finish. HSC 119314 <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 <br />41. Only sterile dressings may be used to cover a procedure site. HSC 119308 <br />Corrective Action Due By Next Routine Inspection on or <br />about 10/3/16. If Items Listed Are Not Corrected A Re - <br />Inspection Will Be Conducted At A Rate Of $139/Hour. <br />Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 2 of 2 <br />EH -03/2015 <br />