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Body Art Inspec._jn Report <br />San Joaquin County Environmental Health Department <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />(209) 468-3420 <br />www.siogv.org/ehd <br />PR Number <br />PRACTITIONER/ARTIST NAME <br />Keli De enstein <br />Observations and Corrective Actions: <br />Date: e A 17 it'�? <br />am Record: J �V 7 6 41 <br />Program <br />Element: 03 <br />PR Number PRACTITIONER/ARTIST NAME <br />6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br />client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br />sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br />minimum of 90 days after use. HSC 119315(f) <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 />and the word "Biohazard". Sharp waste containers shall be disposed by a licensed waste hauler or approved mail back system. <br />Documentation of proper 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 <br />paper towels dispensed from a wall -mounted, touchless dispenser that is readily accessible to practitioner. HSC 119314(b) <br />18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are <br />available for inspection. HSC 119303 <br />19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br />Form B. HSC 119308(b) <br />32. A body art facility shall have floors, walls, and ceilings that are smooth, nonabsorbent, free of open holes, and washable. <br />The body art facility shall be free of insect and rodent infestation. The procedure area must be separated, by a wall, ceng to <br />floor, from nail and hair activities and be separated from all business not related to body art. Approval of co -located body art <br />facilites are at the discretion of the LEA. A procedure area must be equipped with adequate light to perform a procedure. Each <br />procedure area shall have lined waste containers. HSC 119314 & 119317 <br />34. Cert <br />ificate 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 <br />Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313 <br />All of the above mentioned observations must be corrected <br />and all applicable fees must be <br />id prior to openina. <br />Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 2 of 2 <br />EH -03/2015 <br />