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Body Art Inspection Report Date: June 9,2021 <br /> N: San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> Record: SR0083738 <br /> (209)468-3420 <br /> •',.c ..• e-' www.siogv.org/ehd Program <br /> 9�iFq 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 may be charged. Page 2 of 2 <br /> EH-11/17 <br />