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'O pClU1N .CO. <br /> Body Art Inspection Report <br /> yK San Joaquin County Environmental Health Department Date: June 9, 2021 <br /> 1868 E. Hazelton Ave., Stockton, CA 95205 Program <br /> (269) 468-3426 Record: SR0083738 <br /> c p� w .sioavorolehd Program <br /> / F O Ra`' Element: 4103 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Observations and Corrective Actions : <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) — A sterilization certificate was not available for the 1P cartridges with lot # <br /> E00408265. Provide EHD with a copy of the sterilization certificate for the above mentioned cartridge. <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 /> The paper towel holder was not touchless in the procedure room . Replace the paper towel holder with a mounted <br /> touchless dispenser and provide photographic evidence to the EHD. <br /> 13 . Practitioner shall provide evidence of a completed, EHD approved , OSHA Bloodborne Pathogen Training consistent with <br /> section 119307 - The Bloodborne Pathogen Training Certificate provided was not from the approved EHD list. Provide <br /> a certificate to the EHD from an approved course. <br /> Unless otherwise noted submit all corrections to the EHD by June 23 2021 <br /> and pay all applicable fees prior to opening . <br /> Notes: <br /> 1 . Inspection report emailed to facility owner, Nicholette Von Markle at nickifaber72@gmail . com . <br /> 2 . Clean Harbors Enviro Services mailback system will be used for sharps waste disposal . <br /> 3 . Practitioner will provide lip blush and ombre brow services. <br /> Reinspection on/about: A reinspection fee of $152 per hour maybe charged. Page 2 of 2 <br /> EH-11 /17 <br />