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Ulry <br /> Body Art Inspection Report Date: February 13,2025 <br /> aSan Joaquin County Environmental Health Department Program <br /> 1868 E.Hazellon Ave.,Stockton,CA 95205 Record: PR0524524 <br /> 09) <br /> vP• w .s oay.orc0/ehd Program <br /> Element: 4120 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO536982 Bao Nguyen BBP Exp.4130125 <br /> Observations and Corrective Actions: <br /> 7. HSC 119314-Sharps containers labeled, used, and disposed of appropriately <br /> OBSERVATIONS: <br /> A razor inside of the biohazard waste container was not contained inside of a sharps waste container. -Corrected <br /> CORRECTIVE ACTIONS: <br /> 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 of by a licensed waste hauler or approved mail back <br /> system. Documentation of proper disposal shall be maintained for 3 years. Ensure all sharps waste is placed into a sharps <br /> waste container for disposal. <br /> 18. HSC 119303 -Client records approved and available-Consent form and questionnaire <br /> OBSERVATIONS: <br /> 1. The client consent form did not include all items from Form B. <br /> 2. The medical questionnaire did not include all the items from Form B. <br /> CORRECTIVE ACTIONS: <br /> 1. The facility's client consent form and medical questionnaire must include all the information listed in Form B and are available <br /> for inspection. Include the following on the client consent form and provide a copy to the EHD: <br /> -Client is at least 18 years of age. <br /> -Description of what the client should expect following the procedure. <br /> 2. The facilities client consent form and medical questionnaire must include all the information listed in Form B and are available <br /> for inspection. Include the following on the medical questionnaire and provide a copy to the EHD: <br /> -History of herpes infection at the procedure site. <br /> -History of hemophilia or other bleeding disorders. <br /> -Other risk factors for bloodborne pathogens. <br /> 32. HSC 119314-Floors and walls clean and in good repair,adequate light <br /> OBSERVATIONS: <br /> Holes observed in the wall of Bao Nguyen's procedure area. <br /> CORRECTIVE ACTIONS: <br /> A body art facility shall have floors,walls, and ceilings that are smooth, nonabsorbent,free of open holes, and washable. Repair <br /> the holes and provide photographic evidence to the EHD. <br /> 33. HSC 119314-Workstation, surfaces, including chairs,armrests, etc. in good repair <br /> OBSERVATIONS: <br /> A torn procedure table and stool were observed in the procedure area.—Corrected <br /> CORRECTIVE ACTIONS: <br /> All surfaces and objects in the procedure area, including chairs, armrests,tables, countertops, and trays, shall be in good repair <br /> and capable of being disinfected. <br /> Reinspection onlabout: A reinspection fee of$172 per hour may be charged. Page 2 of 3 <br /> EH-11/17 <br />