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Body Art Inspecti•Report <br />~�oG< San Joaquin County Environmental Health Department <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />(209)4 68-3420 <br />www.siogv.org/ehd <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />PR0538859 <br />Alec Peralta, 1313P -CM expired 5/9/16 663A <br />PR0542606 <br />Zachary Peralta, BBP-CM expired 2/24/19 II <br />PRO537414 <br />Philip Vasquez, 1313P -CM expired 4/14/19 10/2&P <br />PRO541543 <br />Stevie Vasquez, 1313P -CM 9/20/19 <br />Observations and Corrective Actions: <br />a <br />Date: <br />Program —ego, <br />Record: �" <br />Program <br />Element: <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />at 5 t� <br />d6 It N <br />JE * s 9 <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 />The procedure room used by Stevie Vasquez does not have a touchless paper towel dispenser. Provide a <br />touchless paper towel dispenser for the procedure room by 612412019. <br />7. The sharps waste container shall be within arm's reach and labeled with the word "sharps waste" or with the biohazard <br />symbol and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail <br />back system. Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e) <br />No evidence of a sharps disposal since 5118117 (Sharps Solutions). Sharps must be disposed of at least once per <br />year. Submit evidence of a recent sharps disposal to the EHD by 612412019. <br />8. Jewelry placed in newly pierced skin shall be sterilized prior to piercing or purchased presterilized. If purchased <br />presterilized, sterile packs shall be discarded if integrity is compromised. Clean calipers shall be used and the skin marked <br />using clean toothpicks and ink or a single -use marking pen. Sterilized instruments shall be stored in sterilization packaging <br />or in sterilization equipment cartridge until time of use. Sterile instrument packs shall be evaluated before use and shall be <br />discarded if integrity is compromised. HSC 119310 11u�.dt✓ <br />During the review of the records, ten pieces of expired presterilized equipment were found to be used for <br />procedures. Presterilized items shall not be used once expired. <br />13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent <br />with section 119307. <br />The bloodborne pathogens certificates for Alec Peralta, Zachary Peralta, and Philip Vasquez have expired. <br />Submit evidence of recent training to the EHD by 6/24/2019. <br />18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and <br />are available for inspection. HSC 119303 <br />Some client consent forms are missing required information. Effective immediately, assure that client consent <br />forms are completed at the time of the procedure. <br />34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 <br />Current permits were not posted for Zachary Peralta and Stevie Vasquez were not posted. Correct by 6/24/2019. <br />Reinspecion on/about: A reinspection fee of $152 per hour may be charged. Page 2 of 3 <br />EH -11/17 <br />