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A` Body Art Inspect Report Date: San Joaquin County Environmental Health Department Program i' 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: (209)468-3420 Program µ www.siogv.org/ehd Element: Kristen Patterson-BBP and Permit Current and PRO541638 Posted Gayle Nanette Witt-BBP and Permit Current and PR0541640 Posted Observations and Corrective Actions: 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a minimum of 90 days after use. HSC 119315(f)—Some Everlasting Brows needles were missing their sterilization certificate. Contact Everlasting Brows to obtain sterilization certificate. Maintain record of purchase of needles/blades on site for review. Include the Lot Numer for the needles/blades on the client consent form for review. 7. The sharps waste container shall be within arm's reach and labeled with the word "sharps waste" or with the biohazard symbol and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. Documentation of proper disposal shall be maintained for 3 years. HSC 119314(e)—There is no record of proper disposal of the sharp waste container sent back to the mail-back company. Maintain a copy of the sharp disposal receipt on site. 16. Client shall be at least 18 years of age to receive a tattoo, permanent cosmetics, or branding. Body piercing, unless performed in the presence of parent or guardian, the client, must be 18 years of age. HSC 119302—Keep a copy of the client ID with the consent form on site. 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are available for inspection. HSC 119303—Client consent form is missing the following information: "statement regarding permanent nature of procedure" and "client is at least 18 years of age." Medical questionnaire is missing the following information: "history of herpres infection at the procedure site, history of allergic reactions to latex, history of allergic reactions to antibiotics, history of cardiac valve disease, current medications, requirements for antibiotics prior to surgery or dental procedures, and other risk factors for blood borne pathogens." 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in Form B. HSC 119308(b)— Post-procedure instructions were missing the following information: "restrictions on physical activities,signs and symptoms of infection, and indications when to seek medical care." 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313—A copy of the IPCP is not on site for review. Make sure to keep a copy of the IPCP on site at all time. Note: Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 3 EH-11/17