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Body Art Ins ect&Report <br /> a. Y P P Date: <br /> Q % San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 Program <br /> a� FORa` <br /> wwwsioqv.org/ehd g <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> 537428 Israel Jacobs <br /> 537533 Ebrihimi Razer <br /> Observations and Corrective Actions: <br /> 1. Each sterilization load shall be monitored with mechanical indicators for time, temperature and pressure, Sterilization shall be ac <br /> steam autoclave, manufactured for the sterilization of medical instruments, and pass a Class V integrator test. HSC 119315(b) <br /> 3. Sterilizer shall be loaded, operated, decontaminated, and maintained according to manufacturer's recommendations. HSC 119 <br /> 4. Sterilizer shall be spore-tested after initial installation, after major repair, and at least once per month. A written sterilization sha <br /> for 3 years. The log shall include spore-test results each sterilization cycle, date, contents, exposure time and temperature, results <br /> integrator for every cycle/load, and evidence of a acceptable spore test before reuse of the sterilizer after a failed spore-test. HSC <br /> 5. Decontamination and sterilization areas shall be separated from procedure areas by a space of at least 5 feet or by a cleanabl( <br /> equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper towels dispensed from a wall <br /> touchless dispenser that is readily accessible to practitioner. HSC 119314(c) <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 /> "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. Documentation <br /> disposal shall be maintained for 3 years. HSC 119314(e) <br /> 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use pZ <br /> dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) <br /> 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with secti� <br /> 16. Client shall be at least 18 years of age to receive a tattoo, permanent cosmetics, or branding. Body piercing, unless performec <br /> presence of parent or guardian, the client, must be 18 years of age. HSC 119302 <br /> 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are availal <br /> inspection. HSC 119303 <br /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in f <br /> 119308(b) <br /> 28. Sterilized instrument packs, equipment and jewelry shall be stored in a labeled container or cabinet that is protected from dust <br /> Sterile instrument packs shall be evaluated before use; instrument packs shall be discarded or reprocessed if condition is compror <br /> 119315 <br /> 32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. The <br /> shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to floor, from nail and hair <br /> separated from all business not related to body art. Approval of co-located body art facilites are at the discretion of the LEA. A prc <br /> must be equipped with adequate light to perform a procedure. Each procedure area shall have lined waste containers. HSC 1193 <br /> 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312 <br /> 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written Infectior <br /> and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313 <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 i <br /> Reinspecion on/about: 1'oI I1PI Iq A reinspection fee of$125 per hour may charged. Page 2 of 3 <br /> EH-04/2014 <br />