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u,N Body Art Inspect* Repor46t�,. Y P P Date: San Joaquin County Environmental Health Department Program T 4; 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: P JWSU ova (209)468-3420 Program FcRc`,, www.slogv.orq/ehd g Element: PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME PR0540033 Angel U arte PRO537406 Ulices Carmona PR0540280 Brandon Phillips-not working here PRO540775 Michelle Arvallo Observations and Corrective Actions: 1. Each sterilization load shall be monitored with mechanical indicators for time, temperature and pressure, Sterilization shall be accomplished by steam autoclave, manufactured for the sterilization of medical instruments, and pass a Class V integrator test. HSC 119315(b) 2. Instruments or other reusable items shall be placed in a basin of water or cleaned, decontaminated, packaged, and sterilized immediately after each procedure. HSC 119309 If not being processed for immediate use, clean instruments shall be placed in sealed sterilization package that contains process indicator, name of instrument, date sterilized, and initial of person/operator. HSC 119315(a) 5. Decontamination and sterilization areas shall be separated from procedure areas by a space of at least 5 feet or by a cleanable barrier and equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(c) 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) 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) 9. No food, drink, tobacco product, or personal effects are permitted in the procedure area. HSC 119309 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) 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 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in Form B. HSC 119308(b) 32. A body art facility shall have floors,walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceiling to floor, from nail and hair activities and be separated from all business not related to body art. Approval of co-located body art facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each procedure area shall have lined waste containers. HSC 119314& 119317 Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 2 of 3 EH-03/2015